13.2 Binge Eating Disorder and Other Specified Feeding or Eating Disorders

Binge eating disorder involves recurrent episodes of consuming large amounts of food, accompanied by a sense of lack of control. It's more common than anorexia and bulimia combined, affecting about 3.5% of women and 2% of men in the US.

Other specified feeding or eating disorders don't meet full criteria for anorexia, bulimia, or binge eating disorder. These include atypical anorexia, low-frequency bulimia, and night eating syndrome. Understanding these disorders helps in recognizing and treating diverse eating-related issues.

Binge Eating Disorder and Other Specified Feeding or Eating Disorders

Definition of binge eating disorder

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• Binge eating disorder (BED) characterized by recurrent episodes of consuming unusually large amount of food in short period accompanied by sense of lack of control
• Diagnostic criteria for BED include:
  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone due to embarrassment about amount of food consumed
  • Feeling disgusted, depressed, or guilty after overeating
• Episodes occur at least once a week for three months
• Binge eating not associated with regular compensatory behaviors (purging, excessive exercise)

Characteristics of binge eating disorder

• BED more common than anorexia nervosa and bulimia nervosa combined
• Typically develops in early adulthood but can occur at any age
• Affects approximately 3.5% of women and 2% of men in United States
• Higher prevalence among individuals seeking weight loss treatment (30-40%)
• Associated with obesity but not all individuals with BED overweight or obese
• Comorbidity with other psychiatric disorders such as mood disorders (depression), anxiety disorders (generalized anxiety disorder), and substance use disorders (alcohol use disorder)

Other specified eating disorders

• Other specified feeding or eating disorders (OSFED) encompass eating disorders that do not meet full diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder
• Examples of OSFED include:
  • Atypical anorexia nervosa: Significant weight loss and restrictive eating behaviors but weight remains within or above normal range
  • Bulimia nervosa of low frequency and/or limited duration: Binge eating and compensatory behaviors occur less than once a week and/or for less than three months
  • Binge eating disorder of low frequency and/or limited duration: Binge eating episodes occur less than once a week and/or for less than three months
  • Purging disorder: Recurrent purging behavior to influence weight or shape without binge eating episodes
  • Night eating syndrome: Recurrent episodes of night eating characterized by excessive food consumption after evening meal or during nighttime awakenings

Binge eating vs other eating disorders

• BED vs Bulimia Nervosa:
  • In BED, binge eating episodes not followed by regular compensatory behaviors (purging, excessive exercise) whereas in bulimia nervosa they are
  • Individuals with BED often have higher body weights compared to those with bulimia nervosa
• BED vs Anorexia Nervosa:
  • Individuals with BED do not engage in restrictive eating behaviors or have fear of gaining weight which are characteristic of anorexia nervosa
  • BED associated with overweight or obesity while anorexia nervosa characterized by significantly low body weight
• BED vs OSFED:
  • BED meets full diagnostic criteria for specific eating disorder while OSFED encompasses eating disorders that do not meet full criteria for anorexia nervosa, bulimia nervosa, or BED
  • OSFED includes subthreshold or atypical presentations of eating disorders such as binge eating or purging that occurs at lower frequency or for shorter duration than required for BED or bulimia nervosa diagnosis