Background: Binge eating prevalence may vary by participant characteristics, with implications for overweight/obesity treatment. We aimed to estimate binge eating prevalence across age, sex and BMI severity in adults enrolled in behavioural weight management trials.
Methods: This secondary individual participant data (IPD) meta-analyses included behavioural weight management trials in adults with overweight/obesity that assessed eating disorder outcomes and provided IPD to Eating Disorders In weight-related Therapy Collaboration. Binge eating episodes (≥1 day/week; yes/no) were assessed using the Eating Disorder Examination interview/questionnaire or Eating Disorder Diagnostic Scale. Binge eating severity was assessed using the Binge Eating Scale (moderate/severe scores ≥18; severe scores ≥27). Two-stage IPD meta-analyses estimated prevalence and variation across age, sex (female/male) and BMI (kg/m2). Non-linear effects were estimated with natural spline models and multivariate meta-analysis.
Results: 22 trials (k) were included (n=2,772, 80.9% female, median (IQR) age 45 (37-54) years, BMI 33.2 (29.8-37.9) kg/m2). The prevalence for reporting a binge eating episode was 30% (95%CI:18-46, 95% prediction interval [PI]: 3-88, k=14, n=1,772). Moderate/severe binge eating prevalence was 36% (95%CI: 31-42, PI%: 22-54, k=10, n=1,256), including 12% reporting severe binge eating (95%CI: 10-14, PI%: 10-14, k=9, n=1,123). Five-year age increases were associated with 4% and 6% lower risk of binge eating episodes and moderate/severe binge eating, respectively. Female participants had a 68% higher risk of moderate/severe binge eating compared to male participants. The relationships between BMI and binge eating were non-linear. Between BMI 25-30 binge eating prevalence was likely to increase from 25% to 40%, and mean BES score from 13 to 16. Mean BES score increased again from BMI 40-55 to 19.
Conclusion: Binge eating prevalence varied with age, sex and BMI severity for adults enrolled in behavioural weight management trials. Screening for binge eating in overweight/obesity treatment is warranted, with findings supporting heightened attention toward younger, female participants with higher BMI.