AGE-OF-ONSET FOR BINGE-EATING - ARE THERE DIFFERENT PATHWAYS TO BINGE-EATING

Objective: In examining individuals with binge eating disorder (BED) w e aimed to determine whether their binge eating preceded their first d iet or their first diet preceded their binge , eating, the age of thei r first diet, the age of their first binge, and the age when they met DSM-IV criteria for BED. Additionally, we aimed to identify psychologi cal factors that may distinguish the two groups. Method: Eighty-seven individuals with BED (19 men and 68 women) were administered the Eatin g Disorders Examination, the Structured Clinical Interview for DSM-III -R, and several other measures of psychological functioning andpsychia tric disturbance. Results: Forty-five percent of the subjects reported that dieting preceded their first binge episode (dietfirst) and 55% r eported that binge eating preceded their first diet (bingefirst). Ther e were no significant differences in current eating disturbance, body mass index (BMI) or age for these two groups, but they differed on the age of the first episode of binge eating and the age when binging met BED criteria. The group reporting having binged first had a younger a ge of onset of binge eating and a younger age at which binge eating me t diagnostic criteria than the dietfirst group. The bingefirst group a lso had a history of more psychiatric problems and were more likely to ha ve an Axis II personality disorder. Discussion: Age of onset of th e first binge and BED is markedly different depending on whether an in dividual began dieting or binging first. These findings suggest that t here may be important etiological differences between individuals who binge first and those who diet first. Moreover, individuals who binge first may be at greater risk for psychiatric disturbance. (C) 1997 by John Wiley & Sons, Inc.