Conceptualising Binge Eating: A Review of the Theoretical and Empirical Literature

Abstract

Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.

The revised short-form of the Eating Beliefs Questionnaire: Measuring positive, negative, and permissive beliefs about binge eating

“…However, at present this remains an area of uncertainty in the literature. While most influential cognitive models of binge eating focus on the role of restrictive eating behaviour, low self-esteem, and overvaluation of body shape and weight, few also consider the core cognitive processes that function to maintain binge eating (see Burton & Abbott [ 18 ] for a review). One exception that emphasises the role of specific cognitions in maintaining binge eating behaviours is Cooper, Wells and Todd’s cognitive model of BN [ 19 ].…”

“…It is also predicted that the revised version of the EBQ will demonstrate good psychometric properties including adequate internal consistency, and convergent validity. More specifically, we hypothesised that the revised EBQ will demonstrate positive correlations with measures of constructs relevant to binge eating including negative affect, eating disorder symptoms and behaviours, eating disorder related cognitions, negative core beliefs, and poor emotional regulation [ 18 ]. Based on the findings of previous research [ 23 ], we predicted that the permissive belief scale will not correlate with body mass index (BMI) or with a measure of dietary restraint, but will correlate with the other included measures of eating disorder symptoms, behaviours, cognitions and related constructs.…”

“…To provide a thorough assessment of the EBQ’s construct validity, the test battery included a range of measures which assess known correlates of binge eating and/or eating disorders [ 18 ], including body mass (BMI), overall mood and distress (DASS-21), eating disorder symptoms and related behaviours (EDE-Q and Dutch Eating Behaviour Questionnaire), eating disorder related cognitions (EDE-Q, Eating Disorders Thoughts Questionnaire), negative core-beliefs (Eating Disorders Core Beliefs Questionnaire), and poor distress tolerance (Difficulty with Emotional Regulation Scale).…”

Beliefs about Binge Eating: Psychometric Properties of the Eating Beliefs Questionnaire (EBQ-18) in Eating Disorder, Obese, and Community Samples

“…In an attempt to understand the complex eating disorder symptom of binge eating better, a number of psychological models for BN and binge eating have been proposed in the literature, with many focusing on the role of restrained eating practices, poor self-esteem, poor distress tolerance, an overvaluation of body weight and shape, and specific unhelpful beliefs about binge eating (for a review of psychological models of binge eating see Burton & Abbott, 2017 [ 14 ]). In order to develop and evaluate effective psychological treatments for binge eating, it is important to be able to reliably measure the features underlying the development and maintenance of binge eating.…”

Beliefs about binge eating: The psychometric properties of the Persian version of the eating beliefs questionnaire

“…In order to examine each of factors, several reliable and valid measuring tools have been proposed. [ 12 ]…”