Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Self-reported binge eating in severe pediatric obesity: impact on weight change in a randomized controlled trial of family-based treatment



This study sought to document self-reported binge eating in a large sample of severely obese children and to examine the impact of binge eating on changes in percent overweight among children randomized to family-based behavioral treatment (intervention) versus control (usual care).

Participants and methods:

As part of a larger randomized controlled trial, 192 children aged 8–12 years (M=10.2, s.d.=1.2) with a mean body mass index (BMI) percentile of 99.2 (s.d.=0.7) completed assessments at baseline and 6-, 12-, and 18 months post-randomization. A parent or guardian also participated. Child psychological symptoms, including binge eating, were measured before randomization using self-report questionnaires. Child height and weight were measured at baseline, 6-, 12-, and 18 months. The primary study outcome was percent overweight (that is, percent over median BMI for age and sex).


Twenty-two children (11.5%) endorsed binge eating at baseline (Binge Eating Group). Children in the Binge Eating Group were younger and had more depressive, anxiety, and eating disorder symptoms, and lower self-esteem than children in the rest of the sample (No Binge Eating Group). There also were differences between the Binge Eating and No Binge Eating groups with respect to the short-term effects of treatment group assignment on change in percent overweight during the study. Specifically, improvements in percent overweight in the intervention condition relative to usual care were documented in the No Binge Eating Group only. Among children in the Binge Eating Group, those assigned to intervention showed a 2.6% increase in percent overweight, on average, at the completion of acute treatment as compared to an 8.5% decrease among children without binge eating. However, these effects were not maintained during follow-up.


Results of this study suggest the importance of considering binge eating in the development of weight management programs for severely obese youth.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. Morgan CM, Yanovski SZ, Nguyen TT, McDuffie J, Sebring NG, Jorge MR et al. Loss of control over eating, adiposity, and psychopathology in overweight children. Int J Eat Disord 2002; 31: 430–441.

    Article  Google Scholar 

  2. Tanofsky-Kraff M, Faden D, Yanovski SZ, Wilfley DE, Yanovski JA . The perceived onset of dieting and loss of control eating behaviors in overweight children. Int J Eat Disord 2005; 38: 112–122.

    Article  Google Scholar 

  3. Tanofsky-Kraff M, Yanovski SZ, Wilfley DE, Marmarosh C, Morgan CM, Yanovski JA . Eating-disordered behaviors, body fat, and psychopathology in overweight and normal-weight children. J Consult Clin Psychol 2004; 72: 53–61.

    Article  Google Scholar 

  4. Decaluwe V, Braet C . Prevalence of binge-eating disorder in obese children and adolescents seeking weight-loss treatment. Int J Obes Relat Metab Disord 2003; 27: 404–409.

    Article  CAS  Google Scholar 

  5. Decaluwe V, Braet C, Fairburn CG . Binge eating in obese children and adolescents. Int J Eat Disord 2003; 33: 78–84.

    Article  Google Scholar 

  6. Eddy KT, Tanofsky-Kraff M, Thompson-Brenner H, Herzog DB, Brown TA, Ludwig DS . Eating disorder pathology among overweight treatment-seeking youth: clinical correlates and cross-sectional risk modeling. Behav Res Ther 2007; 45: 2360–2371.

    Article  Google Scholar 

  7. Glasofer DR, Tanofsky-Kraff M, Eddy KT, Yanovski SZ, Theim KR, Mirch MC et al. Binge eating in overweight treatment-seeking adolescents. J Pediatr Psychol 2007; 32: 95–105.

    Article  Google Scholar 

  8. Goossens L, Braet C, Decaluwe V . Loss of control over eating in obese youngsters. Behav Res Ther 2007; 45: 1–9.

    Article  Google Scholar 

  9. Isnard P, Michel G, Frelut ML, Vila G, Falissard B, Naja W et al. Binge eating and psychopathology in severely obese adolescents. Int J Eat Disord 2003; 34: 235–243.

    Article  Google Scholar 

  10. Levine MD, Ringham RM, Kalarchian MA, Wisniewski L, Marcus MD . Overeating among seriously overweight children seeking treatment: results of the children's eating disorder examination. Int J Eat Disord 2006; 39: 135–140.

    Article  Google Scholar 

  11. Goossens L, Braet C, Van Vlierberghe L, Mels S . Weight parameters and pathological eating as predictors of obesity treatment outcome in children and adolescents. Eat Behav 2009; 10: 71–73.

    Article  Google Scholar 

  12. Braet C . Patient characteristics as predictors of weight loss after an obesity treatment for children. Obesity (Silver Spring) 2006; 14: 148–155.

    Article  Google Scholar 

  13. Wonderlich SA, Gordon KH, Mitchell JE, Crosby RD, Engel SG . The validity and clinical utility of binge eating disorder. Int J Eat Disord 2009; 42: 687–705.

    Article  Google Scholar 

  14. Tanofsky-Kraff M, Cohen ML, Yanovski SZ, Cox C, Theim KR, Keil M et al. A prospective study of psychological predictors of body fat gain among children at high risk for adult obesity. Pediatrics 2006; 117: 1203–1209.

    Article  Google Scholar 

  15. Tanofsky-Kraff M, Yanovski SZ, Schvey NA, Olsen CH, Gustafson J, Yanovski JA . A prospective study of loss of control eating for body weight gain in children at high risk for adult obesity. Int J Eat Disord 2009; 42: 26–30.

    Article  Google Scholar 

  16. Kalarchian MA, Levine MD, Arslanian SA, Ewing LJ, Houck PR, Cheng Y et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics 2009; 124: 1060–1068.

    Article  Google Scholar 

  17. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R et al. CDC growth charts: United States. Adv Data 2000; 8(314): 1–27.

    Google Scholar 

  18. Paluch RA, Epstein LH, Roemmich JN . Comparison of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol 2007; 19: 487–494.

    Article  Google Scholar 

  19. Maloney MJ, McGuire JB, Daniels SR . Reliability testing of a children's version of the Eating Attitude Test. J Am Acad Child Adolesc Psychiatry 1988; 27: 541–543.

    Article  CAS  Google Scholar 

  20. Smolak L, Levine MP . Psychometric properties of the Children's Eating Attitudes Test. Int J Eat Disord 1994; 16: 275–282.

    Article  CAS  Google Scholar 

  21. Kovacs M . Children's Depression Inventory Manual. Multi-Health Systems, Inc.: North Tonawanda, NY, 1992.

    Google Scholar 

  22. Spielberger CD, Edwards CD, Lushene RE, Montuori J, Plaztek D . STAIC Preliminary Manual. Consulting Psychologists Press: Palo Alto, CA, 1973.

    Google Scholar 

  23. Harter S . Manual for the Self-Perception Profile for Children. University of Denver: Denver, CO, 1985.

    Google Scholar 

  24. Achenbach TM, Elderbrook C . Manual for the Child Behavior Checklist and Revised Child Behavior Profile. University of Vermont Department of Psychiatry: Burlington, VT, 1991.

    Google Scholar 

  25. Reinehr T, Temmesfeld M, Kersting M, de Sousa G, Toschke AM . Four-year follow-up of children and adolescents participating in an obesity intervention program. Int J Obes (Lond) 2007; 31: 1074–1077.

    Article  CAS  Google Scholar 

  26. Savoye M, Shaw M, Dziura J, Tamborlane WV, Rose P, Guandalini C et al. Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial. JAMA 2007; 297: 2697–2704.

    Article  CAS  Google Scholar 

  27. Wilfley DE, Stein RI, Saelens BE, Mockus DS, Matt GE, Hayden-Wade HA et al. Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial. JAMA 2007; 298: 1661–1673.

    Article  CAS  Google Scholar 

  28. Rodearmel SJ, Wyatt HR, Stroebele N, Smith SM, Ogden LG, Hill JO . Small changes in dietary sugar and physical activity as an approach to preventing excessive weight gain: the America on the Move family study. Pediatrics 2007; 120: e869–e879.

    Article  Google Scholar 

  29. Decaluwe V, Braet C . Assessment of eating disorder psychopathology in obese children and adolescents: interview versus self-report questionnaire. Behav Res Ther 2004; 42: 799–811.

    Article  Google Scholar 

  30. Tanofsky-Kraff M, Morgan CM, Yanovski SZ, Marmarosh C, Wilfley DE, Yanovski JA . Comparison of assessments of children's eating-disordered behaviors by interview and questionnaire. Int J Eat Disord 2003; 33: 213–224.

    Article  Google Scholar 

  31. Stice E, Davis K, Miller NP, Marti CN . Fasting increases risk for onset of binge eating and bulimic pathology: a 5-year prospective study. J Abnorm Psychol 2008; 117: 941–946.

    Article  Google Scholar 

Download references


This study was supported by NIH grants to Dr Marcus (R01 HD38425 and minority supplement HD38425-02S1), as well as the University of Pittsburgh Obesity and Nutrition Research Center (P30 DK46204), and Children's Hospital of Pittsburgh General Clinical Research Center (M01-RR00084 and UL1-RR024153 [CTSA]).

Author information

Authors and Affiliations


Corresponding author

Correspondence to J E Wildes.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wildes, J., Marcus, M., Kalarchian, M. et al. Self-reported binge eating in severe pediatric obesity: impact on weight change in a randomized controlled trial of family-based treatment. Int J Obes 34, 1143–1148 (2010).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • childhood obesity
  • binge eating
  • eating disorder
  • treatment moderator
  • clinical trial

This article is cited by


Quick links