An investigation of objective and subjective types of binge eating episodes in a clinical sample of people with co-morbid obesity (original) (raw)

Binge eating behavior in patients with eating disorders

Obesity research, 1994

The purpose of this study was to determine whether the objectively observed binge eating behavior of obese subjects meeting the proposed DSM-IV criteria for binge eating disorder would be similar to that observed in patients with bulimia nervosa. Non-obese patients with bulimia nervosa (BN), obese subjects with binge eating disorder (BED), obese and non-obese women without eating disorders were each instructed to binge eat single- and multiple-item meals. In the multiple-item meal, the obese subjects with BED ate significantly more (1515 kcal) than obese subjects without BED (1115 kcal), but they ate less than the normal-weight bulimic patients (2680 kcal). The non-obese controls ate amounts similar to the obese non-binge-eating-disordered group (1093 and 1115.2 kcal, respectively). In the single-item meal, consisting of ice cream, patients with BN ate significantly more than any other group (1307 kcal), while obese subjects with or without binge-eating disorder ate significantly more (762 kcal) than non-obese controls (308 kcal). This study has demonstrated that although both BN and BED are characterized by recurrent episodes of binge eating, quantitatively there appear to be differences between the eating disturbances in the two disorders. Because single- and multiple-item meals differ in external cues, these results also suggest that the obese subjects with BED may be disinhibited by external cues, while obese subjects without BED may be inhibited by external cues.

The diagnostic validity of the criteria for binge eating disorder

The International journal of eating disorders, 2008

This paper considers whether the criteria currently used to classify the diagnosis of binge eating disorder (BED) are valid and appropriate. We review evidence that reflects on the validity of the current criteria for binge eating episodes and BED, using literature retrieved through major psychology and psychiatry search engines (e.g., PsycInfo, PubMed). Evidence from experimental research points to the relative importance of episode frequency, the amount of food consumed at episodes, the subjective sense of loss of control over eating, and several additional criteria associated with binge episodes in BED. Evidence on the differences in psychopathology between BED and bulimia nervosa and between BED and obesity without binge eating, as related to diagnostic criteria, is reviewed. Although evidence concerning the diagnostic criteria of BED is mixed, broadening certain diagnostic criteria for binge eating episodes and BED might more accurately reflect the research literature and incre...

The clinical significance of binge eating disorder

International Journal of Eating Disorders, 2003

Objective: Current controversy exists regarding the status of binge eating disorder (BED) as a diagnostic entity. A critique of the literature is provided to address the question of whether BED represents a clinically significant syndrome. Method: The scientific evidence is considered through addressing five questions that are key in evaluating the clinical utility of any mental disorder. Results: Individuals with BED meaningfully differ from individuals without eating disorders, and share important similarities to, yet are distinct from, individuals with anorexia nervosa (AN) and bulimia nervosa (BN). BED is associated with co-occurring physical and mental illnesses, as well as impaired quality of life and social functioning. Questions about the course of the disorder and the optimal treatment regimen for the syndrome need to be explored further. Discussion: BED's distinctive combination of core eating disorder psychopathology, and other co-occurring physical and psychiatric conditions, impaired psychosocial functioning, and overweight constitute an eating disorder of clinical severity and a significant public health problem.

Diagnostic Issues of Binge Eating in Eating Disorders

European Eating Disorders Review

BACKGROUND: Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for eating disorders (EDs) are problematic and due to be revised. One area of debate concerns binge eating. AIMS: We investigated the impact of four aspects of binge eating (binge size, loss of control, frequency of objective and subjective binge eating) assessed by questionnaire and interview in adult ED patients on concurrent and follow-up symptoms. METHOD: Data came from two independent naturalistic Swedish ED databases (N = 2354, with 12-month follow-up; and N = 597, with 36-month follow-up). RESULTS: We found fair concurrent validity of criteria assessed using questionnaire, but poor concurrent validity for interview assessment, and no prognostic validity regardless of assessment method. CONCLUSIONS: The findings give support to some planned DSM-5 revisions, but challenge the assumption of binge eating as a useful diagnostic criterion, as well as having implications for measurement. Copyright © 201...

Psychiatric disorders among obese binge eaters

International Journal of Eating Disorders, 1990

This study compared the prevalence of psychiatric disorders among obese binge eaters (n = 25) and obese non-binge eaters (n = 25) of similar age and weight. Subjects were interviewed by clinicians who were blind to the patients' binge status using the Diagnostic Interview Schedule. Sixty percent of bingers met criteria for one or more psychiatric disorders, compared with 28% of nonbingers, with differences most apparent in affective disorder; 32% of obese bingers reported a history of affective disorder versus only 8% of nonbingers. Obese binge eaters also reported significantly more psychiatric symptoms, especially symptoms of depression, anxiety, and sexual dysfunction.

Medical comorbidity of binge eating disorder

Eating and weight disorders : EWD, 2016

To gain further understanding of the general medical comorbidity of binge eating disorder (BED) beyond its association with obesity. We reviewed studies of general medical comorbidity in people with BED or clinically significant binge eating behavior beyond obesity. We also reviewed studies of BED in specific medical conditions. Three broad study categories of medical comorbidity in BED were found: cross-sectional studies of medical conditions in BED; prospective studies of medical conditions in BED; and studies of BED in specific medical conditions. Cross-sectional epidemiologic data suggest that BED is associated with medical conditions related to obesity, including diabetes, hypertension, dyslipidemias, sleep problems/disorders, and pain conditions, and that BED may be related to these conditions independent of obesity and co-occurring psychiatric disorders. Prospective data suggest that BED may be associated with type 2 diabetes and metabolic syndrome. BED or binge eating behavi...

Characteristics of binge eating disorder in relation to diagnostic criteria

Neuropsychiatric disease and treatment, 2016

The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included "binge eating disorder," DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and "shape and weight concerns." Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors' knowledge and/or on a review of the reference lists from relevant articles obtained through the literatu...

Refining the definition of binge eating disorder and nonpurging bulimia nervosa

The International journal of eating disorders, 2003

The diagnostic concept of binge eating disorder (BED) was introduced in response to the clinical observation of Stunkard (1959) that some people with obesity have recurrent episodes of binge eating. We suggest that the DSM-IV concept of BED has resulted in the recruitment of heterogeneous research samples, amongst which are some people with BED, as described by Stunkard, some with bulimia nervosa, some with other types of eating disorder, and some with no eating disorder. We consider the difficulties distinguishing BED from other forms of overeating, especially in patients with obesity, and from nonpurging bulimia nervosa. We propose revised diagnostic criteria for BED and bulimia nervosa that are designed to minimize these problems.