Fairburn et al,1 in the May 1998 issue of the ARCHIVES, identified a number of risk factors for binge eating disorder, a research category included in the appendix of DSM-IV. Comparison groups included healthy controls, women with other psychiatric disorders, and women with bulimia nervosa. While knowledge of such risk factors sheds some light on the development of binge eating disorder, the study design leaves out a critically important comparison group: women with obesity but without any psychiatric disorder. One of the main concerns in whether to include binge eating disorder in DSM-IV was trying to draw the line between binge eating disorder and normality.2 The establishment of clear differences between binge eaters and those who have a more generalized overeating pattern (ie, patients who are obese) is therefore of great importance. When designing studies of binge eating disorder, investigators should consider collecting such information to enrich the database that will be used as the basis for revising DSM-IV in the future.
Pincus HA, First M. Critical Differences Between Binge Eating and Overeating. Arch Gen Psychiatry. 1999;56(10):951. doi: