Functional assessment and binge eating. A review of the literature and suggestions for future research.

The authors read every paper they could find on binge eating. They looked for studies that asked: what happens right before a binge, and what does the person get out of it?

They found almost none. Most eating-disorder work used surveys, not hands-on tests. So they wrote a map of what was missing and told researchers where to go next.

Only a handful of studies had watched binge eating in real time. None had run full functional analyses like we do for self-injury.

The review shouted one clear point: we need to test triggers and pay-offs the ABA way—antecedent-behavior-consequence—before we treat.

Eugenia Gras et al. (2003) later did exactly what the review begged for. They tracked mood minute-by-minute and showed binges spike positive affect—evidence for negative reinforcement. That single-case study extends the 1997 call into real data.

Melanson et al. (2023) scanned 1,333 functional analyses from 2012-2022. Their giant scoping review includes our target paper and shows the field moved toward brief, outpatient FAs. The binge-eating gap flagged in 1997 is still tiny, but the tools are now ready.

Kleinert et al. (2007) echoed the same plea: streamline FA for clinics. Their ID/DD focus and the eating focus differ, yet both reviews push the same fix—make functional assessment quick and usable outside the lab.

If you treat adults who binge, you can borrow the same FA formats we use for problem behavior. Run a brief alone, attention, demand, and tangible condition. Record what happens to mood and context. You might discover the binge is maintained by escape from aversive thoughts or access to sensory relief. Once you know the function, you can replace the binge with a safer behavior that gives the same pay-off.