Clinically significant BE is related to poorer surgical outcomes, and additional interventions may be needed to improve long term outcomes. Though surgery does alter body's physiology, claims that the psychological aspects of BE are "cured" by obesity surgery must be viewed with caution. Researchers and practitioners must reach a consensus on how to define BE after gastric surgery so that future long-term prospective studies may further evaluate the effect of BE on surgical outcome and vice versa.

Objective The aim of this study was to examine whether objective and subjective binges differ significantly from each other in relation to measures of psychopathology in a sample of women who meet DSM‐IV diagnostic criteria for bulimia nervosa. Method: Baseline data from the Eating Disorder Examination (EDE) were analyzed and the average of the sum of and the difference between objective and subjective binge episodes were converted to z scores. Regressions were run with other baseline measures including the Structured Clinical Interview for Diagnosis of DSM‐III‐R (SCID) I and II disorders, EDE subscales, and psychological measures. Results: We found no significant difference between the two types of binges on all but one measure, the “Can Do” subscale of the Self‐Efficacy Questionnaire, in a regression with the z score of total binges. Discussion: The lack of significant findings questions the diagnostic validity of the “large amount of food” criterion used to define binge eating in the DSM‐IV. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 307–312, 1998.

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Objective The purpose of this study was to provide information regarding the criteria used by women with binge eating disorder (BED) to classify an eating episode a binge. Method: Sixty women who met DSM‐IV research criteria for BED were interviewed and asked to define binge eating in their own words. Two independent raters classified subjects' responses according to a structured classification scheme. Results: Loss of control over eating was the only criterion used to define binge eating by a majority (82%) of our subjects. Large amount of food and eating to relieve negative affect were reported less frequently, but appeared to be important criteria. Discussion: The findings from this study are important to consider in an evaluation of the proposed DSM‐IV research criteria for BED. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 313–317, 1998.