title: Associations among binge eating behavior patterns and gastrointestinal symptoms: a population-based study.
abstract: BACKGROUND
  The psychological symptoms associated with binge eating disorder (BED) have been well documented. However, the physical symptoms associated with BED have not been explored. Gastrointestinal (GI) symptoms such as heartburn and diarrhea are more prevalent in obese adults, but the associations remain unexplained. Patients with bulimia have increased gastric capacity. The objective of the study was to examine if the severity of binge eating episodes would be associated with upper and lower GI symptoms.
  
  
  METHODS
  Population-based survey of community residents through a mailed questionnaire measuring GI symptoms, frequency of binge eating episodes and physical activity level. The association of GI symptoms with frequency of binge eating episodes was assessed using logistic regression models adjusting for age, gender, body mass index (BMI) and physical activity level.
  
  
  RESULTS
  In 4096 subjects, BED was present in 6.1%. After adjusting for BMI, age, gender, race, diabetes mellitus, socioeconomic status and physical activity level, BED was independently associated with the following upper GI symptoms: acid regurgitation (P<0.001), heartburn (P<0.001), dysphagia (P<0.001), bloating (P<0.001) and upper abdominal pain (P<0.001). BED was also associated with the following lower GI symptoms: diarrhea (P<0.001), urgency (P<0.001), constipation (P<0.01) and feeling of anal blockage (P=0.001).
  
  
  CONCLUSIONS
  BED appears to be associated with the experience of both upper and lower GI symptoms in the general population, independent of the level of obesity. The relationship between increased GI symptoms and physiological responses to increased volume and calorie loads, nutritional selections and rapidity of food ingestion in individuals with BED deserves further study.
authors.affiliation: Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: F
authors.initials: F
authors.lastname: Cremonini
authors.forename: M
authors.initials: M
authors.lastname: Camilleri
authors.forename: M M
authors.initials: MM
authors.lastname: Clark
authors.forename: T J
authors.initials: TJ
authors.lastname: Beebe
authors.forename: G R
authors.initials: GR
authors.lastname: Locke
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: L M
authors.initials: LM
authors.lastname: Herrick
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002032:Bulimia / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult