Screening for binge eating disorder in obese outpatients

The prevalence of binge eating disorder (BED) in clinical samples of obese patients is controversial, and sensitive diagnostic protocols for use in ro utine clinical practice need to be further defined. Three hundred forty-fou r obese (body mass index [BMI] greater than or equal to 30 kg/m(2)) patient s were studied with the Structured Clinical Interview for DSM-III-R to inve stigate the lifetime prevalence of mental disorders. The current prevalence of BED was assessed using DSM-IV criteria. Eating attitudes and behavior w ere investigated with the Bulimic Investigation Test, Edinburgh (BITE) and the Binge Eating Scale (BES), The Beck Depression inventory (BDI) and Spiel berg's State-Trait Anxiety Inventory (STAI) were also applied. The prevalen ce of BED was 7.5%. Patients with BED had a higher BMI compared with obese patients without BED. Differences in the lifetime prevalence of mental diso rders in patients with and without BED were not statistically significant. Using the BES as a screening instrument for BED with a threshold of 17, the sensitivity was 84.8%, specificity 74.6%, positive predictive value 26.2%, and negative predictive value 97.9%, Using the BITE with a threshold of at least 10, the sensitivity was 91%, specificity 51.4%, positive predictive value 71.8%, and negative predictive value 98.2%. The BITE can be a valid a lternative to the BES as a screening method for BED in obese patients. Copy right (C) 2000 by W.B. Saunders Company.