Binge eating disorder (BED) is characterized by binge eating without subsequent purging episodes. The disorder was first described in 1959 by psychiatrist and researcher Albert Stunkard as "night eating syndrome" (NES). The term "binge eating " was coined to describe the same binging-type eating behavior but without the exclusive nocturnal component.[1] Binge eating is one of the most prevalent eating disorders among adults,[2] though there tends to be less media coverage and research about the disorder in comparison to anorexia nervosa and bulimia nervosa.
Previously considered a topic for further research exploration, binge
eating disorder was included in the eating disorders section of the DSM-5 in 2013.[3]
BED is present in 0.8% of male U.S. adults and 1.6% of female U.S. adults in a given year.[3]
"A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa."[5]
Binge eating is a core symptom of binge eating disorder; however, not everyone who binge eats has binge eating disorder.[6] An individual may occasionally binge eat without experiencing many of the negative physical, psychological, or social effects of binge eating disorder. This example may be considered an eating problem (or not), rather than a disorder.
However, other research suggests that binge eating disorder can also be caused by environmental factors and the impact of traumatic events. One study showed that women with binge eating disorder experienced more adverse life events in the year prior to the onset of the development of the disorder, and that binge eating disorder was positively associated with how frequently negative events occur.[9] Additionally, the research found that individuals who had binge eating disorder were more likely to have experienced physical abuse, perceived risk of physical abuse, stress, and body criticism.[9][9] Other risk factors may include childhood obesity, critical comments about weight, low self-esteem, depression, and physical or sexual abuse in childhood.[10] A few studies have suggested that there could be a genetic component to binge eating disorder,[2] though other studies have shown more ambiguous results. Studies have shown that binge eating tends to run in families and a twin study by Bulik, Sullivan, and Kendler has shown a, "moderate heritability for binge eating" at 41 percent.[11] More research must be done before any firm conclusions can be drawn regarding the heritability of binge eating disorder. Studies have also shown that eating disorders such as anorexia and bulimia reduce coping abilities, which makes it more likely for those suffering to turn to binge eating as a coping strategy.[12]
A correlation between dietary restraint and the occurrence of binge eating has been shown in some research.[6] While binge eaters are often believed to be lacking in self-control, the root of such behavior might instead be linked to rigid dieting practices. The relationship between strict dieting and binge eating is characterized by a vicious circle. Binge eating is more likely to occur after dieting, and vice versa. Several forms of dieting include delay in eating (e.g., not eating during the day), restriction of overall calorie intake (e.g., setting calorie limit to 1,000 calories per day), and avoidance of certain types of food (e.g., "forbidden" food, such as sugar, carbohydrates, etc.) [13][14] Strict and extreme dieting differs from ordinary dieting. Some evidence suggests the effectiveness of moderate calorie restriction in decreasing binge eating episodes among overweight individuals with binge eating disorder, at least in the short-term.[15][16]
BED is present in 0.8% of male U.S. adults and 1.6% of female U.S. adults in a given year.[3]
Signs and symptoms
The following are DSM-5 criteria that must be present to make a diagnosis of binge eating disorder. Studies have confirmed the high predictive value of these criteria for diagnosing BED.[4]"A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of 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 what most people would eat in a similar period of time 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).
- 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 feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa."[5]
Binge eating is a core symptom of binge eating disorder; however, not everyone who binge eats has binge eating disorder.[6] An individual may occasionally binge eat without experiencing many of the negative physical, psychological, or social effects of binge eating disorder. This example may be considered an eating problem (or not), rather than a disorder.
Causes
Before binge eating disorder received its own category in the DSM-5 in 2013, there was resistance to give binge eating disorder the status of a full-fledged eating disorder because many perceived binge eating disorder to be the cause of individual choices.[7] More research is needed to uncover the causes of binge eating disorder. Previous research has focused on the relationship between body image and eating disorders, and concludes that disordered eating might be linked to rigid dieting practices.[citation needed][8] In the majority of cases of anorexia, extreme and inflexible restriction of dietary intake leads at some point to the development of binge eating, weight regain, bulimia nervosa, or a mixed form of eating disorder not otherwise specified. Binge eating may begin when individuals recover from an adoption of rigid eating habits. When under a strict diet that mimics the effects of starvation, the body may be preparing for a new type of behavior pattern, one that consumes a large amount of food in a relatively short period of time.However, other research suggests that binge eating disorder can also be caused by environmental factors and the impact of traumatic events. One study showed that women with binge eating disorder experienced more adverse life events in the year prior to the onset of the development of the disorder, and that binge eating disorder was positively associated with how frequently negative events occur.[9] Additionally, the research found that individuals who had binge eating disorder were more likely to have experienced physical abuse, perceived risk of physical abuse, stress, and body criticism.[9][9] Other risk factors may include childhood obesity, critical comments about weight, low self-esteem, depression, and physical or sexual abuse in childhood.[10] A few studies have suggested that there could be a genetic component to binge eating disorder,[2] though other studies have shown more ambiguous results. Studies have shown that binge eating tends to run in families and a twin study by Bulik, Sullivan, and Kendler has shown a, "moderate heritability for binge eating" at 41 percent.[11] More research must be done before any firm conclusions can be drawn regarding the heritability of binge eating disorder. Studies have also shown that eating disorders such as anorexia and bulimia reduce coping abilities, which makes it more likely for those suffering to turn to binge eating as a coping strategy.[12]
A correlation between dietary restraint and the occurrence of binge eating has been shown in some research.[6] While binge eaters are often believed to be lacking in self-control, the root of such behavior might instead be linked to rigid dieting practices. The relationship between strict dieting and binge eating is characterized by a vicious circle. Binge eating is more likely to occur after dieting, and vice versa. Several forms of dieting include delay in eating (e.g., not eating during the day), restriction of overall calorie intake (e.g., setting calorie limit to 1,000 calories per day), and avoidance of certain types of food (e.g., "forbidden" food, such as sugar, carbohydrates, etc.) [13][14] Strict and extreme dieting differs from ordinary dieting. Some evidence suggests the effectiveness of moderate calorie restriction in decreasing binge eating episodes among overweight individuals with binge eating disorder, at least in the short-term.[15][16]
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