What is binge eating? A comparison of binge eater, peer, and professional judgments of eating episodes

Binge eating is a central diagnostic feature of bulimia nervosa (BN) and binge-eating disorder (BED), yet the phenomenon of bingeing has not been adequately defined, and there is considerable variability in how individuals label eating episodes as binges. We examined the agreement among binge-eating individuals, non-eating-disordered peers, and professional dietitians over whether particular eating episodes were binges. Twenty-nine females with BED, fifteen nonclinical binge eaters (NCB), three peer judges, and three dietitians rated a sample of eating episodes of the binge-eating individuals as either binges or nonbinges based on the types and amounts of food eaten as well as the duration of each eating episode. BED participants labeled a significantly higher proportion of their intakes as binges relative to NCB participants. Peer judges were more likely than were dietitians to label participants' eating episodes as binges. Agreement within dietitian and peer groups was poor to fair, whereas agreement between these groups was fair. Finally, agreement between participants and the external judges (i.e., peers, dietitians) was poor. Possible explanations for these findings as well as implications for the diagnosis of BN and BED are discussed.