Overview of binge eating disorder

Binge eating disorder is characterised by recurrent episodes of uncontrolled overeating—it is the most common eating disorder. It has a global lifetime prevalence of approximately 3% in females and 1% in males. Binge eating disorder has a usual onset during late adolescence and early adulthood. People with a history of trauma, restrictive dieting, family history of bulimia nervosa, or high body mass index (BMI) are at increased risk of developing the disorder. Patients usually present for treatment many years after the onset of symptoms, with concerns about weight loss or medical or psychiatric comorbidities, such as depression and anxiety.

The core diagnostic criteria of binge eating disorder are:

• recurrent episodes of binge eating (at least weekly for 3 or more months) with marked distress and subsequent negative emotions (eg guilt, disgust)
• the absence of regular use of weight-control measures or compensatory behaviours.

Binge eating is usually rapid, solitary, and carried out in the absence of hunger or until the person is uncomfortably full. Patients are often of adequate weight or have a high BMI. Overvaluation of body weight or shape is sometimes present.

If a patient meets all the diagnostic criteria for binge eating disorder, except their symptoms are of shorter duration (ie less than 3 months) and the binge eating occurs at a lower frequency (ie less than once weekly), they are diagnosed with subthreshold binge eating disorder . Although subthreshold binge eating disorder is a diagnostic subcategory of Other specified feeding or eating disorder (OSFED), it is managed the same as binge eating disorder.