Can a Short Screening Tool Discriminate Between Overeating and Binge Eating in Treatment‐Seeking Individuals with Obesity?

Abstract

Existing screening tools are inadequate in differentiating binge eating from normative overeating in treatment-seeking individuals with overweight or obesity, as these individuals tend to overendorse loss-ofcontrol (LOC; the hallmark characteristic of binge eating) on self-report measures. In order for treatment centers to efficiently and accurately identify individuals who would benefit from specialized treatment, it is critical to develop effective brief screening tools. This study examined the sensitivity and specificity of a self-report screener designed to be used by an outpatient treatment center on a large scale. Methods: Participants were treatment-seeking individuals (N = 364) with overweight or obesity who were administered the screener and who completed a subsequent interview assessing for LOC and binge eating. Results: Discriminant analyses revealed that the screener achieved 77.6% sensitivity and 77.0% specificity in predicting clinician-assessed LOC and 75.2% sensitivity and 74.1% specificity in predicting "fullthreshold" binge eating (i.e., ≥12 objectively large binge-eating episodes within the past 3 months). Post hoc analyses indicated that male participants were more likely to be misclassified with the screener. Conclusions: The self-report screener demonstrated satisfactory predictive ability, which is notable given the challenges of discriminating between LOC and normative overeating. However, room for improvement remains. In particular, the inclusion of additional screener items that more fully capture the binge-eating experience in males is warranted.

Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires

“…Further, another study identified in our search but not included in our review reported higher scores on the dietary restraint and eating concern subscales of the EDE‐Q compared to the EDE interview in patients' post‐bariatric surgery (de Zwaan et al, 2004). Interestingly, a new screening tool aiming to identify loss of control and binge eating specifically (Manasse et al, 2021), found that items included in the screening tool based on the DSM‐5 criteria for BED did not have good accuracy at distinguishing binge eating from overeating. This highlights that further consideration of the individual subscales of such tools may be warranted to determine the optimal cut‐point to identify individuals with overweight or obesity at risk of an ED.…”

“…et al, 2004). Interestingly, a new screening tool aiming to identify loss of control and binge eating specifically (Manasse et al, 2021), found that items included in the screening tool based on the DSM-5 criteria for BED did not have good accuracy at distinguishing binge eating from overeating. This highlights that further consideration of the individual subscales of such tools may be warranted to determine the optimal cut-point to identify individuals with overweight or obesity at risk of an ED.…”

Time-Limited Eating and Continuous Glucose Monitoring in Adolescents with Obesity: A Pilot Study

“…Binge Eating Disorder Screener (BEDS) [49][50][51][52]. Given that adolescents with obesity are at high risk of binge eating disorder (BED) symptoms, our goal was to screen participants at baseline to ensure appropriate referrals are made in a timely manner.…”

“…This data was utilized to compute the following measures: mean, maximum, and minimum glucose levels; standard deviation of glucose; mean amplitude of glycemic excursion; and overall percent of total time spent in euglycemic range (percent time in range = 70-180 mg/dL). All CGM data were housed in Clarity (Dexcom and Dexcom CLARITY are registered trademarks of Dexcom, Inc., San Diego, CA, USA) and the study team had weekly access to assess all glycemic excursions that occurred during the self-reported fasting periods [50][51][52][53]. For those in the TLE + real-time CGM feedback group, every time they viewed their CGM data in the app, the event was captured, and time stamped in the Clarity system.…”