346 Feeding and Eating Disorders
may affect the clinician’s esti mation of whether the intake is excessive. For example, a
quantity of food that might be regarded as excessive for a typical meal might be consid-
ered normal during a celebration or holiday me al. A “discrete period of time” refers to a
limited period, usually less than  2 hours. A single episode of binge eating need not be re-
stricted to one setting. For example, an individual may begin a binge in a restaurant and
then continue to eat on re turning home. Continual snacki ng on small amounts of food
throughout the day would not be considered an eating binge. 
An occurrence of excessive food consumptio n must be accompanied by a sense of lack
of control (Criterion A2) to be considered an episode of binge eating. An indicator of loss
of control is the inability to refrain from eating  or to stop eating once started. Some indi-
viduals describe a dissociative quality during , or following, the bing e-eating episodes. The
impairment in control associated with binge eating may not be abso lute; for example, an
individual may continue binge eating while the telephone is ringing but will cease if a
roommate or spouse unexpected ly enters the room. Some in dividuals report that their
binge-eating episodes are no longer characterize d by an acute feeling of  loss of control but
rather by a more generalized pattern of uncont rolled eating. If individuals report that they
have abandoned efforts to control their eati ng, loss of control should be considered as
present. Binge eating can also be planned in some instances.
The type of food co nsumed during binges varies both across individuals and for a
given individual. Binge eating appears to be characterized more by an abnormality in the