Recurrent binge eating poses a serious health risk to women. Previously studied almost exclusively in the context of bulimia nervosa, a subgroup of individuals with recurrent binge eating has now been recognized, and a new diagnostic category, binge eating disorder (BED), has been proposed to facilitate research and treatment of these individuals. BED is associated with adiposity and with psychiatric impairment. Initial research also suggests that BED is a problem not only among Caucasian women, the population typically included in research of eating disorders. Rather, black women seem to be at equal risk for the disorder. Moreover, the greatly elevated rates of obesity among black women call for an exploration of the relationship between binge eating and obesity in black women. Research is needed to examine risk for BED and such research needs to consider multiple risk factors, to attend to the question of specificity of risk factors, and to address the pressing question of risk factors for BED in black women.
The aims of this study are: 1) to test a multifactorial risk factor model of BED; 2) to determine the extent to which identified risk factors are specific to BED and not associated with merely the risk for psychiatric disorder in general; and 3) to examine racial differences in the relative contribution of specific risk factors for BED. To accomplish these aims, a case-control design will be implemented, involving a community-based sample of 600 black and white women aged 18 to 30 years. A case-control study involves identifying cases whose rates of exposure to hypothesized putative risk factors are measured and compared with exposure rates of controls. To identify cases of BED and to find psychiatric controls and normal controls, a two-stage screening procedure will be applied. An initial sample of 10,000 women will be screened by telephone. Women who meet initial inclusion criteria will be interviewed in person to verify their group status. Diagnoses will be based on SCID and EDE interviews. A total of 200 BED cases will be recruited. For each index case (BED case), two control subjects will be selected, matched to the index case on race, age, and SES. Psychiatric control subjects will meet Axis I criteria (DSM IV) for a major psychiatric disorder and will be included to test whether risk factors identified for BED are specific to this eating disorder rather than generic to developing a mental disorder. All subjects will be assessed for exposure to risk factors, using the Risk Factor Interview and the Parental Bonding Instrument. This study will provide information for prevention and intervention of binge eating disorder.
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