Binge Eating Disorder

Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating.

In 1997, binge eating disorder (BED) was included into the DSM-IV as a provisional diagnostic category requiring further study. About 30% of the participants in weight loss programs meet criteria for BED. The prevalence of BED in the general population is 2%; BED is 1.5 times more common in women than men. In treating obese patients with BED there are several potential goals of treatment, including cessation of binge eating and improvement of eating-related psychopathology (e.g. concerns about weight and shape, restraint eating), weight loss or prevention of further weight gain, improvement of physical health, and reduction of psychiatric comorbidity. Contrary to expectations, weight loss programs do not appear to worsen the eating disorder, and successful treatment of binge eating does not automatically promote weight loss. Controlled treatment studies have shown that psychotherapeutic approaches and drug treatment may successfully reduce binge eating episodes in patients with BED. Remission rates are generally high (e.g. 50% and more following cognitive behavioral therapy), and the overall prognosis is better than for patients with bulimia nervosa.