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

Marly Amorim Palavras; Christina Marcondes Morgan; Ferrari Maria Beatriz Borges; Angélica Medeiros Claudino; Phillipa J Hay

doi:10.1186/2050-2974-1-26

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

J Eat Disord. 2013 Aug 8:1:26. doi: 10.1186/2050-2974-1-26. eCollection 2013.

Authors

Marly Amorim Palavras¹, Christina Marcondes Morgan¹, Ferrari Maria Beatriz Borges², Angélica Medeiros Claudino¹, Phillipa J Hay³

Affiliations

¹ Programa de Atenção aos Transtornos Alimentares (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
² Sociedade Brasileira de Psicologia Analítica, São Paulo, SP, Brazil.
³ Centre for Health Research School of Medicine University of Western Sydney, Psychiatry James Cook University, Sydney, Australia ; University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia.

Abstract

Background: Objective 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.

Methods: This 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.

Results: The 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.

Conclusion: Treatment 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.

Keywords: Binge eating; Diagnostic criteria; Objective binge eating episodes; Subjective binge eating episodes.