• Frequency of inappropriate compensatory behaviors, dietary restraint, over-valuation of weight/shape, functional impairment, self-esteem, and social impairment [ Time Frame: Measured at post-treatment, Week 12, Month 6, and Year 1 ] [ Designated as safety issue: No ]
• Body weight [ Time Frame: Measured at post-treatmentand Year 1 ] [ Designated as safety issue: No ]

• Frequency of inappropriate compensatory behaviors, dietary restraint, overevaluation of weight/shape, functional impairment, self-esteem, and social impairment assessed at baseline, 12 weeks, 6 months, and 12 months
• body weight assessed at baseline and 12 months

This study will determine the effectiveness of guided self-help treatment in treating individuals with binge eating disorder (BED).

Binge eating disorder (BED) is a serious condition characterized by compulsive overeating and feelings of powerlessness. The condition often has a negative impact on both physical and emotional health. This study will examine ways to help people determine whether they have BED and will test whether guided self-help (GSH) treatment is effective in treating BED.

Participants will be randomly assigned to receive either GSH treatment or usual clinical care (which may include general support and talk therapy) for 3 months. The GSH treatment is a cognitive behavioral therapy-based program that will be administered over 8 sessions. Participants receiving GSH will be given a book that focuses on dealing with BED; they will also meet with a therapist regularly to have their progress monitored. The Eating Disorders Examination (EDE), self-reports, questionnaires, and surveys will be used to assess participants. Assessments will be conducted at study entry, at Weeks 2 and 4 of the treatment, at the end of the treatment, and at 6 and 12 months post-treatment.

• Eating Disorders
• Bulimia

• Behavioral: Guided self-help cognitive behavioral therapy (CBT)
• Behavioral: Usual clinical care

• Experimental: Participants will receive guided self-help cognitive behavioral therapy
• Active Comparator: Participants will receive treatment as usual

Inclusion Criteria:

• Diagnosis of binge eating disorder (BED) bulimia nervosa (BN), or spectrum BN, defined as recurrent binge eating at least once a week for 3 months
• Body mass index (BMI) between 18 and 45
• Continuous membership in the Kaiser Permanente Northwest Division for at least 12 months prior to study entry

Exclusion Criteria:

• Diagnosis of anorexia nervosa or psychotic disorder
• Significant organic brain syndromes, retardation, pervasive developmental disorder, or autism
• At risk for suicide
• Pregnancy