Internal and external antecedents of binge eating episodes in a group of women with bulimia nervosa

OBJECTIVE: This research examined the internal and external factors that predict whether a food craving develops into a binge in bulimia nervosa. METHOD: Fifteen bulimic women kept diary records of food cravings over the course of a week, noting their internal state, environmental triggers, and whether the craving developed into a binge. Eighty cravings were examined, of which approximately one half developed into binges. RESULTS: At the bivariate level, binge eating resulted from cravings more often if the women were alone, in the morning, and following eating the craved food. These factors interacted, so that binges were more likely if the women avoided a craved food in the morning, but not later in the day. CONCLUSIONS: These findings support a model of binge eating for which both internal states (craving, eating the craved food) and external factors (time of day, social circumstances) need to be taken into account. Relevant models of craving are discussed, along with their implications for clinical practice.