Previous studies tested the efficacy of sertraline in Binge Eating Disorder (BED) over a period of 6 weeks. The present open study assesses the efficacy of sertraline over a period of 24 weeks in obese persons with binge eating behaviour (with or without the full criteria for BED) confirmed by high scores on the Binge Eating Scale (BES). Thirty-two obese outpatients (14 with BED and 18 without full criteria for BED), without co-occurring psychiatric comorbidities, were treated with sertraline (dose range 100-200 mg/d). Subjects were assessed at baseline and at 8, 12 and 24 weeks of treatment for number of binges, weight and psychopathology. After 8 weeks of treatment a significant improvement in the BES score and a significant weight loss emerged. These results were maintained over 24 weeks. A moderate drop out rate was detected, but no significant association with the severity of side effects was found. Further studies are needed to confirm the usefulness of sertraline in the treatment of patients with BED and also in binge eaters with a less severe eating psychopathology.