Abstract
Background
Metabolic and bariatric surgery is effective for sustained weight loss, but binge
eating disorder (BED) can be associated with poorer outcomes and lead to weight regain.
A common measure used to screen for BED is the Binge Eating Scale (BES). A BES cut-off
score of ≥17 previously identified patients who have a high likelihood of meeting
criteria for BED. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lowered the threshold for meeting criteria for BED, and the
psychometrics of the BES need to be reevaluated.
Objective
The objective of the current investigation is to evaluate whether alternative cut-scores
on the BES result in better classification of BED based on the DSM-5 revision of the
the BED diagnostic criteria.
Setting
Academic medical hospital in the Midwestern United States.
Methods
Patients (n =1133) seeking metabolic and bariatric surgery were randomly split into
2 samples for validation and replication. The validation sample consisted of 561 patients
(30.1% men, 35% non-White). The replication sample consisted of 572 patients who were
demographically similar to the first random split sample (e.g., 25.3% men, 34.4% non-White).
Results
Of these patients, 13.5% met DSM-5 criteria for BED in the validation sample and 13.8%
met criteria for BED in the replication sample. Lowering the interpretative cut-off
to ≥15 on the BES yielded sensitivity values of >.72, specificity values of >.67,
and an accurate classification of BED in >.70 of patients across both samples. These
classification values were as good as or better than the standard cut-off score of
≥17 in both samples.
Conclusions
The BES is appropriate to screen for BED in patients who are seeking bariatric surgery.
A 2-point decrease in the BES score for clinical interpretation is appropriate—lowering
it from 17 to 15 given DSM-5 updates to diagnostic criteria.
Keywords
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 15,
2023
Received:
September 16,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
