Because
binge eating in obese individuals has been postulated to be a reaction to
dietary restriction, we examined the recorded food intake of 17 obese women with and 16 obese women without
binge eating disorder (BED) during 1-week periods before and 3 months after a very
low calorie diet program in order to determine the effects of
dietary restriction on
binge eating frequency and severity. Before
weight loss, rather than reporting severe
caloric restriction, women with BED reported greater average energy intake than nonbinge eaters on both a total (2707 vs. 1869 k cal/day, p < .01) and weight-adjusted (25.1 vs. 18.1 kcal/kg, p < .01) basis, with both higher intake on nonbinge days and an increased frequency of binge days. After
weight loss, there was no significant difference in energy intake, on either a total or weight-adjusted basis, between subjects with and without BED. Although average daily energy intake fell for both groups after
weight loss, only subjects with BED reported significantly decreased energy intake when adjusted for change in
body weight. This resulted from decreased intake on nonbinge days and a decreased frequency of binge days. Before
weight loss, subjects with BED reported an average energy intake equivalent to 94% of their predicted energy expenditure. Whereas subjects without BED reported intake only 64% of predicted (p = .002). After
weight loss, there was no significant difference between subjects with and without BED in the percentage of predicted energy expenditure reported as intake (64% vs. 58%). Restraint was similar in both groups before
weight loss, but those with BED reported greater hunger and disinhibition. After
weight loss treatment, restraint increased significantly, whereas disinhibition and hunger remained elevated in subjects with BED. Disinhibition, rather than restraint, appears to be a major contributor to the disordered eating of these individuals. Unlike normal-weight women with
bulimia nervosa,
dietary restriction does not appear to worsen symptoms of
binge eating in obese women with BED. Over the short term, subjects with BED may respond to a standard
weight loss treatment program with improvements in
binge eating behaviors.