Stepped Care Treatment for Binge-Eating

Inclusion Criteria: * Adult female, 18 years to 60 years * Meets DSM-IV criteria for Binge Eating Disorder * Resides within commuting distance * Consents to research protocol, i.e. * 18-24 months in assessment and treatment * willing to be part of a biological assessment/physiological assessment * have to be prepared that they will receive a brief individual treatment and if this does not work for them, that they will receive more intensive treatment including both group and individual treatment. * agreement not to see other health professionals unless recommended * seeing their own Primary care Physician/Nurse Practitioner for medical screening prior to study (i.e., before being allocated a guided self-help therapist) * payment for their own medical assessment, monitoring, and medication if needed Exclusion Criteria: * Anorexia nervosa * Schizophrenia, Schizophreniform, or Schizoaffective Disorders, Psychosis NOS, or Bipolar Mood Disorder * Needs priority treatment for other debilitating conditions, e.g. current substance dependence requiring inpatient detox * chronic absence of shelter * IQ less than 70 * Impending jail/prison, court order to treatment, court order to treatment or to jail, or agency order to treatment or to loss of child custody (due to consequent inability to freely drop-out of treatment) * Is pregnant, plans to become pregnant during treatment, or becomes pregnant before random assignment to study condition * Medical instability * Has had or is seeking Gastric bypass surgery * On anti-seizure medication, beta-blockers, asthma medication, medication for heart disease, or any other medication that affects appetite or weight * Psychotropics are acceptable if the doses are stable for at least 3 months prior to screening