Binge Eating Disorder
Overview
Binge Eating Disorder (BED) is a serious mental health condition characterized by recurrent episodes of excessive food consumption accompanied by a sense of loss of control and psychological distress. It is the most common eating disorder in the United States, affecting approximately 3.5% of women, 2% of men, and up to 1.6% of adolescents. BED is often associated with symptoms of guilt, embarrassment, and distress, as well as the risk of various medical complications, such as obesity and its related conditions.
Classification and Diagnosis
BED is classified under the category of Eating Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 diagnostic criteria for BED include recurrent episodes of binge eating characterized by both consuming an objectively large amount of food within a two-hour period, and a sense of lack of control over eating during the episode. The episodes are associated with at least three of the following: eating more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not physically hungry; eating alone due to embarrassment; and feeling disgusted, depressed, or guilty after overeating. Importantly, binge eating episodes are not associated with regular compensatory behaviors (such as purging, fasting, or excessive exercise) as seen in other eating disorders like Bulimia Nervosa.
Causes and Risk Factors
The exact cause of BED is unknown, but it is believed to result from a combination of genetic, biological, psychological, and environmental factors. Some research suggests that BED may be associated with irregularities in the brain circuits that control food intake and body weight, while other studies have found a higher prevalence of BED among individuals with a family history of the disorder. Psychological factors such as body dissatisfaction, low self-esteem, and difficulty coping with feelings can also contribute to the development of BED. Additionally, societal and cultural pressures to maintain a certain body shape or size may play a role in triggering binge eating behaviors.
Treatment
Treatment for BED typically involves a multidisciplinary approach that includes psychological therapy, nutritional counseling, and medication. Cognitive-behavioral therapy (CBT) is considered the first-line treatment for BED, as it has been shown to reduce binge eating behaviors and improve psychological well-being. Other forms of therapy, such as interpersonal therapy (IPT) and dialectical behavior therapy (DBT), may also be effective. In terms of medication, selective serotonin reuptake inhibitors (SSRIs) and the stimulant lisdexamfetamine have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of BED.
Prognosis
The prognosis for individuals with BED varies widely, with some individuals achieving full recovery while others continue to struggle with binge eating behaviors. Factors that may influence prognosis include the severity of the disorder, the presence of co-occurring mental health conditions, and the individual's level of motivation and adherence to treatment.
Epidemiology
BED affects both men and women, and can occur in individuals of all ages, races, and socioeconomic statuses. However, it is more common in women and often begins in late adolescence or early adulthood. The lifetime prevalence of BED in the general population is estimated to be approximately 2.6%.