Binge Eating Disorder: What You Need to Know

April 24, 2015

Only one-third of patients with eating disorders are ever asked about their problems with food. Screening in primary care is essential.

♦ Binge eating disorder (BED) is the most common eating disorder in the United States. Lifetime prevalence in adult women is approximately 3.5% and in adult men, 2.0%. Prevalence among adolescents is an estimated 1.6 %.♦ Up to one-quarter of obese patients may have BED.♦ Hallmark behavior of BED is frequent episodes of binge eating associated with a feeling of loss of control. Emotional distress afterward is significant. Comorbid depression and other psychiatric conditions are common.♦ Screening for BED and other eating disorders is essential but also challenging because of the shame associated with the behaviors.♦ Cognitive-behavioral therapy is considered the gold standard of psychological treatment.  ♦ There is one FDA-approved agent for BED; a wide range of antidepressants are used with variable success.Click through the slides above for more details on the disorder and its management.__________________________________________________________________References Hsu LKG, Mulliken B, McDonagh B, et al. Binge eating disorder in extreme obesity. Int J Eat Disord. 2002;26:1398-1403.Bulik CM, Sullivan PF, Kendler KS. Medical and psychiatric morbidity in obese women with and without binge eating. Int J Eat Disord. 2002;32:72-78.American Psychiatric Publishing. Food and Eating Disorders. http://www.dsm5.org/documents/eating%20disorders%20fact%20sheet.pdf. Accessed April 10, 2015.Hartmann AS, Gorman MJ, Sogg S, et al. Screening for DSM-5 Other Specified Feeding or Eating Disorder in a Weight-Loss Treatment–Seeking Obese Sample. Prim Care Companion CNS Disord. 2014;16(5). doi:10.4088/PCC.14m01665.Fairburn CG, Cooper Z. The Eating Disorder Examination. In: Fairburn CG, Wilson GT, eds. Binge Eating: Nature, Assessment and Treatment. 12th ed. New York: Guilford Press; 1993:317–360.First MB, Spitzer RL, Gibbon M, et al. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002.Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994;16:363-370.Yanovski S. Binge eating disorder: current knowledge and future directions. Obes Res. 1993;1:306-324.Gormally J, Black S, Duston S, et al. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7:47-55.Garner DM, Olmstead MP, Polivy J. Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord. 1983;2:15-34.Stunkard AJ, Messik S. The three-factor eating questionnaire to measure dietary restraint disinhibition and hunger. J Psychosom Res. 1985;13:137White MA, Whisenhunt BL, Williamson DA, et al. Development and validation of the Food-Craving Inventory. Obes Res. 2002;10:107-114.Williams PM, Goodie J, Motsinger C. Treating eating disorders in primary care. Am Fam Physician. 2008;77:187-195.Brownley KA, Peat CM, La Via M, et al. Pharmacological approaches to the management of binge eating disorder. Drugs. 2015;75:9-32.