*4.4. Limitations*

Of course, interpreting these findings is subject to limitations. First, the current study investigated the psychopathological space between obese individuals with and without BED in a cross-sectional design. Although the evidence largely supports the idea of BED and obesity forming part of a broad spectrum of eating-related behaviors and disorders in terms of childhood adversities and different aspects of general and eating-related psychopathology, the cross-sectional design prevents any exploration of a transition of individuals from one group to another. This gap may be addressed in studies using similar methods but with a longitudinal design. Second, due to the fact that we included both incident (treatment-naive) as well as prevalent (treatment-experienced) patients, we cannot exclude the possibility that prior recommendations and treated aspects of eating disorder-specific pathology could have modified the answers collected in the questionnaires, limiting interpretations as to whether the observed patterns are sensitive to change. Third, and relatedly, it must be noted that control participants were primarily recruited among individuals considering bariatric surgery as an option for weight loss (OB group), hospital staff, and medical students (normal-weight controls). Although participant groups were comparable in terms of sociodemographic features, we cannot exclude that the observed data pattern is sensitive to sample composition differences.
