Obesity and eating disorders: an interactive and complex coexistence

Abstract

Obesity is the medical condition most frequently observed in people with eating disorders. It often coexists with binge-eating disorder and with some cases of bulimia nervosa, night eating syndrome, and atypical anorexia nervosa. Obesity can precede the onset of eating disorders, sometimes representing a risk factor for their onset, or can be in part the consequence of recurrent binge-eating episodes. Eating disorders and obesity, when they coexist, tend to interact negatively with each other and make treatment more problematic. Weight loss is always contraindicated when obesity coexists with bulimia nervosa and atypical anorexia nervosa. Still, it is not contraindicated when it coexists with binge-eating disorder or night eating syndrome. However, the weight loss outcome with current treatments is often unsatisfactory. A potential strategy to improve this poor outcome is an integrated treatment combining the new incretin-based medications for the treatment of obesity with enhanced cognitive behavior therapy (CBT) of binge-eating disorder and CBT of obesity.