Dr. Devlin began his presentation by defining binge eating disorder as characterized by regular episodes of uncontrolled eating. Compulsive overeating is another name for the same disorder, he pointed out. Binge eating disorder affects non-obese as well as obese persons, although those who seek treatment are typically obese. Studies using double-labeled water have reported that obese persons eat more than non-obese persons.

Dr. Devlin pointed out that binge eating disorder is a provisional diagnosis found in Appendix B of the DSM-IV; final criteria require further study. Binge eating disorder has many presentations: conceptual models focus on 1) overeating due to altered satiety mechanisms or disturbed eating patterns; 2) behavior associated with distress regarding body weight, shape, and image; 3) overeating associated with depression; and (4) a variant of bulimia nervosa. Accordingly, binge eating disorder may respond selectively to different treatments.

In the first model, Dr. Devlin noted an association between obesity and binge eating, but pointed out that it is not yet known whether binge eating patterns contribute to the onset and/or maintenance of obesity in these patients or, conversely, if they result from the patient's obesity and attempts to lose weight. Binge eaters cycle through alternating periods of overeating and controlled eating. Standard behavioral treatment is used to manage all types of obesity.

The second model views binge eaters as distressed about body image and obesity. Distressed binge eaters usually control their eating until they feel defeated about their inability to control it. They then relapse and resume binge eating. Identifying reasons for this distress is the focus of treatment.

A connection between obesity and depression has documented: binge eaters have higher rates of depression when compared with obese non-binge eaters. Some physicians view binge eating as a variant of bulimia nervosa distinct from non-purging bulimia nervosa. Treatment includes cognitive behavioral therapy and antidepressant medications.