Can a Short Screening Tool Discriminate Between Overeating and Binge Eating in Treatment-Seeking Individuals with Obesity?

Objective Existing screening tools are inadequate in differentiating binge eating from normative overeating in treatment-seeking individuals with overweight or obesity, as these individuals tend to overendorse loss-of-control (LOC; the hallmark characteristic of binge eating) on self-report measures. In order for treatment centers to efficiently and accurately identify individuals who would benefit from specialized treatment, it is critical to develop effective brief screening tools. This study examined the sensitivity and specificity of a self-report screener designed to be used by an outpatient treatment center on a large scale. Methods Participants were treatment-seeking individuals (N = 364) with overweight or obesity who were administered the screener and who completed a subsequent interview assessing for LOC and binge eating. Results Discriminant analyses revealed that the screener achieved 77.6% sensitivity and 77.0% specificity in predicting clinician-assessed LOC and 75.2% sensitivity and 74.1% specificity in predicting full-threshold binge eating (i.e., >= 12 objectively large binge-eating episodes within the past 3 months). Post hoc analyses indicated that male participants were more likely to be misclassified with the screener. Conclusions The self-report screener demonstrated satisfactory predictive ability, which is notable given the challenges of discriminating between LOC and normative overeating. However, room for improvement remains. In particular, the inclusion of additional screener items that more fully capture the binge-eating experience in males is warranted.

Automated summary

This study examined the sensitivity and specificity of a self-report screener in predicting binge eating and loss-of-control in overweight or obese individuals seeking treatment. The screener demonstrated satisfactory predictive ability, but male participants were more likely to be misclassified. Further improvements, especially in capturing the binge eating experience in males, are warranted.