Binge Eating Disorder Patients Research Articles

Risk of binge eating disorder in patients with metabolic dysfunction-associated steatotic liver disease

Purpose Very few data exist on the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and eating disorders. The study aimed to evaluate the presence of binge eating disorder (BED), in MASLD subjects.Methods Demographic, clinical investigation, anthropometric measurements and laboratory were collected in 129 patients with MASLD (34.1% males; age, 53.7 years; BMI, 34.4 kg/m2) addressed by general practitioners to a hospital-based unit of metabolic disorders. The risk of binge eating was tested by the binge eating scale (BES); values in the range 17–26 were considered “possible” BED, values > 26 were considered “probable” BED. Hepatic steatosis and fibrosis were tested by surrogate biomarkers and imaging (transient elastography). Calorie intake and lifestyle were self-assessed by questionnaires.Results Possible BED was present in 17.8% of cases, probable BED in another 7.6%, and were neither associated with gender, obesity class, diabetes, features of metabolic syndrome, nor with presence and severity of hepatic steatosis and fibrosis. Also steatosis grade by CAP and fibrosis stage by liver stiffness did not correlate with BES. However, an association was present between the daily caloric intake and “possible” BED (odds ratio, 1.14; 95% confidence interval, 1.05–1.24; “probable” BED, 1.21; 1.07–1.37), after adjustment for confounders.Conclusion Binge eating, as scored by BES, is present in a significant proportion of MASLD cases screened for metabolic disorders in a specialized center. It may impact behavioral treatment, reducing the chance of weight loss without systematic psychological support.Level of Evidence: Level III, cohort analytic study

Binge Eating Disorder in Patients with Bipolar Disorder and Relationship with Clinical Features

IntroductionCurrent studies indicate a strong relationship between Eating Disorders and obesity, while studies on Bipolar Disorder (BPD) show that patients with BPD form an important risk group in terms of obesity.ObjectivesThe aim of this study is to investigate the frequency of Binge Eating Disorder (BED) in patients diagnosed with euthymic Bipolar Disorder 1 (BPD 1), and the relationship between their clinical featuresMethodsThis study included 150 patients between 18-65 years of age, diagnosed with euthymic BPD 1 according to DSM 5 criteria. Structured Clinical Interview for DSM-5 Disorders, Structured Sociodemographic Form, Young Mania Scale, Beck Depression Scale, Eating Disorders Assessment Scale (EDAS) , Eating Attitude Test (EAT) were applied to participants.ResultsA diagnosis of BED was detected in 19.3% of the patients. Body weight, highest weight and BMI values were significantly higher in those who were diagnosed with BED compared to those who were not diagnosed with BED. Most of the diagnosed with BED are women; gender was found to be determinant for BED. The total and subscale scores of EAT and EDAS of those with a diagnosis of BED were statistically significantly higher than those who did not. The rate of attacks with psychotic symptoms, rapid cycling and presence of suicide attempt were significantly higher in those with a diagnosis of BED compared to those who did not.ConclusionsBED may be frequent in BPD 1 patients. Noticing BED in BPD1 patients might help both the more effective treatment of BPD and the prevention of obesity.DisclosureNo significant relationships.

Time evaluation and its accuracy in eating disorders: differences in relation to interoceptive awareness

PurposeTime evaluation has been poorly studied in eating disorder (ED) patients despite its relationship with body awareness, which is a core psychopathological feature in EDs and is influenced by impulsivity, interoception, and working memory. This study aims to evaluate time estimation and its accuracy across the ED spectrum in connection with specific and general psychopathology.MethodsA group of 215 women was enrolled in a computerized task involving the estimation of 1-min intervals. Impulsivity and body awareness constructs (self-monitoring, depersonalization, interoceptive deficit) were evaluated and examined for significant correlations with time estimation and the accuracy of the measure.ResultsPatients with EDs showed an impaired ability to estimate time, with an accuracy that positively correlated with compulsive self-monitoring (p = 0.03). Differences between diagnostic subgroups showed an overestimation of time in anorexia nervosa patients and an underestimation of time in binge eating disorder patients, whose time estimation was also less accurate.ConclusionThe relationship between time estimation and compulsive self- monitoring might corroborate the presence of an imbalanced integration of information in patients with EDs that was not present in the community women included in the study. Time perception should be further evaluated in the ED field, and longitudinal changes due to psychopathological recovery or BMI changes should be examined.Level of evidenceLevel III: Evidence obtained from a well-designed cohort or case–control analytic study.

Eating disorders: A neglected group of mental disorders in patients requesting aesthetic surgery

BackgroundThere is a lack of data concerning the prevalence of eating disorders in patients requesting aesthetic surgery in spite of a large body of literature on the psychopathology of these patients. This may mostly be due to insufficient diagnostic assessment instruments. Therefore, the aim of this study was to determine the prevalence of eating disorders and their comorbidities in patients undergoing aesthetic surgery. MethodsThe assessment of prevalence of the eating disorders as anorexia nervosa, bulimia nervosa and binge eating disorder as well as other mental disorders was performed with the Structured Clinical Interview for DSM-IV mental disorders (SCID), axis 1. Results212 patients (198 females, 14 males), requesting different types of aesthetic surgery, were included in this study. Eating disorders had a current prevalence of 8.0% (17/212) and a lifetime prevalence of 11.3% (24/212). Anorexia nervosa was predominantly found in patients with breast augmentation [current: 7.4% (2/27); lifetime: 11.1% (3/27)] and rhinoplasty [6.3 (1/16); 12.6% (2/16)]. Bulimia nervosa dominated in patients with liposuction [10% (3/30); 13.3% (4/30)] and binge eating disorder in patients with abdominoplasty [current/lifetime: 10.8% (4/37)]. Levels of significance (p ≤ 0.002) were reached for prevalence of the eating disorders in above mentioned types of surgery, when compared to prevalence data of the general population (two proportion Z test for SPSS). ConclusionEating disorders are distributed according to a certain pattern in the different types of aesthetic surgery. Interestingly, the current prevalence of eating disorders (17/212) was comparable to that of body dysmorphic disorder (26/212).

The neural substrates of risky rewards and losses in healthy volunteers and patient groups: a PET imaging study.

Risk is an essential trait of most daily decisions. Our behaviour when faced with risks involves evaluation of many factors including the outcome probabilities, the valence (gains or losses) and past experiences. Several psychiatric disorders belonging to distinct diagnostic categories, including pathological gambling and addiction, show pathological risk-taking and implicate abnormal dopaminergic, opioidergic and serotonergic neurotransmission. In this study, we adopted a transdiagnostic approach to delineate the neurochemical substrates of decision making under risk. We recruited 39 participants, including 17 healthy controls, 15 patients with pathological gambling and seven binge eating disorder patients, who completed an anticipatory risk-taking task. Separately, participants underwent positron emission tomography (PET) imaging with three ligands, [18F]fluorodopa (FDOPA), [11C]MADAM and [11C]carfentanil to assess presynaptic dopamine synthesis capacity and serotonin transporter and mu-opioid receptor binding respectively. Risk-taking behaviour when faced with gains positively correlated with dorsal cingulate [11C]carfentanil binding and risk-taking to losses positively correlated with [11C]MADAM binding in the caudate and putamen across all subjects. We show distinct neurochemical substrates underlying risk-taking with the dorsal cingulate cortex mu-opioid receptor binding associated with rewards and dorsal striatal serotonin transporter binding associated with losses. Risk-taking and goal-directed control appear to dissociate between dorsal and ventral fronto-striatal systems. Our findings thus highlight the potential role of pharmacological agents or neuromodulation on modifying valence-specific risk-taking biases.

Profiling Metacognition in Binge Eating Disorder

Research has shown that metacognition may play a role in problem eating. In this study we explored whether aspects of metacognition are relevant to the understanding of binge eating in patients with Binge Eating Disorder. We aimed to ascertain: (1) the presence of metacognitive beliefs about binge eating; (2) the goal of, and stop signal for, binge eating; and (3) the impact of binge eating on self-consciousness. Ten Binge Eating Disorder patients took part in the study and were assessed using the metacognitive profiling semi-structured interview. Results suggested that all patients endorsed both positive and negative metacognitive beliefs about binge eating. The goals of binge eating were stop thinking about personal concerns and improve emotional state. All patients reported that they did not know when these goals had been reached. The stop signals for binge eating included physical discomfort, beliefs about binge eating not being the best way to solve problems, and environmental stimuli. All patients also confirmed that a reduction in self-consciousness occurred during a binge eating episode. The results of this study confirm that metacognition may indeed be relevant to the understanding of Binge Eating Disorder.

A Pilot Study of a Videoconferencing-Based Binge Eating Disorder Program in Overweight or Obese Females.

Background:There has been increasing interest in using videoconferencing in health care, but limited research was conducted in Binge Eating Disorder (BED) patients. This 3-month pilot study aimed to assess the feasibility, acceptability, and preliminary efficacy of a videoconferencing (VC)-based treatment program in overweight and obese females with BED.Methods:Eighteen participants, aged 20-73, were diagnosed and randomized into either a face-to-face (F2F) group or a VC-based group. In the F2F group, participants received 12 one-on-one weekly counseling sessions from a Licensed Mental Health Counselor and Registered Dietitian Nutritionist. In the VC group, participants received the same counseling through an online telemedicine software. Measured outcomes include retention, adherence to treatment, and attitudinal and behavioral changes of participants.Results:In the end of study, of the 9 participants randomized into each group, 8 (88.9%) F2F participants and 4 (44.4%) VC participants completed the study. On average, F2F finishers attended 94.8% of sessions and completed 66.2% of dietary diaries. VC finishers attended 95.8% of sessions and completed 55.4% of diaries. No changes in weight and binge eating episode were observed in either group. F2F finishers had significant improvement on uncontrolled eating (p = 0.01), emotional eating (p = 0.004), food addiction diagnosis (p = 0.04), loss of control (p = 0.04), and clinical significance (p = 0.04). VC finishers observed significant improvements in eating disorder examination shape concern (p = 0.03) and global score (p = 0.03).Conclusion:VC-based treatment program is feasible and could be effective for BED patients. Long-term large-scale randomized clinical trials are warranted to further assess the efficacy.

Psychometric proprieties of the Italian version of the questionnaire on eating and weight patterns (QEWP-5) and its accuracy in screening for binge-eating disorder in patients seeking treatment for obesity.

The aim of the current study was to assess the psychometric proprieties of the Italian version of the latest edition of the Questionnaire of Eating and Weight Patterns (QEWP-5), evaluating its accuracy in screening patients with binge-eating disorder (BED). The Italian translation of the tool was administered to 604 Italian-speaking adults seeking treatment for obesity. The clinical sample was given the Eating Disorder Examination interview to assess for BED. Participants also completed the Symptom Checklist 90, the Obesity-Related Well-Being and the Binge-Eating Scale. The sensitivity of the QEWP-5 was 0.49, and its specificity 0.93. The positive and negative predictive values were 0.34 and 0.96, respectively. Agreement between QEWP-5 and EDE using Cohen's kappa was 0.35. Nevertheless, among patients with an EDE diagnosis of no BED, those 'QEWP-5-positive' for BED displayed higher eating-disorder and general psychopathology scores, poorer weight-related quality of life, and greater severity of binge-eating behaviours than those 'QEWP-5-negative' for BED. Despite the low concordance with the EDE interview in terms of detecting the presence of BED, the QEWP-5 may be a useful initial screening tool for the clinical assessment of adults seeking treatment for obesity. Level V, Descriptive study.

Effects of a Web-based Binge Eating Disorder Intervention Program on Depression and Quality of Life in Overweight or Obese Females (P16-065-19)

Abstract Objectives Web-based treatment programs have shown encouraging results in reducing symptoms in Binge Eating Disorder (BED) patients in European studies but no significant studies have been conducted with American subjects. This pilot randomized controlled trial aimed to assess the efficacy of a web-based outpatient treatment program in overweight and obese females diagnosed with BED in the United States. Methods A total of 12 overweight or obese women with BED, aged 20–73, were analyzed in this study. In face-to-face (FF) group (n = 8), participants received a total 12 one-on-one weekly counseling from either a mental health counselor or a Registered Dietitian (RD) sessions. In web-based (WB) group (n = 4), participants received the same counseling through an online telemedicine software program. Outcomes were measured at 3 months including questionnaires SCL-90R (Symptom Checklist 90 Revised), BDI-II (Beck Depression Inventory II), and IWQOL-Lite (Impact of Weight on Quality of Life – short form) assessing psychological health, and quality of life. Between group and within group differences were examined. Results In the end of study, significant improvements were observed in WB group for SCL-90R depression scale (P = 0.000), and IWQOL total score (P = 0.02). There were no significant changes in FF participants. There were no differences between two groups in the end of program neither. Conclusions Web-based treatment programs could potentially be an effective approach for binge eating disorder patients. Large scale randomized clinical trials are warranted to further assess the efficacy of web-based approaches in treating eating disorders. Funding Sources Us Women and Girls’ Health Endowed Research Professorship; Complimentary telemedicine software from Fruit Street company.

Weight and age do not account for a worse executive functioning among BED-obese patients.

Research has demonstrated impaired executive functioning among Binge Eating Disorder (BED) patients that could be influenced by age and weight. We aim to compare decision-making, set-shifting and central coherence between BED-obese patients (BED-Ob), non-BED-obese patients (non-BED-Ob), and normal-weight healthy controls (NW-HC) without the influence of these variables. Overall, 35 BED-Ob, 32 non-BED-Ob and 26 NW-HC participants completed the Iowa Gambling Task, the Trail Making Test and the Rey-Osterrieth Complex Figure Test. BED-Ob patients showed higher cognitive impairment compared to NW-HC on decision-making, set-shifting, visual attention and memory. BED-Ob patients have an impaired cognitive profile on decision-making, set-shifting, visual attention and memory but not impaired central coherence. As all groups were aged-matched and no significant differences between BED-Ob and non-BED-Ob participants were evident, our results demonstrate that this impairment is independent from weight/age, pointing out that it is BED itself to account for inefficiencies in cognitive functioning. Level III,case-control study.

Epigenetics in eating disorders: a systematic review.

Eating disorders are complex heritable conditions influenced by both genetic and environmental factors. Given the progress of genomic discovery in anorexia nervosa, with the identification of the first genome-wide significant locus, as well as animated discussion of epigenetic mechanisms in linking environmental factors with disease onset, our goal was to conduct a systematic review of the current body of evidence on epigenetic factors in eating disorders to inform future directions in this area. Following PRISMA guidelines, two independent authors conducted a search within PubMed and Web of Science and identified 18 journal articles and conference abstracts addressing anorexia nervosa (n = 13), bulimia nervosa (n = 6), and binge-eating disorder (n = 1), published between January 2003 and October 2017. We reviewed all articles and included a critical discussion of field-specific methodological considerations. The majority of epigenetic analyses of eating disorders investigated methylation at candidate genes (n = 13), focusing on anorexia and bulimia nervosa in very small samples with considerable sample overlap across published studies. Three studies used microarray-based technologies to examine DNA methylation across the genome of anorexia nervosa and binge-eating disorder patients. Overall, results were inconclusive and were primarily exploratory in nature. The field of epigenetics in eating disorders remains in its infancy. We encourage the scientific community to apply methodologically sound approaches using genome-wide designs including epigenome-wide association studies (EWAS), to increase sample sizes, and to broaden the focus to include all eating disorder types.

Association between binge eating disorder and psychiatric comorbidity profiles in patients with obesity seeking bariatric surgery

BackgroundEating disorders could be an important factor in the development of obesity, but psychiatric comorbidities are very heterogeneous in patients with obesity. Moreover, relationship between binge eating disorder and other psychiatric comorbidities is not clear. Our objective was to identify psychiatric comorbidity profiles of bariatric surgery candidates and to analyze the association between these profiles and binge-eating disorder. MethodsOur sample consisted of bariatric surgery candidates (n = 92) with mean Body Mass Index at 41.3 ± 0.6 kg/m2. To construct profiles, we classified patients according to their psychiatric comorbidities using cluster analysis techniques. We used logistic regression modelling to analyze associations between the presence of binge-eating disorder and the psychiatric comorbidity profiles. ResultsWe identified four profiles of psychiatric phenotypes. One of these profiles was not associated with any psychiatric disorder. Binge eating disorder was significantly associated with two profiles (p < 0.05): a profile with bipolar and obsessive-compulsive disorder (OR = 7.7 [1.7; 35.1]), and a profile with bipolar and panic disorder (OR = 20.7 [3.1; 137.5]). ConclusionsOur multidimensional approach identified certain profiles specifically associated with binge-eating disorder in patients with obesity seeking bariatric surgery. These results may lead to a better understanding of the relationship between obesity and psychiatric disorders.

The effect of dialectical behaviour therapy on binge eating, difficulties in emotion regulation and BMI in overweight patients with binge-eating disorder: A randomized controlled trial

ObjectiveThis study was conducted to determine the effect of dialectical behaviour therapy (DBT) on binge eating disorder (BED), difficulties in emotion regulation (DER), and body mass index (BMI) of patients suffering from BED and overweight. MethodsSixty female binge eating disorder patients of 19–52 old were randomly assigned into two groups. Thirty patients received dialectical behaviour therapy and the rest (i.e. control group) stayed in the waitlist for 10 weeks in the randomized controlled trial. Patients received a total of 20 treatments (two treatments per week). ResultsAfter 10 weeks, DBT resulted in a significant reduction in the BMI of the patients under treatment (+3.49 ± 1.94 vs. +1.93 ± 1.22kg/m2, P< 0.001). Also, meaningful differences were observed in binge eating scale (BES) (+6.73 ± 3.22 vs. +1.36 ± 1.90, P< 0.001) and difficulties in emotion regulation scale (DERS) (+79.30 ± 27.83 vs. −15.43 ± 24.32, P= 0.01) of the treatment group compared to the control group. ConclusionThis study showed that the relation of the DBT intervention had positive effects on BMI, BED and DER.

Food-Related Impulsivity in Obesity and Binge Eating Disorder-A Systematic Update of the Evidence.

The specific eating pattern of Binge Eating Disorder (BED) patients has provoked the assumption that BED might represent a phenotype within the obesity spectrum that is characterized by increased impulsivity. Following the guidelines of the PRISMA statement (preferred reporting items for systematic reviews and meta-analyses), we here provide a systematic update on the evidence on food-related impulsivity in obese individuals, with and without BED, as well as normal-weight individuals. We separately analyzed potential group differences in the impulsivity components of reward sensitivity and rash-spontaneous behavior. Our search resulted in twenty experimental studies with high methodological quality. The synthesis of the latest evidence consolidates conclusions drawn in our initial systematic review that BED represents a distinct phenotype within the obesity spectrum that is characterized by increased impulsivity. Rash-spontaneous behavior in general, and specifically towards food, is increased in BED, while food-specific reward sensitivity is also increased in obese individuals without BED, but potentially to a lesser degree. A major next step for research entails the investigation of sub-domains and temporal components of inhibitory control in BED and obesity. Based on the evidence of impaired inhibitory control in BED, affected patients might profit from interventions that address impulsive behavior.

Delay Discounting of Reward and Impulsivity in Eating Disorders: From Anorexia Nervosa to Binge Eating Disorder.

Evidence points to eating disorder patients displaying altered rates of delay discounting (one's degree of preference for immediate rewards over larger delayed rewards). Anorexia nervosa (AN) patients are believed to have an increased capacity to delay reward, which reflects their ability to override the drive to eat. Contrarily, binge eating disorder (BED) patients are associated with a reduced predisposition to delay gratification. Here, we investigated monetary delay discounting and impulsivity in 80 adult women with EDs (56 AN and 24 BED), diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, and 80 healthy controls. AN-restrictive (AN-R) subtype patients showed less steep discounting rates than BED and AN-bingeing/purging subtype patients. Compared with healthy controls and AN-R patients, BED and AN-bingeing/purging patients presented higher delay discounting and positive and negative urgency levels. Our findings suggest that restriction in AN-R patients is associated with disproportionate self-control, whereas bingeing behaviours could be more driven by emotional states and impulsivity traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n=54) and the other with BED (OB-BED, n=48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.

Parental and Adult Attachment and Eating Symptomology in Eating Disorder Patients and Sine Morbo Individuals

Attachment can contribute to eating disorder symptomology through various paths, including emotion regulation. However, the relationship between parental and adult attachment and emotional eating and other eating disorder symptoms have been barely investigated on comparative samples. This cross-sectional, questionnaire-based online survey aimed to assess the relationship between parental and adult attachment qualities with the eating behavior severity, emotional eating, and the level of depression in 67 female anorexia nervosa, bulimia nervosa, and binge eating disorder patients, compared to 67 female sine morbo individuals. Eating disorder patients less frequently had secure attachment, and were more often fearful or preoccupied than sine morbo individuals. In sine morbo individuals lower adult attachment security, but in patients, lower parental care was related to eating disorder symptoms. In sine morbo individuals, higher preoccupation, but in patients, higher fearfulness and lower care was related to emotional eating. Lower attachment security (OR = 0.54), younger age (OR = 0.93) and higher depression (OR = 1.04) explained 36.6% of the variance of diagnosed eating disorders. A complex interplay could be highlighted between dysfunctional attachment dimensions and eating symptomology in both groups—but with different patterns. Perceived parental care may be influential for eating disorder patients, whilst the degree of adult attachment security can be influential for sine morbo individuals. Lower attachment security was a predictor of eating disorders, which suggests the protective value of enhancing attachment security. However, further attachment-based interventions are required.

Mo1468 - Pilot Study of the Prevalence of Binge Eating Disorder in Patients with Non-Alcoholic Fatty Liver Disease

Mo1468 - Pilot Study of the Prevalence of Binge Eating Disorder in Patients with Non-Alcoholic Fatty Liver Disease

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients

BackgroundVery little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a specialized eating disorder clinic.MethodsIn total 1165 adults with an eating disorder were assessed with a battery of standardized instruments, for measuring inter alia ADHD screening, demographic variables, eating disorder symptoms and psychiatric comorbidity. Chi-square tests were used for categorical variables and Kruskal-Wallis tests for continuous variables.ResultsAlmost one third (31.3 %) of the patients scored above the screening cut off indicating a possible ADHD. The highest prevalence rates (35–37 %) were found in Bulimia Nervosa and Anorexia Nervosa bingeing/purging subtype, while Eating Disorder Not Otherwise Specified type 1–4 and Binge Eating Disorder patients reported slightly below average (26–31 %), and Anorexia Nervosa restricting subtype patients even lower (18 %). Presence of binge eating, purging, loss of control over eating and non-anorectic BMI were related to results indicating a possible ADHD. Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses.ConclusionsThere is a high frequency of ADHD symptoms in patients with binge eating/purging eating disorders that motivates further studies, particularly concerning the effects of ADHD medication. The finding that the frequency of ADHD symptoms in anorexia nervosa with binge eating/purging is as high as in bulimia nervosa highlights the need also for this group.

Eating attitudes of anorexia nervosa, bulimia nervosa, binge eating disorder and obesity without eating disorder female patients: differences and similarities

The objective was to compare eating attitudes, conceptualized as beliefs, thoughts, feelings, behaviors and relationship with food, of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) patients and a group of obese (OBS) without eating disorders (ED). Female patients from an Eating Disorder (ED) Unit with AN (n=42), BN (n=52) and BED (n=53) and from an obesity service (n=37) in Brazil answered the Disordered Eating Attitude Scale (DEAS) which evaluate eating attitudes with 5 subscales: relationship with food, concerns about food and weight gain, restrictive and compensatory practices, feelings toward eating, and idea of normal eating. OBS patients were recruited among those without ED symptoms according to the Binge Eating Scale and the Questionnaire on Eating and Weight Patterns. ANOVA was used to compare body mass index and age between groups. Bonferroni test was used to analyze multiple comparisons among groups. AN and BN patients presented more dysfunctional eating attitudes and OBS patients less dysfunctional (p<0.001). For DEAS total score, AN and BN patients were similar and all other were different (p<0.001). Similarities suggested between BN and BED were true just for the “Relationship with food” and “Idea of normal eating.” BED patients were worst than OBS for “Relationship with food” and as dysfunctional as AN patients — besides their behavior could be considered the opposite. Differences and similarities support a therapeutic individualized approach for ED and obese patients, call attention for the theoretical differences between obesity and ED, and suggest more research focused on eating attitudes.