Abstract
Studies comparing individuals with loss of control (LOC) eating who do and do not have objectively large binge episodes have found that degree of LOC is more important than binge size to psychological and behavioral outcomes. However, the relative importance of these characteristics has not been investigated in a population with binge eating disorder (BED), who by definition all have objectively large binge episodes. Persons with BED and higher weight (N = 34) were enrolled in a BED treatment trial and completed the Loss of Control Over Eating Scale, the Eating Disorder Examination, and measures of eating behavior, mood, and quality of life. Body mass index (BMI) was calculated from measured height and weight. The size of the largest binge episode (measured in kilocalories) and degree of LOC were entered into multiple regression equations to determine their relationships with disordered eating symptoms, depression, quality of life, and BMI in this pilot study. Greater LOC had a stronger independent association than binge size with higher total eating psychopathology, shape dissatisfaction, hunger, food cravings and food addiction symptoms. Larger binge size had a stronger independent association than LOC with higher weight concern and lower general and social quality of life. Both characteristics were associated with higher eating concern and neither were associated with depression or BMI. Both binge size and degree of LOC are associated with important psychosocial treatment targets in patients with BED. Future research should validate the largest binge episode measurement method and replicate the present findings in a larger sample.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of data and materials
The data that support the findings of this study may be available from Kelly Allison by formal request.
Code availability
N/A.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5, 5th ed. Arlington VA.
American Psychiatric Association. (1994). Diagnostic and statistical manual for mental disorders: DSM-IV, 4th ed. Washington, DC
Barnes, R. D., Masheb, R. M., White, M. A., & Grilo, C. M. (2011). Comparison of methods for identifying and assessing obese patients with binge eating disorder in primary care settings. International Journal of Eating Disorders, 44, 157–163. https://doi.org/10.1038/jid.2014.371
Beglin, S. J., & Fairburn, C. G. (1992). What is meant by the term “binge”? Am J Psychiatry, pp. 123–124
Brownstone, L., Bardone-Cone, A., Fitzsimmons-Craft, E., et al. (2013). Subjective and objective binge eating in relation to eating disorder symptomatology, negative affect, and personality dimensions. International Journal of Eating Disorders, 46, 1–17. https://doi.org/10.1002/eat.22066
Cepeda-Benito, A., Gleaves, D. H., Williams, T. L., & Erath, S. A. (2000). The development and validation of the State and Trait Food-Cravings Questionnaires. Behavior Therapy, 31, 151–173.
Chao, A. M., Wadden, T. A., Walsh, O. A., et al. (2019). Perceptions of a large amount of food based on binge-eating disorder diagnosis. International Journal of Eating Disorders. https://doi.org/10.1002/eat.23076
Cohen, J. (2013). Statistical power analysis for the behavioral sciences. Academic Press.
Endicott, J., Nee, J., Harrison, W., & Blumenthal, R. (1993). Quality of life enjoyment and satisfaction questionnaire: A new measure. Psychopharmacology Bulletin, 29, 321–326.
Evenepoel, C., Clevers, E., Deroover, L., et al. (2020). Accuracy of nutrient calculations using the consumer-focused online app MyFitnessPal: Validation study. Journal of Medical Internet Research, 22, 1–9. https://doi.org/10.2196/18237
Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
Fairburn, C. G., & Cooper, Z. (1993). The eating disorder examination (12th ed.). In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment, and treatment (pp. 317–360). The Guilford Press.
Forney, K. J., Holland, L. A., Joiner, T. E., & Keel, P. K. (2015). Determining empirical thresholds for “definitely large” amounts of food for defining binge-eating episodes. Eating Disorders, 23, 15–30. https://doi.org/10.1080/10640266.2014.931763
Gearhardt, A. N., Corbin, W. R., & Brownell, K. D. (2016). Development of the Yale food addiction scale version 2.0. Psychology of Addictive Behaviors, 30, 113–121. https://doi.org/10.1037/adb0000136
Goldfein, J. A., Devlin, M. J., & Kamenetz, C. (2005). Eating Disorder Examination-Questionnaire with and without instruction to assess binge eating in patients with binge eating disorder. International Journal of Eating Disorders. https://doi.org/10.1002/eat.20075
Griffiths, C., Harnack, L., & Pereira, M. A. (2018). Assessment of the accuracy of nutrient calculations of five popular nutrition tracking applications. Public Health Nutrition, 21, 1495–1502. https://doi.org/10.1017/S1368980018000393
Grilo, C. M., Masheb, R. M., & Wilson, G. T. (2001b). Different methods for assessing the features of eating disorders in patients with binge eating disorder: A replication. Obesity Research, 9, 418–422. https://doi.org/10.1038/oby.2001.55
Grilo, C. M., Masheb, R. M., & Wilson, G. T. (2001c). A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 317–322. https://doi.org/10.1038/oby.2001.55
Grilo, C. M., Masheb, R. M., & Wilson, G. T. (2001a). Subtyping binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 1066–1072. https://doi.org/10.1037/0022-006X.69.6.1066
Guss, J. L., Kissileff, H. R., Devlin, M. J., et al. (2002). Binge size increases with body mass index in women with binge-eating disorder. Obesity Research, 10, 1021–1029. https://doi.org/10.1038/oby.2002.139
IBM Corp. (2017). IBM SPSS statistics for windows version 25.
Keel, P. K., Mayer, S. A., & Harnden-Fischer, J. H. (2001). Importance of size in defining binge eating episodes in bulimia nervosa. International Journal of Eating Disorders, 29, 294–301. https://doi.org/10.1002/eat.1021
Kelly, N. R., Cotter, E., & Guidinger, C. (2018). Men who engage in both subjective and objective binge eating have the highest psychological and medical comorbidities. Eating Behaviors, 30, 115–119. https://doi.org/10.1016/j.eatbeh.2018.07.003
Kessler, R. C., Berglund, P. A., Chiu, W. T., et al. (2013). The prevalence and correlates of binge eating disorder in the WHO World Mental Health Surveys. Biological Psychiatry, 73, 904–914. https://doi.org/10.1016/j.biopsych.2012.11.020
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.
Latner, J. D., Mond, J. M., Kelly, M. C., et al. (2014). The loss of control over eating scale: Development and psychometric evaluation. International Journal of Eating Disorders, 47, 647–659. https://doi.org/10.1002/eat.22296
Mond, J. M., Latner, J. D., Hay, P. H., et al. (2010). Objective and subjective bulimic episodes in the classification of bulimic-type eating disorders: Another nail in the coffin of a problematic distinction. Behaviour Research and Therapy, 48, 661–669. https://doi.org/10.1016/j.brat.2010.03.020
Niego, S. H., Pratt, E. M., & Agras, S. (1997). Subjective or objective binge: Is the distinction valid? International Journal of Eating Disorders, 22, 291–298. https://doi.org/10.1002/(SICI)1098-108X(199711)22:3%3c291::AID-EAT8%3e3.0.CO;2-I
Palavras, M. A., Hay, P. J., Lujic, S., & Claudino, A. M. (2015). Comparing symptomatic and functional outcomes over 5 years in two nonclinical cohorts characterized by binge eating with and without objectively large episodes. International Journal of Eating Disorders, 48, 1158–1165. https://doi.org/10.1002/eat.22466
Palavras, M. A., Morgan, C. M., Borges, F. M. B., et al. (2013). An investigation of objective and subjective types of binge eating episodes in a clinical sample of people with co-morbid obesity. Journal of Eating Disorders, 1, 1–7. https://doi.org/10.1186/2050-2974-1-26
Stunkard, A. J., & Messick, S. (1988). Eating inventory manual. The Psychological Corporation.
Stunkard, A. J., & Messick, S. (1985). The three-factor eating questionnaire to measure dietary restraint, disinhibition, and hunger. Journal of Psychosomatic Research 29:71–83. https://doi.org/10.1016/0022-3999(85)90010-8
Telch, C., Pratt, E., & Niego, S. (1998). Obese women with binge eating disorder define the term binge. International Journal of Eating Disorders, 24, 313–317.
Under Armour Inc. (2019). Myfitnesspal. www.myfitnesspal.com. Accessed 27 Jan 2021.
Watson, H. J., Fursland, A., Bulik, C. M., & Nathan, P. (2013). Subjective binge eating with compensatory behaviors: A variant presentation of bulimia nervosa. International Journal of Eating Disorders, 46, 119–126. https://doi.org/10.1002/eat.22052
Funding
This investigator-initiated study was supported by an unrestricted grant from Novo Nordisk (KCA). AMC was supported, in part, by the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR017209. AMC reports grant funding from and serving on advisory boards for Shire Pharmaceuticals; consulting for WW International, Inc., outside the current work. RIB reports grant support from Eisai Inc. and Novo Nordisk as well as consulting for WW International, Inc., outside the current work.
Author information
Authors and Affiliations
Contributions
MBB, JST, AMC, RIB, TAW, and KCA conceived the study hypotheses. MBB, AMC, EJ, CM, KG, CMW, RIB and KCA performed study assessment procedures. MBB and JST performed the statistical analyses. MBB, JST, AMC, TAW, and KCA collaborated to interpret the results and draft the initial manuscript. All authors participated in the subsequent revisions and approval of the final manuscript.
Corresponding author
Ethics declarations
Conflict of interests
The authors (Maija B. Bruzas, Jena S. Tronieri, Ariana M. Chao, Elizabeth Jones, Cooper McAllister, Kathryn Gruber, Courtney McCuen-Wurst, Robert I. Berkowitz, Thomas A. Wadden, Kelly C. Allison) have no conflicts of interest to declare that are relevant to the content of this article.
Consent to participate
Informed consent was obtained from all individual participants included in the study.
Consent for publication
Patients signed informed consent regarding publishing their unidentified data.
Ethical approval
This study was approved by the University of Pennsylvania’s institutional review board and performed in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendix
Appendix
Examples of rules applied for calorie estimation of binge episodes
For fast-food items, participants usually provided enough information to match the foods directly in the database (e.g., McDonald’s McGriddle, Wendy’s medium fries). For pizza, potato chips, ice cream, cookies, and cereal, brands were only sometimes provided, so we picked standard popular brands from our region (unless the patient stated a particular brand and type/flavor). Some examples of these are in the table below. In some cases, our selections might have underestimated calories in an item for a participant (e.g., we assumed Breyers natural vanilla but the participant actually had Breyers Snickers ice cream which has more calories). In other cases, our selections might have overestimated calories in an item (e.g., we assumed Honey Nut Cheerios but the participant actually had Rice Chex which has fewer calories). This is a limitation to our study, but the choices would suggest that our over- and under-estimates happened equally.
Food | Brand | Variety |
|---|---|---|
Pizza | Domino’s © | 14 inch cheese pizza |
Potato chips | Lays © | Classic potato chips |
Ice cream | Breyers © | Natural vanilla ice cream |
Crackers | Keebler © | Club crackers |
Cereal | General Mills © | Honey Nut Cheerios |
Cookies | Keebler © | Chips Ahoy chocolate chip |
Rights and permissions
About this article
Cite this article
Bruzas, M.B., Tronieri, J.S., Chao, A.M. et al. Binge size and loss of control as correlates of eating behavior and psychopathology among individuals with binge eating disorder and higher weight. J Behav Med 45, 603–612 (2022). https://doi.org/10.1007/s10865-022-00312-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-022-00312-7