present. Binge eating can also be planned in some instances.
The type of food consumed during binges varies both across individuals and for a given
individual. Binge eating appears to be characterized more by an abnormality in the amount
of food consumed than by a cr aving for a specific nutrient.
Binge eating must be characterized by marked  distress (Criterion C) and at least three
of the following features: eating much more rapidly than normal; eating until feeling un-
comfortably full; eating large amounts of food when not feeling physically hungry; eating
alone because of feeling embarrassed by how much one is eating; and feeling disgusted
with oneself, depressed, or very  guilty afterward (Criterion B).
Individuals with binge-eating disorder are typically ashamed of their eating problems
and attempt to conceal their symptoms. Binge ea ting usually occurs in secrecy or as incon-
spicuously as possible. The most common antece dent of binge eating is negative affect.
Other triggers include interpersonal stressors; dietary restraint; negative feelings related
to body weight, body shape, and food; and boredom. Binge eating may minimize or mit-
igate factors that precipitated the episode in  the short-term, but negative self-evaluation
and dysphoria often are the delayed consequences.
Associated Features Supporting Diagnosis
Binge-eating disorder occurs in normal-weight/ overweight and obese individuals. It is re-
liably associated with overweight and obes ity in treatment-seekin g individuals. Never-
theless, binge-eating disorder is distinct from obesity. Most obese individuals do not
engage in recurrent binge eating. In addition, compared with weight-matched obese indi-
viduals without binge-eating disorder, those with the disorder consume more calories in
laboratory studies of eating behavior and ha ve greater functional impairment, lower qual-