An investigation of objective and subjective types of binge eating episodes in a clinical sample of people with co-morbid obesity

Abstract

BackgroundObjective binge eating episodes (OBEs) refer to binge eating on an unusually large amount of food and are the core symptom in current definitions of bulimia nervosa (BN) and binge eating disorder (BED). Subjective binge eating episodes (SBEs) refer to eating on a small or moderate amount of food (that is perceived as large) and like OBEs are associated with loss of control (LOC). Reaching consensus on what is considered a large amount of food can however be problematic and it remains unclear if the size of a binge is an essential component for defining a binge eating episode. The aim of this study was to compare the eating disorder features and general psychopathology of subjects reporting OBEs with those reporting only SBEs.MethodsThis is a retrospective secondary analysis of data from 70 obese participants at the recruitment phase of a multicentre trial for BED. Individuals who answered positively to the presence of binge eating and LOC over eating had their binge eating episodes further explored by interview and self-report. Two groups, those who reported current OBEs (with or without SBEs) and those who reported current SBEs only were compared for age, gender, marital status, body mass index (BMI), indicators of LOC over eating, severity of binge-eating and associated psychopathology.ResultsThe majority of participants in both the OBE and SBE groups endorsed the experience of at least four indicators of LOC. There were no significant differences between the groups. Both groups had high levels of binge-eating severity, moderate severity of associated depressive symptoms and frequent psychiatric co-morbidity.ConclusionTreatment seeking participants with obesity who reported SBEs alone were similar to those who reported OBEs in terms of eating disorder features and general psychopathology. These findings suggest that classificatory systems of mental illnesses should consider introducing SBEs as a feature of the diagnostic criteria for binge eating and, thus, facilitate the inclusion of participants with SBEs in treatment trials.

Comparing symptomatic and functional outcomes over 5 years in two nonclinical cohorts characterized by binge eating with and without objectively large episodes

“…When general psychopathology is considered, as in this study, no significant differences among the binge eating groups were found and higher levels were described for SBEs and OBEs groups compared with control groups . Likewise, Latner et al have stressed the relevance of SBEs as a marker of psychopathology.…”

Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: The mediating role of loss of control eating

“…that contribute to the psychological state of the individual. In fact, the lack of differences in binge‐eating severity, compensatory behaviors, self‐esteem, depressive symptoms, or in disordered eating psychopathology reported by previous studies comparing patients with bulimia with OBE vs. SBE (Fitzsimmons‐Craft et al, ; Palavras et al, ) may be BECAUSE OF the core psychopathology of the eating disorder. The fact that this study compares eating behaviors reported by individuals that do not meet criteria for an eating disorder allow us to investigate the unique contribution of LOC eating and of the eating behaviors to psychopathology.…”

Neurofeedback Against Binge Eating: A Randomized Controlled Trial in a Female Subclinical Threshold Sample

“…For validation, the frequency of pretreatment binge eating episodes was correlated with respective EDE‐Q values (items on ‘loss of control‐eating’ and ‘objective binge eating’). A significant correlation was found with EDE‐Q loss of control‐eating, r = .29, p = .030, indicating the validity of the measure in assessing subjective binge eating (Palavras, Morgan, Borges, Claudino, & Hay, ). Distress experienced due to subjective binge eating was assessed on a 6‐point rating scale (0 = not at all ; 5 = very strong ).…”