Rationale: Binge drinking (BD), characterized by recurring alternations between intense intoxication episodes and abstinence periods, is the most frequent alcohol consumption pattern in youth and is growing in prevalence among older adults. Many studies have underlined the specific harmful impact of this habit by showing impaired abilities in a wide range of cognitive functions among binge drinkers, as well as modifications of brain structure and function.Aims: Several controversies and inconsistencies currently hamper the harmonious development of the field and the recognition of BD as a specific alcohol consumption pattern. The main concern is the absence of consensual BD conceptualization, leading to variability in experimental group selection and alcohol consumption evaluation. The present paper aims at overcoming this key issue through a two-step approach.Methods and conclusions: First, a literature review allows proposing an integrated BD conceptualization, distinguishing it from other subclinical alcohol consumption patterns. Six specific characteristics of BD are identified, namely, (1) the presence of physiological symptoms related to BD episodes, (2) the presence of psychological symptoms related to BD episodes, (3) the ratio of BD episodes compared to all alcohol drinking occasions, (4) the frequency of BD episodes, (5) the consumption speed and (6) the alternation between BD episodes and soberness periods. Second, capitalizing on this conceptual clarification, we propose an evaluation protocol jointly measuring these six BD characteristics. Finally, several research perspectives are presented to refine the proposed conceptualization.

Background: Binge eating disorder (BED) is very frequently observed in patients considered for weight loss surgery and seems to influence their outcome critically. Literature highlights a global emotional overload in individuals with BED, but little is known on the mechanisms involved. The present study aimed to focus on emotion regulation, impulsivity, depression, and anxiety in people with and without BED and fulfilling inclusion criteria for bariatric surgery. Doing so, we sought to individualize factors related to BED. Then, we examined the contribution of depression, anxiety, emotion regulation difficulties, and impulsivity to inappropriate eating behaviors observed in patients with BED. Methods: A sample of 121 individuals (79.3% female, mean age: 40.82 ± 9.26, mean current body mass index (BMI): 44.92 kg/m² ± 7.55) seeking bariatric surgery were recruited at the Champagne Ardenne Specialized Center in Obesity in Reims, France from November 2017 to October 2018. They were stratified as with or without BED according to the binge eating scale. Characteristics identified in univariate analyses as differentiating the two groups were then included in multivariable analyses. Results: Multivariable analyses showed that limited access to emotional regulation strategies was significantly associated with BED. Furthermore, inappropriate eating behaviors were independently associated with age, depression severity, anxiety, emotional dysregulation, and impulsivity in BED group. Conclusions: The present findings are indicative of an association between emotion deficit and BED in obese patients seeking bariatric surgery. Patients with BED could benefit from the addition of an emotion regulation intervention.