Objective: E valuating the influence of dieting and of being overweight on binge-eating episodes and on psychological traits in severely obese patients. Method: Clinical interviews and self-report questionnaires prior to and 2 years following biliopancreatic diversion (BPDj when subjects adopt a completely free eating style and achieve in maintaining a normal or nearly normal body weight. Results: At two years following the operation, the prevalence of binge-eating episodes sharply fell and the subjects' overall psychological conditions improved; only a few patients started binging. Discussion: These results point out the importance of dieting and ot overweight itself in determining eating behavior disturbances or psychopathology. The fact that only a very small number ofpatients continue or start binging following BOP suggests that a minority of obese bingers should be considered as true eating-disordered patients. 0 I996 by john Wiley & Sons, Inc.
Binge eating, which was first described more than 30 years ago by Stunkard (1959), refers to episodes of eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances. These episodes are accompanied by a sense of lack of control over what or how much is being eaten and marked psychological distress regarding binge eating (Spitzer et al., 1991).
Several reports have found a direct relationship between binge eating and dieting (Marcus, Wing, &