Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Sample and Procedure
2.3. Ethics Approval
2.4. Outcome Measures and Assessment Tools
2.5. Statistical Analysis
3. Results
3.1. Findings in Relation to BED Diagnostic Specifiers and Other Clinical Features
3.2. Association of Higher BMI with Age, Pain, Anxiety/Depression, MHRQoL and PHRQoL
4. Discussion
4.1. Strengths and Limitations
4.2. Clinical Implications
5. Conclusions and Recommendations for Future Research
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
DSM-5 | Diagnostic and Statistical Manual of Mental Disorders Fifth edition |
BED | Binge eating disorder |
BMI | Body mass index |
HBW | High body weight |
PHRQoL | Physical health-related quality of life |
MHRQoL | Mental health-related quality of life |
HOS | Health Omnibus Survey |
PCS | Physical Health Component Summary scale |
MCS | Mental Health Component Summary scale |
Appendix A. Questionnaire
E: HEIGHT/WEIGHT E1: What is your height without shoes? Recorded as units in centimetres, feet/inches, or unknown E2: What is your weight (undressed in the morning)? Recorded as units in kilograms, stone/pounds, or unknown G: WEIGHT CONTROL Changing the subject. I would now like to ask you about episodes of overeating. By overeating, or binge eating, I mean eating an unusually large amount of food in one go and at the time feeling that your eating was out of control. Respondent could not prevent themselves from overeating, or could not stop eating once they started. G1 Over the past three months how often have you overeaten? Would you say… 1 Not at all Go to G6 2 Less than weekly 3 Once a week 4 Two or more times a week 5 Don’ t knows Go to G6 6 Refused Go to G6 G2 Is the binge or overeating you experience usually associated with distress? 1 Not at all 2 Yes—little 3 Yes—a lot 4 Refused G3 Is the binge or overeating you experience usually associated with? Multiple response show prompt card G1 1 Eating much more rapidly than normal yes/no 2 Eating until feeling uncomfortably full yes/no 3 Eating large amounts of food when not feeling physically hungry yes/no 4 Eating alone because you are embarrassed about how much you are eating yes/no 5 Feeling disgusted, guilty or very depressed after eating yes/no 6 None of these yes/no 7 Refused G4 Over the past 3 months typically (on average) how many times a week have you overeaten?
| G6 Over the past 3 months have you felt your eating was out of control when others might not agree the amount of food was unusually large (e.g., 2–3 pieces of bread)? Would you say… Note ‘Out of control’ refers to respondent could not prevent themselves from overeating, or they could not stop eating once they had started on smaller or more usual amounts of food. 1 Not at all Go to G8 2 Less than weekly 3 Once a week 4 Two or more times a week 5 Don’ t know Go to G8 6 Refused Go to G8 G7 Is this smaller overeating you experience usually associated with distress? 1 Not at all 2 Yes— little 3 Yes—a lot 4 Refused The next questions are about various weight-control methods some people use. G8 Over the past 3 months have you regularly used, that is at least once a week, any of the following: laxatives, diuretics (water tablets), made yourself sick, in order to control your shape or weight? 1 Yes 2 No 3 Refused G9 Over the past three months have you regularly done any of the following: gone on a very strict diet, or eaten hardly anything at all for a time, in order to control your shape or weight? At least once weekly, or recurrently during the three months. 1 Yes 2 No 3 Refused G10 On a scale of 0–6, where 0 is Not at all important and 6 is Extremely or the most important issue. How important an issue has your weight and/or your shape been to how you think about (judge or view) yourself as a person in the past three months? It has been a really important issue to them, their self-esteem or their self-confidence Recorded as a number or (R) for refused O7 Pain/Discomfort? Show prompt card O4 1 I have no pain or discomfort 2 I have slight pain or discomfort 3 I have moderate pain or discomfort 4 I have severe pain or discomfort 5 I have extreme pain or discomfort. O8 Anxiety/Depression? Show prompt card O5 1 I am not anxious or depressed 2 I am slightly anxious or depressed 3 I am moderately anxious or depressed 4 I am severely anxious or depressed 5 I am extremely anxious or depressed |
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Unweighted Sample | Weighted Sample | Comments About Weighted Sample | |||
---|---|---|---|---|---|
Socio-Demographic Characteristics | Number | Col% | Number | Col% | |
All | 230 | 100.0 | 255 | 100.0 | 11% Over estimated |
Gender | |||||
Male | 105 | 45.7 | 142 | 55.6 | Over estimated |
Female | 125 | 54.3 | 113 | 44.4 | |
Age group (years) | |||||
18–29 | 31 | 13.5 | 54 | 21.4 | Over estimated |
30–44 | 78 | 33.9 | 87 | 34.1 | |
45–64 | 75 | 32.6 | 85 | 33.4 | |
65 and above | 46 | 20.0 | 28 | 11.2 | Underestimated |
Mean age (St. deviation) | 47.7 (16.1) | 43.6 (15.6) | |||
Marital status | |||||
Married | 106 | 46.1 | 132 | 51.8 | Over estimated |
De Facto | 27 | 11.7 | 34 | 13.3 | |
Separated/divorced | 36 | 15.7 | 21 | 8.3 | Underestimated |
Widowed | 19 | 8.3 | 10 | 3.9 | Underestimated |
Never Married | 42 | 18.3 | 58 | 22.8 | |
Country of birth | |||||
Australia/New Zealand | 168 | 73.0 | 186 | 73.1 | |
Asia | 23 | 10.0 | 31 | 12.2 | |
Europe/North America | 35 | 15.1 | 33 | 13.0 | |
Other | 4 | 1.8 | 4 | 1.7 | |
Employment status | |||||
Working full-time | 91 | 39.6 | 114 | 45.0 | Over estimated |
Working part-time | 43 | 18.7 | 49 | 19.1 | |
Home duties | 14 | 6.1 | 17 | 6.6 | |
Student | 8 | 3.5 | 13 | 5.2 | |
Unemployed/retired/other | 60 | 26.1 | 47 | 18.6 | Underestimated |
Not working due to injury/disability | 14 | 6.1 | 14 | 5.5 | |
Schooling status | |||||
Left school after before or after age 15 | 68 | 29.6 | 72 | 28.4 | |
Left school after 15 but still studying | 9 | 3.9 | 18 | 7.0 | Over estimated |
Trade qualification/apprenticeship | 35 | 15.2 | 45 | 17.7 | |
Certificate/diploma | 65 | 28.2 | 62 | 24.6 | |
Bachelor’s degree or higher | 53 | 23.0 | 57 | 22.3 |
BED Diagnostic Specifiers and Other Mental Health Measures | Total Participants | Reported (No or Yes) | |||
---|---|---|---|---|---|
No | Yes | ||||
Number | Row % | Number | Row % | ||
Categorical measures (reported as n, %) | |||||
BED diagnostic specifiers (reported multiple responses) | |||||
B1. Eating much more rapidly than normal (no, yes) | 255 | 214 | 84.2 | 40 | 15.8 |
B2. Eating until feeling uncomfortably full (no, yes) | 255 | 129 | 50.5 | 126 | 49.5 |
B3. Eating large amounts of food when not feeling hungry (no, yes) | 255 | 162 | 63.6 | 93 | 36.4 |
B4. Eating alone embarrassed about how much are eating (no, yes) | 255 | 248 | 97.5 | 6 | 2.5 |
B5. Feeling disgusted, guilty or very depressed after eating (no, yes) | 255 | 222 | 87.1 | 33 | 12.9 |
Any types of distress associated BE (no = not at all, yes = a little or a lot) | 253 | 152 | 59.6 | 101 | 39.7 |
Weight/shape overvaluation scale (no = 0–3 score; yes = 4–6 score) | 255 | 117 | 46.1 | 137 | 53.9 |
Number of BED specifiers reported by individuals | Number | Col% | |||
None of the BET of B1 to B5 reported | 59 | 23.0 | |||
One BED specifier reported | 121 | 47.4 | |||
Two BED specifiers reported | 58 | 22.8 | |||
Three specifiers reported | 9 | 3.6 | |||
4 to 5 specifiers reported | 8 | 3.2 | |||
Total cases | 255 | 100 | |||
Continuous measures [presented as mean, standard deviation] | Number | Mean (SD) | Range (min, max) | Skewness | Kurtosis |
Body mass index (BMI) | 255 | 30.3 (6.6) | 19.0, 57.9 | 0.9 | 0.9 |
Pain/Discomfort (1 to 5) | 255 | 1.8 (0.9) | 1, 5 | 1.2 | 1.1 |
Anxiety/Depression (1 to 5) | 255 | 1.4 (0.7) | 1, 5 | 1.8 | 3.4 |
MHRQoL [based on MCS in SF-12 scale score 0 to 100] | 255 | 49.7 (9.7) | 15.8, 64.8 | −1.2 | 0.6 |
PHRQoL [based on PCS in SF-12 scale score 0 to 100] | 255 | 47.9 (10.4) | 14.6, 65.1 | −1.1 | 0.6 |
Gender, Age and BED Diagnostic Specifiers, Distress, Weight/Shape Overvaluation | Body Mass Index (BMI) | |
---|---|---|
Mean | SD | |
All participants | 30.3 | 6.6 |
Gender | ||
Male | 29.5 | 5.6 |
Female | 31.3 | 7.5 |
p-values from t-test | 0.036 | |
Age groups (years) | ||
15–29 | 27.8 | 5.9 |
30–44 | 30.2 | 6.3 |
45 and above | 31.5 | 6.8 |
p-values from F-test | 0.003 | |
B1. Eating much more rapidly than normal | ||
No | 30.7 | 6.7 |
Yes | 28.0 | 5.7 |
p-values from t-test | 0.009 | |
B2. Eating until feeling uncomfortably full | ||
No | 30.1 | 6.4 |
Yes | 30.5 | 6.8 |
p-values from t-test | 0.673 | |
B3. Eating large amounts of food when not feeling hungry | ||
No | 29.0 | 5.9 |
Yes | 32.5 | 7.1 |
p-values from t-test | 0.001 | |
B4. Eating alone because embarrassed how much you are eating | ||
No | 30.1 | 6.6 |
Yes | 35.5 | 5.3 |
p-values from t-test | 0.047 | |
B5. Feeling disgusted, guilty or very depressed after eating | ||
No | 29.9 | 6.6 |
Yes | 32.8 | 6.3 |
p-values from t-test | 0.019 | |
Number of BED specifiers (B1–B5) reported by individuals | ||
None of the BED specifiers of B1 to B5 reported | 29.7 | 5.8 |
One BED specifier reported | 29.4 | 6.4 |
Two BED specifiers reported | 31.7 | 7.4 |
Three to Five specifiers reported | 33.4 | 6.3 |
p-values rom F test | 0.030 | |
Presence of any distress with binge-eating | ||
No | 29.3 | 6.2 |
Yes | 31.6 | 6.9 |
p-values from t-test | 0.008 | |
Weight/shape overvaluation | ||
No | 29.5 | 6.5 |
Yes | 31.0 | 6.6 |
p-values from t-test | 0.067 |
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Mohsin, M.; Hamoui, M.; Kozmér, S.; Touyz, S.; Currow, D.; Hay, P. Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study. Obesities 2025, 5, 45. https://doi.org/10.3390/obesities5020045
Mohsin M, Hamoui M, Kozmér S, Touyz S, Currow D, Hay P. Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study. Obesities. 2025; 5(2):45. https://doi.org/10.3390/obesities5020045
Chicago/Turabian StyleMohsin, Mohammed, Malakeh Hamoui, Stella Kozmér, Stephen Touyz, David Currow, and Phillipa Hay. 2025. "Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study" Obesities 5, no. 2: 45. https://doi.org/10.3390/obesities5020045
APA StyleMohsin, M., Hamoui, M., Kozmér, S., Touyz, S., Currow, D., & Hay, P. (2025). Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study. Obesities, 5(2), 45. https://doi.org/10.3390/obesities5020045