Onset of dieting vs binge eating in outpatients with binge eating disorder

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Abstract
To examine the potential significance of the sequence of the onset of dieting and binge eating in binge eating disorder (BED). BED patients were interviewed and completed a battery of psychometrically well-established measures of current eating behaviors, eating disorder psychopathology, and associated psychological functioning. Participants were 98 consecutive outpatients with BED evaluated for a clinical trial. Interview data, self-report measures and measured body weight were examined. Participants who reported that dieting preceded binge eating (DIETfirst, 65%) were compared to those who reported that binge eating preceded their first diet (BINGEfirst, 35%). The study groups did not differ in demography, current or highest body mass index, current eating behaviors or psychopathology, or psychological functioning. The two groups did not differ in age of first diet; however, the BINGEfirst group was significantly younger when first overweight, at onset of binge eating, and at onset of BED diagnosis. The BINGEfirst group reported a higher frequency of being teased about their weight. A substantial subgroup of BED patients report that binge eating preceded their first diet. This finding, which replicates previous reports for BED and appears higher than that generally reported for bulimia nervosa, may have implication for etiologic models of binge eating.