Psychosocial variables, eating behavior, depression, and binge eating in morbidly obese subjects

Binge eating disorder (BED) is a frequent and significant psychiatric comorbidity among patients seeking treatment for obesity. The purpose of this study was to determine whether morbidly obese subjects with BED differ from those without BED (NBED) in terms of eating behavior, social/environmental variables, and depression.

Out of 110 morbidly obese (BMI > or = 40 kg/m2) subjects, 88 could be reliably classified as BED (19) or NBED (69). These subjects (age 42.0+/-13.4 years, BMI 47.0+/-5.7 kg/m2) were examined by a semi-structured interview and by validated questionnaires to assess depression and eating behavior.

Subjects with BED showed higher scores of disinhibited eating (12.3+/-2.7 vs. 9.1+/-3.6, p<0.05), were more likely to attribute obesity to their eating habits (chi2=8.4, p<0.05), and rated their social environment regarding relationships as less supportive and cohesive (chi2=10.6, p=0.001). In addition, patients with BED experienced an earlier onset of obesity (chi2=6.3, p<0.05). No relationship, however, was found between binge eating disorder and depression.

Morbidly obese patients with BED exhibit typical psychological features when compared to those without BED. Their recognition by a structured psychological evaluation in conjunction with questionnaires might be necessary to develop appropriate therapeutic strategies to facilitate weight loss.