Binge eating has been identified as a common problem in samples of obese persons. Earlier studies found that approximately 30% of participants presenting for weight loss treatment could be diagnosed with Binge Eating Disorder (BED). This study investigated the prevalence of BED using the Questionnaire on Eating and Weight Patterns (QEWP) and the Interview for the Diagnosis of Eating Disorders (IDED) in a sample of 468 obese adults seeking weight loss treatment at two research facilities. The study found that only a small percentage of the participants met Diagnostic and Statistical Manual for Mental Disorders, 4th Revision (DSM-IV) diagnostic criteria for BED using either the IDED (1.3%) or QEWP (7.3%). A larger percentage of the sample (10.7% based on the IDED and 20.5% based on the QEWP) reported binge eating, but did not endorse all criteria necessary to warrant a diagnosis of BED. The primary finding of the study was that the prevalence of BED in treatment seeking obese adults was much lower than was reported in previous studies. Also, there was significant discrepancy in prevalence rates of BED as defined by self-report and interview assessment methods, with the interview method yielding lower estimates of prevalence. These findings suggest that the prevalence of BED may be lower than estimates of earlier reports. We recommend that future studies of BED use reliable and valid interview methods and that this research focus on more diverse populations, including men and a variety of racial and ethnic groups.

Body fat distribution is a reliable predictor of the health risks of obesity. Abdominal obesity (AO) has been associated with various health complications whereas gluteal-femoral obesity (GFO) appears to be less hazardous. Body size overestimation, a type of body image disturbance, is found in a subset of obese persons. OBJECTIVE: The current study examined body size estimation accuracy as a function of body fat distribution. DESIGN: Cross-sectional, retrospective review of clinical records. SUBJECTS: 101 obese women (Mean age 39.4) joining a weight loss program. MEASUREMENTS: Subjects provided body size estimates using a live video distortion procedure and were grouped into tertiles (AO; Mixed type obesity (MTO); GFO) on the basis of their waist-to-hip ratios. RESULTS: GFO women had signi®cantly lower body size estimates and felt thinner than did AO or MTO women. In addition, more AO women (20.6% vs GFO: 8.8%) overestimated their body size by more than 15% whereas more GFO women (29.4% vs AO: 5.9%) underestimated their body size by more than 15%. CONCLUSION: Body fat distribution appears to be a mediator in body size estimation accuracy. These ®ndings are discussed in terms of possible differences in perceptual and societal experiences among the groups.

OBJECTIVE: To identify three groups of obese people entering weight loss treatment, who have distinctly different cognitive appraisals of dietary transgressions and to compare these groups on self-report inventories of eating patterns, dieting, and depression, as well as on treatment completion rates and weight loss. DESIGN: Retrospective review of clinical records. Using a measure which evaluates eating-related cognitive appraisals, participants were categorized into one of three cognitive groups (All-or-None, Rationalization, Matterof-Degree). SUBJECTS: 289 treatment-seeking obese women (age: 40.9 y, body mass index (BMI): 34.7 kgam 2 ). MEASUREMENTS: Self-reported eating and dieting behavior (Three-Factor Eating Questionnaire and Eating Behavior Inventory); depression (Beck Depression Inventory); attendance information and body weight obtained during treatment. RESULTS: The cognitive group representing objective thinkers (Matter-of-Degree) reported signi®cantly fewer problems with overeating and more personal control over eating than did the rigid, dichotomous thinkers (All-orNone). In addition, the Matter-of-Degree (MAT) group endorsed signi®cantly less subjective hunger and fewer depressive symptoms than the other two cognitive groups. The Rationalization group was more likely to complete a treatment program than was the All-or-None group, with the MAT group not differing from either. Despite these ®ndings, there were no signi®cant differences among cognitive groups on total weight loss. CONCLUSIONS: Cognitive appraisals of weight-control lapses appear to be associated with self-reported eating behavior, depressive symptoms and treatment completion rates, but not with treatment-induced weight loss. The relationship between long-term weight loss and cognitive appraisals of dieting lapses is yet to be determined. It appears necessary to assess empirically the validity of assumptions regarding factors associated with treatment outcome.