Abstract
PurposeIn the Canadian healthcare setting, there is limited understanding of the pathways to diagnosis and treatment for patients with binge eating disorder (BED).MethodsThis retrospective chart review examined the clinical characteristics, diagnostic pathways, and treatment history of adult patients diagnosed with BED.ResultsOverall, 202 charts from 57 healthcare providers (HCPs) were reviewed. Most patients were women (69%) and white (78%). Mean ± SD patient age was 37 ± 12.1 years. Comorbidities identified in > 20% of patients included obesity (50%), anxiety (49%), depression and/or major depressive disorder (46%), and dyslipidemia (26%). Discussions regarding a diagnosis of BED were typically initiated more often by HCPs than patients. Most patients (64%) received a diagnosis of BED ≥ 3 years after symptom onset. A numerically greater percentage of patients received (past or current) nonpharmacotherapy than pharmacotherapy (84% vs. 67%). The mean ± SD number of binge eating episodes/week numerically decreased from pretreatment to follow-up with lisdexamfetamine (5.4 ± 2.8 vs. 1.7 ± 1.2), off-label pharmacotherapy (4.7 ± 3.9 vs. 2.0 ± 1.13), and nonpharmacotherapy (6.3 ± 4.8 vs. 3.5 ± 6.0) Across pharmacotherapies and nonpharmacotherapies, most patients reported improvement in symptoms of BED (84–97%) and in overall well-being (80–96%).ConclusionsThese findings highlight the importance of timely diagnosis and treatment of BED. Although HCPs are initiating discussions about BED, earlier identification of BED symptoms is required. Furthermore, these data indicate that pharmacologic and nonpharmacologic treatment for BED is associated with decreased binge eating and improvements in overall well-being.Level of evidenceIV, chart review.
Highlights
Binge eating disorder (BED) is characterized by the recurrent consumption of an amount of food within a discrete period that is larger than what most people would eat, by a lack of control, and by marked distress over binge eating (BE) [1]
Numerically greater percentages of patients were improved regarding BED symptoms and overall well-being at follow-up than those who were unchanged or worsened (Table 4). This retrospective chart review describes symptom onset, diagnosis, comorbidities, BED treatments, and treatment outcomes in patients diagnosed with BED symptoms in the Canadian clinical setting
The BED diagnostic pathway was characterized by discussions typically being initiated by healthcare providers (HCPs) more often than by patients, and with initial consultations typically being conducted more often by general practitioner (GP) than psychiatrists
Summary
Binge eating disorder (BED) is characterized by the recurrent consumption of an amount of food within a discrete period that is larger than what most people would eat, by a lack of control, and by marked distress over binge eating (BE) [1]. Studies suggest that BED has a neurobiologic. The prevalence of BED based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria has been examined in several studies [4,5,6,7]. In a US population-based survey, the lifetime prevalence of BED in adults was 2.03% [4]. In a UK-based study, BED point prevalence in a multi-ethnic population was 3.6% [5]. In a Canadian population-based survey, the lifetime prevalence of BED was 3.19% [7]. Epidemiologic studies indicate that the prevalence of BED is generally higher than that of anorexia nervosa (AN) and bulimia nervosa (BN) [8,9,10]
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