Binge-Eating Disorder 351
nitely larger than most people would eat in a similar period of time under similar circum-
stances (Criterion A1). The context in which the eating occurs may affect the clinician’s
estimation of whether the intake is excessive. For example, a quantity of food that might be
regarded as excessive for a typical meal migh t be considered normal  during a celebration
or holiday meal. A “discrete period of time” refers to a limited pe riod, usually less than
2 hours. A single episode of binge eating need not be restricted to one setting. For example,
an individual may begin a binge in a restaurant and then continue to eat on returning
home. Continual snacking on small amounts of  food throughout the day would not be con-
sidered an eating binge. 
An occurrence of excessive food consumptio n must be accompanie d 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 eating , loss of control may still be considered as
present. Binge eating can also be planned in some instances.