Binge Eating in the General Community

There is still much to learn about the psychosocial and behavioral aspects of binge eating in non-clinical populations. It has been estimated that about 35% of college students binge eat (Am J Psychiatry 1990;147:401), and one article suggested that from one-fourth to one-half of obese people who seek treatment for weight loss binge-eat (Int J Eat Disord 1992;11:333).

A study at the University of Minnesota has produced some intriguing information about overweight and normal-weight women in the general community who binge-eat (Int J Obesity 1999;23:576). The researchers found that overweight women were about twice as likely as normal-weight women to binge-eat. However, after studying 816 women aged 20-45 years of age who enrolled in the Pound of Prevention Study, a 3-year prospective weight gain prevention trial, they also learned that both overweight and normal-weight women were similarly affected by dieting, depression, and preoccupation with weight and shape. Compared with normal-weight women, overweight women were less active, spent more hours watching television each week, ate more “fast-food” meals, had a higher total energy intake, and used fewer low-fat eating behaviors.

The binge eaters

Binge eaters were identified with the Questionnaire on Eating and Weight (revised) (Obes Res 1993;1:306). The two key questions that helped classify subjects as binge eaters were: (1) “During the past 6 months, did you ever eat within a 3-hr period what most people would regard as an unusually large amount of food?” and (2)”During the times when you ate this way, did you feel you couldn’t stop eating or control what or how much you were eating?”

The overall prevalence of binge eating during the prior 6 months was 14.0% (9% among normal-weight women and 21% among overweight women). More than half of the binge eaters binged less than once a week. These results suggested that binge eating was not as prevalent in the community as had been estimated. When the researchers investigated the diet histories of both groups over the past 3 years, they found that binge eaters had gained more weight than non-binge eaters. During their lifetime, binge eaters had also intentionally attempted to lose weight slightly more than twice as many times as non-binge eaters

In general, binge eaters scored higher than non-binge eaters on general measures of psychological distress, as well as on tests that specifically focused on body image. Compared to non-binge eaters, binge eaters reported using more ways to diet, more extreme attitudes about weight and shape, and higher levels of depression and stressful life events. In addition, weight/shape was more than 3 times more likely to be the main or most important aspect of self-evaluation among binge eaters compared to non-binge eaters. The frequency and characteristics of binges were similar in both groups.