Binge Eating Disorder

Overview

  • More common in young adults, with lifetime prevalence of 1.9% (binge eating > bulimia > anorexia)

  • As with many eating disorders, more frequent in females than males

  • Median age is 23 years old

Main Concepts:

  • No inappropriate compensatory behaviors

  • Lack of control during eating

Notable Features:

  • Often comorbid with phobias, major depression, PTSD, and alcohol abuse/dependence

High Yield:

  • Patients often feel ashamed and refrain from seeking help

  • Overeating results in medical conditions like diabetes mellitus

Other:

  • Look for clues such as large weight fluctuations

Definition

Criteria:

  1. Eating more rapidly than normal

  2. Eating until uncomfortably full

  3. Eating large amounts when not hungry

  4. Eating alone out of embarrassment by the quantity consumed

  5. Disgusted with oneself, depressed, or guilty after overeating

"Binge eating" = consuming an amount of food in a discrete period of time (e.g. 2 hours) that is definitively more than what most people would eat in a similar amount of time and under similar circumstances.

No compensatory behaviors, compared to bulimia.

Episodes of binge-eating occur, on average, at least 1 / week for 3 months. The level of severity is based on the exact number of binge eating episodes per week for a given patient:

  1. Mild (1 - 3 episodes / week)

  2. Moderate (4 - 7)

  3. Severe (8 - 13) (more than once a day)

Diagnostics


Assessment


Management

Treatment modalities:

  • Individual psychotherapy and behavioral therapy with a strict diet and exercise program

    • Cognitive behavioral therapy (CBT)

    • Behavioral weight loss therapy

  • Treatment of comorbid disorders

  • Pharmacotherapy as adjuncts to promote weight loss, including stimulants to suppress appetite

    • SSRI

    • Stimulants like lisdexamfetamine

The use of group therapy and stimulant medication together is more effective than either alone.

Resources