This study aims to assess the metabolic profile and body composition of patients with obesity with and without symptoms of binge eating disorder (BED). The sample consisted of 154 pubertal children and adolescents with obesity who completed the binge eating scale (BES), a validated Portuguese translation indicating the presence of BED. Individuals scoring 18 or higher on the BES were considered to have symptoms of BED. Laboratory tests were conducted, and body composition was evaluated using dual X-ray absorptiometry. Among the 154 adolescents with obesity, the mean (SD) chronological age was 12.8 (± 2.5) years. Among them, 43 (27.9%) individuals exhibited symptoms of BED, comprising 12 boys (27.9%) and 31 girls (72.1%). Patients with symptoms of BED demonstrated a higher mean basal insulin value (p = 0.035) and zBMI (p = 0.005). Analysis of body composition revealed that individuals with symptoms of BED had a higher percentage of trunk fat (p = 0.016), as well as higher fat mass index (FMI) (p = 0.002) and lean body mass index (LBMI) (p = 0.031). Twenty-seven percent of children and adolescents with obesity displayed symptoms of BED. Those with symptoms of BED exhibited a higher percentage of fat mass in the trunk, along with elevated body fat mass index and basal insulin concentration.