This study was conducted to examine the degree to which binge eating and psychological distress among obese adults are associated with a variety of behavioral patterns and competencies that could substantially affect weight control. Subjects were 167 obese people who sought help in a long-term cognitive behavioral treatment program. Subjects were divided into three groups depending on their level of psychological distress and severity of binge eating. Subjects were also assessed on coping style, subjective distress, weight history, and exercising and eating patterns. Results demonstrated substantial differences between those reporting relatively few problems with binge eating or psychological distress as opposed to those with noteworthy problems in both. The presence of either severe binge eating or psychological distress was associated with problems in regulating food-related behavior and, more generally, to problematic coping styles. These findings support the importance of in-depth assessment when treating obesity, more intensive treatment for some subgroupings, and long-term studies that incorporate comprehensive pretreatment process measure of eating style and psychological distress.