Binge Eating Scale (BES)

Abstract

The Binge Eating Scale (BES) is an established 16-item self-report questionnaire initially developed by Jim Gormally, Sally Black, Sheryl Daston, and David Rardin in 1982. Engineered specifically to evaluate both the behavioral expressions and the cognitive-affective manifestations of binge eating pathology, the BES serves as a cornerstone psychometric instrument in obesity medicine, clinical psychology, psychiatric epidemiology, and bariatric surgery assessment. The scale comprises 16 polytomous items, each presenting three or four weighted statements calibrated to reflect progressive levels of symptom severity, yielding a continuous global severity score ranging from 0 to 46. Psychometric evaluations across diverse clinical and nonclinical populations consistently substantiate a bifurcated yet overarching unifactorial or two-factor structure (capturing behavioral features, such as excessive consumption and eating velocity, alongside affective/cognitive dimensions including guilt, shame, preoccupation, and perceived loss of control). Established cutoff scores categorize respondents into three clinically actionable tiers: no or minimal binge eating (total score ≤ 17), mild-to-moderate binge eating (18–26), and severe binge eating (≥ 27). The instrument demonstrates outstanding psychometric robustness, characterized by high internal consistency (Cronbach’s alpha ranging from .85 to .91; composite reliability up to .96), robust test-retest stability (r = .84 to .87), and an average variance extracted (AVE) exceeding .60. Criterion-related validity assessments utilizing investigator-based gold-standard semi-structured interviews, notably the Eating Disorder Examination (EDE), demonstrate excellent discriminant precision, yielding an area under the receiver operating characteristic curve (AUC) of .90, accompanied by a diagnostic sensitivity of 81.8% and a specificity of 97.8% at the traditional cutoff threshold of 17/18. This comprehensive review examines the theoretical etiology, structural dimensionality, validity matrix, normative score interpretations, and practical administration protocols of the BES in contemporary psychometric and clinical paradigms.

Keywords

Binge Eating Scale, BES, binge eating disorder, eating psychopathology, psychometrics, loss of control eating, obesity assessment, bariatric surgery evaluation, factor analysis, receiver operating characteristic

Authors

The original Binge Eating Scale was conceptualized and empirically validated in 1982 by a multidisciplinary research team led by Jim Gormally, Ph.D., along with co-investigators Sally Black, M.S., Sheryl Daston, M.S., and David Rardin, Ph.D. At the time of the instrument’s design, the investigators were affiliated with the Department of Psychology and the University Counseling Center at the University of Maryland, College Park, United States. Dr. Gormally and his colleagues operated at the forefront of behavioral medicine, focusing on behavioral weight management paradigms, psychological correlates of treatment adherence, and the phenotyping of non-purging eating dysregulation in individuals seeking obesity treatment.

Purpose

The fundamental purpose of the Binge Eating Scale is to provide a standardized, psychometrically validated, dimensional assessment of the severity of binge eating problems. During the early 1980s, empirical research into eating behaviors in obese populations was significantly constrained by the absence of specialized diagnostic taxonomies; Binge Eating Disorder (BED) had not yet been formally codified as an independent psychiatric diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Clinicians and researchers lacked an efficient, targeted metric capable of capturing the nuanced clinical reality of individuals who experienced debilitating, compulsive eating episodes accompanied by psychological distress, but who did not engage in the regular inappropriate compensatory behaviors (such as self-induced vomiting, excessive exercise, or laxative misuse) that typified bulimia nervosa.

The BES was engineered to address this critical diagnostic void. It fulfills several vital functions across clinical and research environments:

• Epidemiological and Clinical Screening: The BES facilitates rapid, cost-effective screening within primary care clinics, weight-loss programs, psychiatric outpatient clinics, and community cohorts. It identifies individuals suffering from latent or subthreshold binge-eating patterns who warrant formal diagnostic evaluation.
• Pre-Surgical Psychosocial Evaluation: The scale has become a standardized component of psychiatric protocols for bariatric surgery candidates (e.g., Roux-en-Y gastric bypass, sleeve gastrectomy). Preoperative identification of severe binge eating is critical, as untreated loss of control eating is associated with suboptimal postoperative weight loss, anatomical pouch dilation, gastrointestinal complications, and elevated rates of psychological distress.
• Dimensional Stratification of Severity: Unlike categorical binary screening tools that merely record presence or absence, the BES captures a wide continuum of eating pathology. It stratifies respondents into non-bingeing, mild-to-moderate bingeing, and severe bingeing cohorts, allowing clinicians to tailor therapeutic intensity accordingly.
• Measurement of Longitudinal Treatment Outcomes: The instrument demonstrates strong sensitivity to therapeutic change. It is extensively utilized in clinical trials investigating pharmacotherapeutic agents (e.g., selective serotonin reuptake inhibitors, lisdexamfetamine dimesylate) and psychotherapeutic interventions (e.g., Cognitive Behavioral Therapy [CBT], Dialectical Behavior Therapy [DBT], and mindfulness-based interventions).

Psychological Construct

The Binge Eating Scale operationalizes binge eating not as a simple caloric surplus or an isolated failure of willpower, but as a complex multidimensional psychological construct defined by the confluence of overt behavioral manifestations and covert affective-cognitive dimensions. Gormally and colleagues recognized that severe eating pathology entails qualitative alterations in how individuals interact with food, their internal physiological states, and their self-evaluative processes.

1. Behavioral Manifestations

The behavioral facet of the BES targets the tangible, observable actions that characterize objective and subjective binge eating episodes. These behavioral markers reflect an involuntary dysregulation of ingestion mechanics and eating rhythms:

• Rapid Eating and Chewing Speed: Consuming food at an accelerated rate, often described by patients as gulping or swallowing sustenance almost without mastication (Item 2), bypassing cephalic phase satiety signaling.
• Consumption of Massive Quantities Beyond Physical Satiation: Ingesting quantities of food substantially larger than what most individuals would consume in a similar period under similar circumstances, continuing well past fullness to the point of uncomfortable or painful distension and physiological distress (Items 5, 8, and 11).
• Chaotic Meal Patterns and Grazing: Disruption of standard circadian meal intervals, characterized by nocturnal hyperphagia, recurring meal-skipping followed by compensatory bingeing, and continuous unstructured grazing throughout the day (Items 9 and 13).
• Secretive Eating: Concealment of eating behaviors from family members, peers, and social networks due to intense embarrassment and anticipated stigmatization (Item 12).

2. Affective and Cognitive Dimensions

The cognitive-affective facet of the construct captures the internal subjective turmoil, distress, and attentional allocation that precede, accompany, and follow binge episodes. These dimensions correspond closely to modern neurocognitive formulations of compulsive eating:

• Perceived Loss of Control: The central phenomenological hallmark of binge eating, characterized by the subjective sensation that one cannot stop eating, cannot modulate what or how much is being eaten, and experiences helpless resignation in the presence of strong cravings (Items 3 and 10).
• Cognitive Preoccupation with Food and Eating: Excessive mental real estate dominated by pervasive thoughts of food, cravings, and continuous internal struggles regarding dietary restraint (Items 14 and 15).
• Pervasive Post-Binge Negative Affect: Intense feelings of self-directed moral disgust, depressive despair, acute remorse, self-loathing, and overwhelming guilt subsequent to overeating episodes (Item 6).
• Weight/Shape Preoccupation and Body Dysphoria: Over-evaluation of body shape and weight in self-worth formulas, accompanied by social physique anxiety and self-alienation (Item 1).
• Emotional and Non-Homeostatic Eating: Ingestion of food driven by emotional distress, boredom, anxiety, or negative affect rather than homeostatic physiological hunger signals, accompanied by an inability to accurately decode interoceptive hunger-satiety cues (Items 4 and 16).
• Dietary Rigidities and Dichotomous “All-or-Nothing” Thinking: Adherence to inflexible dietary rules, where minor infractions trigger perceived catastrophic failure and immediate escalation into a full-scale binge episode (Item 7).

Theoretical Framework

The conceptual framework underpinning the Binge Eating Scale draws heavily from cognitive-behavioral formulations of eating disorders, classical Restraint Theory, and modern affect regulation models. Although devised prior to the definitive codification of Binge Eating Disorder in the DSM-IV and DSM-5, the BES brilliantly anticipated the modern transdiagnostic cognitive-behavioral model advanced by Christopher Fairburn and colleagues.

1. Restraint Theory and the Abstinence Violation Effect

Pioneered by Peter Herman and Janet Polivy in the mid-1970s, Restraint Theory posits that chronic, cognitively mediated efforts to restrict caloric intake introduce profound physiological and psychological vulnerabilities. In individuals who attempt to enforce rigid dietary boundaries, cognitive control replaces physiological hunger and satiety cues. When these cognitive boundaries are inevitably breached—whether by emotional distress, alcohol consumption, social pressure, or inadvertent ingestion of a “forbidden” food—the individual experiences an Abstinence Violation Effect (AVE), a construct originally framed in addiction psychology by Marlatt and Gordon. The individual concludes that because their diet is ruined, there is no reason to resist further consumption (“I’ve already failed, so I might as well eat everything”). Items 7 and 9 in the BES explicitly operationalize this cycle of rigid fasting followed by catastrophic disinhibition.

2. Transdiagnostic Cognitive-Behavioral Formulation

Fairburn’s cognitive-behavioral model posits that the central psychopathological nucleus of eating disorders is the core belief that self-worth is determined almost exclusively by shape, weight, and their control. This over-evaluation fosters extreme dietary restraint, which precipitates neuroendocrine and cognitive vulnerability to physiological bingeing. When a binge occurs, the individual interprets the loss of control as evidence of personal weakness, generating secondary guilt, self-hatred, and anxiety. This affective distress reinforces the desire to strictly diet again, generating a self-perpetuating feedback loop. The BES captures this entire cycle across its items, documenting how weight dissatisfaction (Item 1) reinforces dietary rigidity, triggering loss of control (Items 3, 10), which terminates in intense shame (Item 6).

3. Affect Regulation and Escape Models

Contemporary psychopathology also situates the BES within the Affect Regulation Model (often termed the Comfort Food or Escape Theory developed by Roy Baumeister). Under this model, binge eating serves an acute, albeit maladaptive, affect-modulation function. High-calorie palatable food triggers rapid dopaminergic and opioid activity in the mesolimbic reward circuitry, providing temporary relief from unpleasant affective states (anxiety, loneliness, boredom, interpersonal conflict). Furthermore, the act of consuming food narrows cognitive focus strictly to immediate sensory stimuli, providing cognitive “escape” from threatening ego-dystonic self-awareness. Items 4 (eating when bored) and 5 (eating when not physically hungry) directly reflect this mechanism.

Validity

The Binge Eating Scale has been subjected to extensive psychometric validation across four decades, demonstrating sterling construct, criterion-related, convergent, and discriminant validity across diverse demographic and clinical populations.

1. Criterion-Related and Diagnostic Validity

The diagnostic precision of the BES has been validated through direct comparison with gold-standard, investigator-administered semi-structured diagnostic interviews, most notably the Eating Disorder Examination (EDE) and the Structured Clinical Interview for DSM Disorders (SCID). In validation studies conducted by Freitas et al. (2006), Celio et al. (2004), Greeno et al. (1995), and recent population-based investigations, the scale consistently demonstrated outstanding diagnostic accuracy:

• Receiver Operating Characteristic (ROC) Metrics: In a rigorous clinical validation cohort evaluated by Ferreira et al. using the EDE 16.0D, the BES produced an Area Under the Curve (AUC) of .90 (95% CI [.76, 1.00], p < .001), indicating outstanding diagnostic precision.
• Sensitivity and Specificity: Utilizing the traditional clinical cutoff threshold of 17 (scores ≤ 17 indicating non-bingeing, ≥ 18 indicating clinically meaningful binge pathology), the instrument yielded a sensitivity of 81.8%, a specificity of 97.8%, and an overall correct classification accuracy of 96.7% in detecting DSM-defined Binge Eating Disorder and Bulimia Nervosa cases.
• In specialized bariatric surgery cohorts (Grupski et al., 2013; Robert et al., 2013), sensitivity values ranging from 84% to 93% have been reported, confirming the scale’s utility in identifying candidates who exhibit clandestine disordered eating patterns.

2. Convergent Validity

Convergent validity is documented by strong, statistically significant correlations between the BES and related self-report and clinician-rated measures of eating pathology, emotional functioning, and general psychological distress:

• Eating Pathology: Scores on the BES correlate strongly with the global score of the Eating Disorder Examination Questionnaire (EDE-Q) (r = .68 to .76, p < .001) as well as its specific subscales: Eating Concern (r = .65 to .72), Shape Concern (r = .58 to .67), and Weight Concern (r = .55 to .64).
• Emotional Eating: The BES demonstrates prominent convergence with the Emotional Eating Scale (EES) (r = .61 to .70, p < .001), particularly across the Depression and Anxiety subscales, confirming that higher BES scores reflect eating in response to emotional triggers.
• General Distress and Affective Disorders: Moderate to strong positive correlations exist between the BES and measures of affective distress, including the Depression Anxiety Stress Scales (DASS-21) (Depression: r = .45 to .56; Anxiety: r = .38 to .48; Stress: r = .42 to .52, p < .001) and the Beck Depression Inventory (BDI-II) (r = .50 to .62), reflecting the extensive psychological comorbidity between binge eating and mood pathology.
• Average Variance Extracted (AVE): In structural equation modeling paradigms, the BES exhibits an AVE of .61, exceeding the recommended benchmark of .50 (Fornell & Larcker, 1981), mathematically confirming that the latent constructs account for the majority of the variance in the indicator items.

3. Discriminant and Known-Groups Validity

The BES reliably differentiates between clinical cohorts with established BED, individuals who are obese without binge eating pathology, individuals with bulimia nervosa, and normal-weight healthy controls. Obese individuals with diagnosed BED exhibit statistically significantly higher mean BES scores (typically M = 28.4 to 34.2) than weight-matched obese non-binge eaters (typically M = 8.1 to 13.5; t-test p < .001, Cohen’s d > 1.80). Furthermore, the scale does not merely proxy Body Mass Index (BMI); while moderate correlations exist between BES scores and BMI in unselected population samples (r = .22 to .35), the association is negligible to low within clinical bariatric samples, demonstrating that the BES measures psychological eating disturbance independently of gross adiposity.

Reliability

The psychometric reliability of the Binge Eating Scale has been established across multiple analytical parameters, including internal consistency, item-total correlations, construct reliability, and temporal stability over time.

1. Internal Consistency

Internal consistency metrics for the BES have been reported across numerous research environments:

• Cronbach’s Alpha (α): The scale demonstrates excellent internal consistency. Gormally et al. (1982) initially reported an alpha of .85. Subsequent cross-validation studies in diverse international samples have yielded alpha coefficients consistently spanning .85 to .91 (e.g., .88 in Portuguese validation cohorts by Ferreira et al.; .89 in Brazilian cohorts by Freitas et al.; .85 in Iranian obese samples by Dezhkam et al.; and .87 in US college samples by Anton et al.).
• Composite Reliability (CR): Structural equation modeling approaches have yielded Composite Reliability values up to .96, far exceeding the standard threshold of .70 and establishing that the latent dimensions possess exceptional internal construct reliability.
• Item-Total Correlations: Corrected item-to-total correlations consistently range from .42 to .74 across 15 of the 16 items. The sole item occasionally exhibiting lower corrected item-total correlation is Item 13 (which assesses meal regularity and eating rhythm; r ≈ .27), reflecting its purely behavioral nature regarding schedule rather than internal distress. Psychometric analyses demonstrate that deleting Item 13 or any other individual item does not improve the overall Cronbach’s alpha.

2. Test-Retest Reliability and Temporal Stability

Temporal stability assessments have shown that the BES provides a stable index of eating psychopathology in the absence of therapeutic intervention:

• In test-retest reliability designs with intervals ranging from 1 to 3 weeks, Pearson correlation coefficients between baseline and follow-up administrations typically range from r = .84 to .87 (p < .001).
• Paired-sample t-tests between initial administration (e.g., M = 6.43, SD = 6.54) and retest intervals (M = 6.47, SD = 6.88) demonstrate absence of statistically significant drift (t(29) = .05, p = .962), confirming the stability of the instrument over short-to-medium test intervals.

Factor Analysis

The internal dimensionality of the Binge Eating Scale has been evaluated using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) across diverse clinical and community cohorts.

1. Unidimensional vs. Two-Factor Models

The literature presents evidence supporting both a parsimonious unidimensional model and an empirically robust two-factor correlated model:

• The Unidimensional Model: Proponents of the single-factor solution argue that all 16 items coalesce around a general latent factor of “Binge Eating Severity.” In EFA models, the first unrotated eigenvalue accounts for a dominant proportion of total variance (typically 38% to 48%), with subsequent factors exhibiting significantly lower scree plateaus. For global screening and diagnostic triaging, calculating a single composite score reflects this underlying unified severity continuum.
• The Two-Factor Correlated Model: The two-factor conceptualization aligns directly with Gormally et al.’s original theoretical blueprint, categorizing items into:
1. Factor 1: Behavioral Manifestations of Bingeing (typically comprising Items 2, 4, 5, 8, 9, 11, 12, and 13), capturing rapid food consumption, nocturnal eating, meal chaos, secret consumption, and gastrointestinal fullness.
2. Factor 2: Affective and Cognitive Dimensions (typically comprising Items 1, 3, 6, 7, 10, 14, 15, and 16), capturing perceived loss of control, dietary self-condemnation, obsessive preoccupation with food, body shame, guilt, and interoceptive confusion.

2. Confirmatory Factor Analysis and Fit Indices

Structural equation modeling studies examining the two-factor correlated structure demonstrate excellent goodness-of-fit indices across both clinical bariatric samples and large community populations:

• Comparative Fit Index (CFI): Values consistently range from .93 to .97 (exceeding the standard ≥ .90 benchmark).
• Tucker-Lewis Index (TLI): Coefficients regularly fall between .92 and .96.
• Root Mean Square Error of Approximation (RMSEA): Point estimates consistently fall between .042 and .062 (with 90% confidence intervals staying below .08), indicating excellent close fit.
• Standardized Root Mean Square Residual (SRMR): Observed values generally span .038 to .051, well within the accepted cutoff of < .08.
• Factor Loadings: Standardized factor loadings across items are predominantly robust, ranging from λ = .51 to .84 across both factors, with only Item 13 periodically demonstrating lower loadings (λ ≈ .32 to .41).

Instrument / Measurement Tool

• Test Type: Standardized clinical self-report questionnaire / psychometric rating scale.
• Format: Polytomous, multiple-choice format containing 16 numbered clusters of descriptive statements.
• Item Count: 16 polytomous item sets.
• Administration Modality: Paper-and-pencil self-completion or computerized digital web-based assessment.
• Administration Time: Approximately 5 to 10 minutes.
• Target Population: Adults and adolescents aged 16 and older; widely deployed in clinical psychology, bariatric medicine, psychiatry, nutritional counseling, and community-based health research.
• Response Scale & Weighted Scoring Mechanics: Each of the 16 items comprises 3 or 4 statements reflecting an increasing trajectory of pathology. Each statement carries a designated point weight ranging from 0 to 3 points:
  • In 4-choice items, statements are weighted: 0 points (first statement, absence of pathology), 1 point (second statement, mild disturbance), 2 points (third statement, moderate disturbance), or 3 points (fourth statement, severe disturbance).
  • In 3-choice items (e.g., Item 6), statements are weighted: 0 points (first statement), 1 point (second statement), or 3 points (third statement, reflecting intense severity).
• Total Score Calculation: The global BES score is obtained by summing the designated point values corresponding to the selected statement across all 16 items. The theoretical total score ranges from 0 to 46 points.
• Established Clinical Cutoff Scores (Marcus, Wing, & Lamparski, 1985):
  • Score ≤ 17: No or minimal binge eating. Represents normal eating behaviors or minimal, non-pathological overeating episodes.
  • Score 18 – 26: Mild to moderate binge eating. Indicates clinically meaningful eating dysregulation, marked loss of control, and elevated emotional distress; warrants structured behavioral assessment.
  • Score ≥ 27: Severe binge eating. Strongly suggestive of full-syndrome Binge Eating Disorder (BED) or Bulimia Nervosa; warrants immediate psychiatric evaluation and targeted evidence-based clinical intervention.

Permissions & Fee and Test Year

• Test Publication Year: Originally published in 1982 by Jim Gormally, Sally Black, Sheryl Daston, and David Rardin in the journal Addictive Behaviors.
• Clinical Cutoff Standardization: Formalized in 1985 by Marsha D. Marcus, Rena R. Wing, and Joyce Lamparski in Addictive Behaviors.
• Copyright & Permissions: The original publication is copyrighted by Elsevier Ltd. However, the Binge Eating Scale itself was published within the original public academic article and is widely treated as an open-access psychometric instrument for non-commercial academic research, educational use, and independent clinical practice.
• Fee: Generally free of charge for non-commercial academic, research, and individual clinical screening purposes. Commercial entities, healthcare corporations incorporating the tool into proprietary software platforms, or commercial pharmaceutical clinical trials should seek formal permissions or clear copyright licensing with the primary publisher/authors.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596
• Anton, S. D., Perri, M. G., & Riley, J. R. (2000). Disordered eating behaviors among college students: Prevalence and validation of the Binge Eating Scale. Eating Behaviors, 1(2), 107–114. https://doi.org/10.1016/S1471-0153(00)00013-4
• Arnow, B., Kenardy, J., & Agras, W. S. (1995). The Emotional Eating Scale: The development of a measure to assess coping with negative affect by eating. International Journal of Eating Disorders, 18(1), 79–90. https://doi.org/10.1002/1098-108X(199507)18:1<79::AID-EAT2260180109>3.0.CO;2-V
• Celio, A. A., Wilfley, D. E., Crow, S. J., Mitchell, J., & Walsh, B. T. (2004). A comparison of the Binge Eating Scale, Questionnaire on Eating and Weight Patterns-Revised, and Eating Disorder Examination, with instructions for interview in the assessment of binge eating disorder and its symptoms. International Journal of Eating Disorders, 36(4), 434–444. https://doi.org/10.1002/eat.20057
• Dezhkam, M., Moloodi, R., Mootabi, F., & Omidvar, N. (2009). Standardization of the Binge Eating Scale among Iranian obese population. Iranian Journal of Psychiatry, 4(4), 143–146.
• Fairburn, C. G., & Beglin, S. J. (1994). Assessment of eating disorders: Interview or self-report questionnaire? International Journal of Eating Disorders, 16(4), 363–370. https://doi.org/10.1002/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#
• Fairburn, C. G., Cooper, Z., & O’Connor, M. (2008). Eating Disorder Examination (Edition 16.0D). In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 265–308). Guilford Press.
• Ferreira, C., Pinto-Gouveia, J., & Duarte, C. (2010). Validation of the Portuguese version of the Eating Disorder Examination 16.0D. Psychological Assessment, 22(3), 621–631.
• Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.1177/002224378101800104
• Freitas, S., Lopes, C. S., Appolinario, J. C., & Coutinho, W. (2006). The assessment of binge eating disorder in obese women: A comparison of different instruments. International Journal of Obesity, 30(7), 1148–1152. https://doi.org/10.1038/sj.ijo.0803241
• Gormally, J., Black, S., Daston, S., & Rardin, D. (1982). The assessment of binge eating severity among obese persons. Addictive Behaviors, 7(1), 47–55. https://doi.org/10.1016/0306-4603(82)90024-7
• Greeno, C. G., Marcus, M. D., & Wing, R. R. (1995). Diagnosis of binge eating disorder: Discrepancies between a interview and two self-report instruments. International Journal of Eating Disorders, 17(3), 253–260. https://doi.org/10.1002/1098-108X(199504)17:3<253::AID-EAT2260170307>3.0.CO;2-M
• Grupski, A. E., Hood, M. M., Hall, B. J., Azarbad, L., Fitzpatrick, S. L., & Corsica, J. A. (2013). Examining the Binge Eating Scale in bariatric surgery candidates. Obesity Surgery, 23(1), 48–53. https://doi.org/10.1007/s11695-012-0738-x
• Hood, M. M., Grupski, A. E., Hall, B. J., Ivan, I., & Corsica, J. A. (2013). Factor structure and psychometric properties of the Binge Eating Scale in bariatric surgery candidates. Surgical Endoscopy, 27(7), 2492–2499. https://doi.org/10.1007/s00464-012-2763-7
• Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation of Australia.
• Marcus, M. D., Wing, R. R., & Lamparski, J. (1985). Binge eating and employee weight loss: The effects of binge eating on attendance and weight loss. Addictive Behaviors, 10(2), 163–166. https://doi.org/10.1016/0306-4603(85)90008-5
• Robert, M., Ferrand, C., Chapurlat, R., & Laville, M. (2013). Evaluation of the Binge Eating Scale as a screening tool for binge eating disorder before bariatric surgery. Obesity Surgery, 23(8), 1261–1267. https://doi.org/10.1007/s11695-013-0902-6
• Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69(6), 1061–1065. https://doi.org/10.1037/0022-006X.69.6.1061
• Timmerman, G. M. (1999). Binge Eating Scale: Further assessment of validity and reliability. Journal of Applied Biobehavioral Research, 4(1), 1–12. https://doi.org/10.1111/j.1751-9861.1999.tb00051.x

13. Items of the Scale (Questionnaire)