This study examined eating-disordered pathology in relation to psychopathology and adiposity in 162 non-treatment-seeking overweight (OW) and normal weight (NW) children, ages 6-13 years. Participants experienced objective or subjective binge eating (S/OBE; loss-of-control eating), objective overeating (OO), or no episodes (NE). OW children experienced significantly higher eating-disordered cognitions and behaviors than NW children and more behavior problems than NW children: 9.3% endorsed S/OBEs, 20.4% reported OOs, and 70.4% reported NEs. OW children reported S/OBEs more frequently than did NW children (p =.01), but similar percentages endorsed OOs. S/OBE children experienced greater eating-disordered cognitions (ps from <.05 to <.01) and had higher body fat (p <.05) than OOs or NEs. OOs are common in childhood, but S/OBEs are more prevalent in OW children and associated with increased adiposity and eating-disordered cognitions.

OBJECTIVE-To investigate the relationship between loss of control over eating, adiposity, and psychological distress in a non-treatment sample of overweight children.METHOD-Based on self-reports of eating episodes, 112 overweight children, 6-10 y, were categorized using the Questionnaire of Eating and Weight Patterns -Adolescent Version into those describing episodes of loss of control over eating (LC), and those with no loss of control (NoLC). Groups were compared on measures of adiposity, dieting and eating behavior, and associated psychological distress.RESULTS-LC children (33.1%) were heavier and had greater amounts of body fat than NoLC children. They also had higher anxiety, more depressive symptoms, and more body dissatisfaction. 5.3% met questionnaire criteria for BED. Episodes of loss of control occurred infrequently, were often contextual, and involved usual meal foods. DISCUSSION-As in adults, overweight children reporting loss of control over eating have greater severity of obesity and more psychological distress than those with no such symptoms. It remains unknown whether children who endorse loss of control over eating before adolescence will be those who develop the greatest difficulties with binge eating or obesity in adulthood. KeywordsBinge eating; obesity; child; race; psychopathology Binge eating is a frequent behavior in overweight adults ( Loro & Orleans, 1981;Gormally, Black, Daston & Rardin, 1982;Marcus, Wing & Lamparski, 1985;Spitzer et al, 1992;Fairburn & Wilson, 1993;Grisset & Fitzgibbon, 1996;Robertson & Palmer, 1997), and is Author ManuscriptAuthor Manuscript Author ManuscriptAuthor Manuscript defined by the consumption of large amounts of food associated with a feeling of loss of control over eating (Fairburn & Wilson, 1993). A smaller proportion of individuals reporting binge eating meet criteria for binge eating disorder (BED), a research diagnostic category of the DSM IV that is characterized by recurrent binge-eating episodes associated with marked distress, but without inappropriate compensatory behaviors. The prevalence of BED in obese adults seeking weight loss treatment may be as high as 20% to 30% (Spitzer et al., 1992 while rates of BED in community samples have been estimated at somewhat less than 3% (Yanovski, 1999).In adults, binge eating is often associated with obesity (Telch, Agras & Rossiter, 1988;Smith, Marcus, Lewis, Fitzgibbon & Schreiner, 1998) and other disturbed eating behaviors. Besides having less ability to control eating behavior (Grisset & Fitzgibbon, 1996;Wadden, Foster, Letizia & Wilk, 1993;Kuehnel & Wadden, 1994), obese adults reporting binge eating also have greater concerns with body shape and weight (Marcus, Smith, Santilli, Kaye, 1992;Spitzer et al., 1993;Wilson, Nonas & Rosenblum, 1993), report an earlier onset of obesity and dieting, and describe a higher percentage of their lifetimes spent on a diet than non-binge eating obese individuals (Brody, Walsh & Devlin, 1994). Several studies have shown that obese adult binge eaters also report...

Sibutramine is effective and well tolerated in the treatment of obese patients with BED. Its effects address 3 main domains of the BED syndrome, ie, binge eating, weight, and related depressive symptoms.