Bulimic Spectrum Eating Disorders and Obesity

Abstract

Bulimia nervosa and binge eating disorder are both eating disorders mainly characterized by recurrent binge episodes. These two pathologies are part of the bulimic-spectrum eating disorders (BSED), and are strongly associated with obesity (with percentages of obesity ranging from 33% to 88%). Thus, BSED are related to social and psychopathological impairments and with medical complications which impact, in turn, on the morbidity and also mortality of these patients. Hence, BSED are associated with increased healthcare costs. Furthermore, BSED patients share common psychological, psychopathological, and neuropsychological features. Mentioned binge eating episodes together with body dissatisfaction and loss of control are frequent eating/weight-related symptoms displayed by these patients. BSED usually co-occur with other psychopathological symptoms and mental disorders; with the most common comorbid conditions being anxiety and mood and substance use disorders. Patients also exhibit neuropsychological difficulties, especially in attention, memory, verbal function, and executive function. Alterations in the brain functional connectivity, structural abnormalities and neural vulnerability factors have been related to BSED. Finally, treatment approaches include psychological, behavioral, and pharmacological modalities. Moreover, new treatment approaches focused on cognitive stimulation interventions, such as cognitive remediation or the use of brain stimulation, have been proposed for treat the cognitive impairments observed in BSED.