Using the eating disorder examination to identify the specific psychopathology of binge eating disorder

Objective: The clinical features of binge eating disorder (BED) are not wel l established. Therefore, a comprehensive assessment of the specific psycho pathology of BED as compared to anorexia nervosa (AN) and bulimia nervosa ( BN) is warranted. This comparison was the aim of the present study. Method: Detailed ratings from an investigator-based interview, the Eating Disorder s Examination (EDE), were compared across three groups of female patients: those with BED, AN, and BN, as well as normal-weight and overweight control subjects. Results: When comparing BED to AN and BN, patients with BED had lower levels of restraint, eating concerns comparable to AN patients but lo wer than BN patients, and weight and shape concerns comparable to BN patien ts but higher than AN patients. Significantly more eating disorder psychopa thology was found for BED patients as compared to the overweight controls o n all bar the EDE restraint subscale. On the majority of individual EDE ite ms, BED patients' scores were similar to those of AN and BN patients, inclu ding importance of shape and weight in self-evaluation and preoccupation wi th shape and weight. No significant relationship was found between BED pati ents' degree of overweight and eating psychopathology. Discussion: Our find ings support the status of BED as an eating disorder and suggest that the e levated EDE scores reflect the combined impact of being objectively overwei ght and having disordered cognitions and behaviors about eating, shape, and weight. (C) 2000 by John Wiley & Sons, Inc.