Eating disorders are amongst the most commonly encountered psychiatric disorders experienced by young women. Binge eating disorder (BED) has received some support as a distinct pathology, but is hard to disentangle from other kinds of behaviours. This qualitative study explored awareness and knowledge of BED amongst a group of 18 inner-city general practitioners in NW England. Thematic coding of their accounts suggested a dichotomous tension. (1) Subjects were largely unaware of the existence of BED, and found it difficult to conceptualize its diagnosis and management in primary care. (2) Subjects framed BED as a ‘disorder’ that was firmly within the sphere of patients' personal responsibility, and recognized that psychological distress would be an important causal factor in its aetiology. Subjects were reluctant to consider BED as a diagnosis for obese patients because of the absence of services for onward referral, and because of uncertainties about effective treatment.