binge-eating disorder

n. Binge-eating disorder is characterized by recurrent episodes of binge eating in the absence of regular use of inappropriate compensatory behaviors that are characteristic of bulimia nervosa and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. To be characterized as having a binge-eating disorder, the individual must exhibit behaviors of binge eating at least 2 days a week for 6 months. An episode of binge eating is characterized by the following:

• eating in a discrete period of time (e.g., within any 2-hour period) an amount of food that is definitely larger than most people would eat during a similar period under similar circumstances
• 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)

The end of a binge is difficult to establish in the absence of discrete compensatory behaviors such as vomiting. Therefore, the bingeeating episodes are associated with three (or more) of the following:

• eating much more rapidly than normal
• eating until feeling uncomfortably full
• eating large amounts of food when not feeling physically hungry
• eating alone because of embarrassment about how much one is eating
• feeling disgusted with oneself, depressed, or very guilty after overeating

There is a marked distress among individuals with binge-eating disorder due to the loss of control one exhibits and the implications of a binge for one’s weight and medical health. Approximately one-third of obese patients seeking treatment meet the criteria of a binge-eating disorder and 10-20% of individuals with binge-eating disorder are obese.

The physical complications due to bingeeating disorder include hypertension, congestive heart failure, gastric dilation/rupture (from binges), gallstones, inflammation of the liver (liver failure), decreased fertility, osteoarthritis, type II diabetes, gout, and sleep apnea. Individuals who have binge-eating disorder are also at an increased risk of cancer and death due to complications of obesity.

Therapies for binge-eating disorder include cognitive-behavioral therapy, interpersonal psychotherapy, and antidepressant treatment. However, combination treatment of antidepressants plus cognitive-behavioral therapy does not yield a greater reduction in binge eating compared to cognitive-behavioral therapy or weight loss therapy alone. Interpersonal psychotherapy applied in a group setting is also as effective as cognitive-behavioral therapy for individuals with binge-eating disorder. Exercise and a good nutrition plan are also advised during treatment.

-TJM