How is binge eating disorder diagnosed?

Binge Eating Disorder (BED) is the most common eating disorder in the United States (US). It is characterized by recurrent episodes of binge eating followed by feelings of guilt, shame, or anxiety. Binge eating episodes are defined as eating an unusually large amount of food in a short period of time (e.g., within 2 hours), feeling unable to control one’s eating during the episode, and eating much more rapidly than normal. BED is distinguished from other disorders, such as bulimia nervosa and anorexia nervosa, by the absence of compensatory behaviors, such as purging, excessive exercise, or fasting, after binge eating episodes. BED affects women slightly more often than men.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

To be diagnosed with BED, individuals must meet the following criteria, as specified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
a. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
b. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
2. The binge eating episodes are associated with three (or more) of the following:
a. Eating much more rapidly than normal.
b. Eating until feeling uncomfortably full.
c. Eating large amounts of food when not feeling physically hungry.
d. Eating alone because of feeling embarrassed by how much one is eating.
e. Feeling disgusted with oneself, depressed, or very guilty afterward.
3. Marked distress regarding binge eating is present.
4. The binge eating occurs, on average, at least once a week for 3 months.
5. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Specify if:
In children and adolescents, the behaviors occur at least once a week for at least 3 months.

diagnosis of BED requires a detailed clinical interview. In addition, the following self-report and structured clinical interview instruments may be used to gather information to diagnose BED:

The Binge Eating Scale (BES)
The Binge Eating Disorder Examination (BEDE)
The Eating Disorder Examination Questionnaire (EDE-Q)

These instruments are not used to make the diagnosis of BED, but they may help to gather information about the frequency and severity of binge eating episodes and associated features.

If an individual meets the criteria for BED, the clinician should then assess for the presence of associated features, comorbid psychiatric disorders, and medical complications. The evaluation should also include a comprehensive assessment of eating behaviors and attitudes, body weight and shape concerns, psychological functioning, and medical history..Citation

What are the treatment options for binge eating disorder?

Binge eating disorder (BED) is a serious, life-threatening eating disorder characterized by recurrent episodes of binge eating. Binge eating episodes are associated with a sense of loss of control, distress, and embarrassment. Binge eating disorder is the most common eating disorder in the United States, impacting an estimated 3.5% of women, 1.6% of men, and 1.2% of adolescents.

While there is no one-size-fits-all treatment for binge eating disorder, most people with BED benefit from some form of specialized care. Effective treatments for BED often incorporate a combination of approaches, including cognitive-behavioral therapy, interpersonal therapy, and medication.

Cognitive-behavioral therapy (CBT) is a type of psychotherapy that helps people identify and change negative thoughts and behaviors that contribute to their eating disorder. CBT for BED typically focuses on helping people develop healthier eating habits, cope with difficult emotions, and manage stress.

Interpersonal therapy (IPT) is a type of psychotherapy that focuses on relationships and interpersonal conflict as they relate to eating disorders. IPT for BED can help people understand and cope with relationship problems that may contribute to their disorder.

Medication is often used in conjunction with counseling to treat binge eating disorder. Commonly prescribed medications for BED include antidepressants, anti-obesity drugs, and mood stabilizers.

Binge eating disorder is a serious, life-threatening condition that requires specialized treatment. CBT, IPT, and medication are all effective treatment options for BED.

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