Binge Eating Among Children and Adolescents

With the alarming increase in pediatric obesity1 (Ogden et al., 2006), it is imperative that correlates and predictors of excessive weight gain be identified and targeted for decreasing the vast number of youths struggling with overweight. While genetics plays an enormous role in determining body weight, other physiologic, social, psychological, and behavioral factors have a substantial impact as well.

This section focuses specifically on binge eating, defined as overeating while experiencing a lack of control over what or how much is being eaten (American Psychiatric Association [APA], 2000). Relatively recent evidence suggests that binge eating may play a significant role in the development and maintenance of obesity.

This section will begin with an overview of binge eating in adults, with a focus on the putative diagnosis of binge eating disorder.

A discussion of the challenge involved in measuring binge eating among youths will follow. Cross-sectional data on binge eating among adolescents will then be reviewed, followed by the corresponding literature including child samples. Since a number of studies have combined participants in middle childhood (6-12 years) with adolescents (13-17 years), for the purposes of this section, all studies including individuals younger than 10 years will be included in sections focusing on children.

Prospective studies analyzing the outcomes and predictors of binge eating will be presented. The final section will address directions and challenges for future research.

Throughout this section, only studies that defined binge eating as including a sense of "loss of control" while overeating will be addressed. Studies that equate the construct of binge eating with overeating without assessing whether a loss of control is experienced will not be reviewed.

Furthermore, data regarding binge eating should be considered as in the absence of purging or nonpurging compensatory behaviors. A caveat, however, is that a number of epidemiologic studies do not discriminate binge eating in conjunction with compensatory behaviors from binge eating in the absence of such behaviors.

Binge Eating Disorder in Adults

Although binge eating in obese adults was first described in 1959 (Stunkard, 1959), it was not until 35 years later that the proposed criteria for binge eating disorder (BED) were outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994).

BED is characterized by recurrent episodes of binge eating (overeating while experiencing a sense of loss of control regarding what or how much one is eating) accompanied by dysfunctional eating behaviors and marked distress regarding binge eating (Table 4.1).

People with BED do not regularly engage in inappropriate compensatory behaviors, such as self-induced vomiting, excessive exercise, fasting, or laxative/diuretic use (APA, 2000). As a result, BED is often associated with excess body weight and obesity (Yanovski, Nelson, Dubbert, & Spitzer, 1993).