Outcome of Youths who Binge Eat

Weight Loss Treatment

The pediatric literature examining binge eating in relation to weight loss treatment outcome is limited. Epstein and colleagues found no significant changes in binge eating behaviors following family-based behavioral weight loss treatment for 8- to 12-year-olds (Epstein, Paluch, Saelens, Ernst, & Wilfley, 2001).

By contrast, in a sample of obese youths (7-17 years) taking part in an inpatient non-diet healthy lifestyle program focusing on healthy eating, moderate exercise, and cognitive-behavioral treatment, the mean frequency of binge eating episodes was significantly lower at both post-treatment and 14-month follow-up (Braet, Tanghe, Decaluwe, Moens, & Rosseel, 2004). One recent study examined the impact of LOC eating on weight loss achieved during a family-based behavioral program for 8- to 13-year-olds (Levine, Ringham, Kalarchian, Wisniewski, & Marcus, 2006).

Following treatment, children reporting LOC experienced similar weight loss to those not reporting LOC. These preliminary data suggest that weight loss treatment may not have an adverse impact on young binge eaters and that LOC eating may not affect weight loss outcome.

Prospective Research

Perhaps of greatest concern is the finding that children and adolescents who self-report binge eating episodes tend to experience increased weight and fat gain over time compared with youths who do not report binge eating.

In a large study of boys and girls (9-14 years), Field et al. (2003) found that binge eating, as assessed by survey reports, was an independent predictor of weight gain among boys. As assessed by an adapted version of the EDE, binge eating was a predictor of elevated weight gain (Stice, Cameron, Killen, Hayward, & Taylor, 1999) and obesity onset (Stice, Presnell, & Spangler, 2002) among adolescent girls followed over a four-year period.

However, this finding was not replicated in a third study (Stice, Presnell, Shaw, & Rohde, 2005). Finally, in a study of 146 children aged 6-12 at baseline, all of whom were overweight or at risk for overweight because of a family history of obesity (Whitaker, Wright, Pepe, Seidel, & Dietz, 1997), binge eating at baseline was a predictor of additional increases in body fat mass four years later (Tanofsky-Kraff et al., 2006).

Taken together, these data point to the role that binge eating during youth may play in the development or maintenance of obesity. Additional research is required to determine whether early binge eating increases the risk for other adverse conditions such as full-syndrome eating disorders, other psychiatric disturbance, or additional health consequences above and beyond those associated with obesity.

A number of researchers have examined potential predictive factors for the development of binge eating with the aim of identifying targets for early prevention. To date, a limited number of studies have been published.