Researchers have questioned whether binge eating episodes have to be both objectively large and include a loss of control (LOC) to be clinically significant. The purpose of this study was to examine whether binge eating episode size and LOC are predictors of eating behaviors and psychopathology.
Participants (n=32, age 43.1±11.1 yrs; BMI 37.3±6.3 kg/m2; 58% female; 56% white, 44% black) who enrolled in a treatment trial were assessed at baseline with the Eating Disorder Examination (EDE), which was used to determine calories in the largest objective binge episode (OBE) in the prior 28 days and LOC severity was assessed with The Loss of Control Over Eating Scale (LOCES). Outcome measures included the EDE subscales, Eating Inventory (EI: Cognitive Restraint, Disinhibition, Hunger), Food Cravings Questionnaires (FCQ-State, FCQ-Trait), Yale Food Addiction Scale 2.0 (YFAS), Yale-Brown Obsessive-Compulsive Scale-Binge Eating (YBOCS-BE), and Patient Health Questionnaire-9 (PHQ-9). Separate linear regression models with largest OBE calories and LOC as predictors were used to examine the relationship with outcome variables.
The mean size of the largest OBE was 3047±1244 kcals. Together, OBE calories and LOC explained a significant percentage of the variance in EDE total (31%), EDE Eating Concern (31%), EDE Weight Concern (22%), EDE Shape Concern (21%), EI Disinhibition (30%), EI Hunger (24%), FCQ-State (46%), FCQ-Trait (51%), and YFAS scores (63%).LOC was a significant positive independent predictor of all outcomes except EDE Weight Concern (ps<0.05). OBE calories were only a significant independent predictor of greater EDE Eating Concern and Weight Concern (ps<0.05). OBE calories and LOC did not predict EDE Restraint, EI Cognitive Restraint, YBOCS-BE, or PHQ-9 scores.
Eating behaviors and psychopathology in BED appear to be more strongly related to degree of LOC than to the size of the largest OBE, except weight concern which was more directly related to caloric intake.