Diagnosis Of Binge Eating Disorder Research Articles

Neurocognitive reward processes measured via event-related potentials are associated with binge-eating disorder diagnosis and ecologically-assessed behavior

Altered reward processing has been implicated in the onset and maintenance of binge-eating disorder (BED). However, it is unclear which precise neurocognitive reward processes may contribute to BED. In the present study, 40 individuals with BED and 40 age-, sex-, and BMI-matched controls completed a reward (incentive delay) task while their neural activity was recorded using electroencephalography (EEG). Individuals with BED also completed a 10-day ecological momentary assessment (EMA) protocol assessing binge-eating behavior in the natural environment. Event-related potential (ERP) analysis of the EEG indicated that individuals with BED had stronger anticipatory (CNV) and outcome-related (RewP) neural reward activity to food and monetary rewards, compared to controls. However, within the BED group, greater frequency of binge eating during the EMA protocol was associated with stronger anticipatory (CNV) but weaker outcome-related (RewP) neural reward activity. These associations within the BED group were unique to food, and not monetary, rewards. Although preliminary, these results suggest that both anticipatory (“wanting”) and outcome (“liking”) reward processes may be generally amplified in BED. However, they also suggest that among individuals with BED, disorder severity may be associated with increased anticipatory reward processes (“wanting”), but relatively decreased reward-outcome processing (“liking”), of food rewards specifically.

Care utilization in eating disorders: for whom are multiple episodes of care more likely?

The current study aimed to determine baseline clinical features among adults receiving varied levels of care for transdiagnostic eating disorders (N = 5206, 89.9% female, mean age 29years old) that may be associated with increased care utilization. We used negative binomial regression models to evaluate associations among eating disorder diagnoses, other psychiatric features (e.g., lifetime history of comorbid disorders), and the number of episodes of care for treatment of the eating disorder. Having a diagnosis of binge eating disorder (p < .001) or avoidant restrictive food intake disorder (p = .04) were associated with lower odds of readmissions. A lifetime diagnosis of major depressive disorder (p < .001) or self-injury (p < .001) was each associated with significantly higher odds of readmissions. Care utilization may differ according to eating disorder diagnosis, with a likelihood of increased readmission for those with a history of mood disorder or self-injury. Identification of individuals with greater vulnerability for eating disorder care utilization holds potential in aiding treatment and discharge planning, and development. Level III: evidence obtained from well-designed cohort or case-control analytic studies.

Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients’ perceptions and lived experiences

BackgroundThe overlap in prevalence between type 2 diabetes and binge eating disorder is substantial, with adverse physical and mental health consequences. Little is known about patients’ efforts at managing these two conditions simultaneously. The research objective was to explore patients’ experiences managing co-existing type 2 diabetes or prediabetes and binge eating disorder.MethodsThis is a qualitative descriptive study using semi-structured interviews. Participants included 21 women with type 2 diabetes or prediabetes (90% non-Hispanic White; mean age 49 ± 14.8 years, mean BMI 43.8 ± 8.4; 48% with type 2 diabetes and mean HbA1c was 8.4%). Interviews were analyzed using thematic analysis and NVivo software.ResultsQualitative analysis revealed that participants reported binge episodes frequently started in childhood or adolescence and went undiagnosed for decades; notably, they recalled that diabetes diagnosis preceded the binge eating disorder diagnosis. They also described trying to lose weight throughout their lives and how feelings of deprivation, shame, and failure exacerbated binge eating. Participants further reported how binge eating made diabetes self-care and outcomes worse. Finally, participants observed that when binge eating disorder treatment and diabetes management were synergistically integrated, they experienced improvements in both binge eating and glycemic outcomes. This integration included reframing negative thoughts surrounding binge eating disorder and diabetes self-management and increasing their understanding of how the two disorders were inter-related.ConclusionFindings highlight the importance of increasing healthcare providers’ awareness of and screening for binge eating disorder in the treatment of diabetes and inform specific integrated interventions that address both diagnoses.Plain ENGLISH summaryFrom this study where we interviewed 21 women with binge eating disorder (BED) and type 2 diabetes/prediabetes, we learned how binge eating impacted diabetes management and how diabetes impacted BED. Most participants reported receiving the diabetes diagnosis before being diagnosed with BED despite the earlier onset of binge eating, pointing to the need for BED screening. Participants described trying to lose weight throughout their lives and reported feelings of failure and shame, which made binge eating worse. Binge eating made diabetes management harder, but when diabetes and BED treatment were aligned, participants experienced improvements in binge symptoms and diabetes outcomes.

Psychogenic overeating: problems of classification, diagnosis, approaches to psychotherapy (literature review)

In the article, we analyze the diagnosis of psychogenic overeating (ICD-10), consider the problem of its diagnostic criteria, similarities and differences with the diagnosis of binge-eating disorder (DSM-V), which complicate the work of researchers. We are looking at the need to differentiate the different types of binge eating disorder. The role of psychogenic overeating is noted as a pathogenetic factor that triggers the process of gaining excess weight. We describe in detail the biological (gender and hereditary predisposition), psychological (individual psychological personality traits, adaptive and compensatory resources) and sociocultural (style of family education, social ideas about the reference body image, features of communicative behavior, etc.) groups of factors involved in the formation of psychogenic overeating. The article emphasizes the role of psychological triggers of the disease associated with the emotional-volitional sphere, the specificity of reactions to stressful influences, psychological defenses and perception of the image of one’s body. The article also raises the problem of the lack of adapted and standardized psychodiagnostic tools aimed at studying psychogenic overeating, which complicates the formulation of an accurate diagnosis and the choice of methods of its treatment. The article also discusses such therapeutic approaches to the treatment of the described nosology, such as psychoanalysis, positive psychotherapy, gestalt therapy, transactional analysis, body-oriented therapy. Particular attention is paid to the cognitive-behavioral approach, which has shown high efficiency when working with patients with eating disorders. It is noted, that it is promising to develop algorithms for diagnostics and therapy of the described nosology, the feasibility of identifying individual targets of psychotherapeutic interventions to create personalized complex programs that increase the effectiveness of therapy in relation to immediate and long-term results.

Tıkınırcasına Yeme Bozukluğu ve Tip 2 Diabetes Mellitus

Tıkınırcasına yeme bozukluğu, telafi edici davranışlar olmaksızın, son 3 ay içerisinde en az haftada 1 kez tekrarlayan, bireyin kontrolünü kaybettiği tıkınırcasına yeme atakları ile karakterize olan bir yeme bozukluğudur. Zayıf benlik algısı, depresyon, belirli bir diyete uyma zorunluluğu, vücut ağırlığında artış gibi durumlar, Tip 2 Diabetes Mellitus ve tıkınırcasına yeme bozukluğu arasında çift yönlü bir ilişki oluşturmaktadır. İki rahatsızlığın birlikte seyretmesinin, diyabetli bireylerde metabolik kontrolünün sağlanmasını zorlaştırabileceği düşünülmektedir. Bu konuda literatürde çelişkili sonuçlar mevcut olsa da vücut ağırlığının, glisemik kontrol ve yeme bozukluğu arasındaki ilişkide düzenleyici olduğu düşüncesi yaygındır. Prevalansa yönelik yapılan çalışmalarda Tip 2 diyabetlilerin %0,1’i ile %25,6’sı arasında bir sıklıkta tıkınırcasına yeme bozukluğu olduğu saptanmıştır. Prevalanstaki bu geniş aralığın, çalışmalardaki katılımcılara ait özelliklerin ve kullanılan tarama araçlarının farklılığından kaynaklandığı düşünülmektedir. Tip 2 diyabetlilerde tıkınırcasına yeme bozukluğu tanısı için geliştirilmiş altın standart bir tarama testi bulunmamaktadır. Ancak bazı araştırmacılar, Yeme Bozukluğu İnceleme Anketi (Eating Disorder Examination-Questionnaire) ve Yeme ve Ağırlık Modelleri Anketi’nin (Questionnaire of Eating and Weight Patterns) taramada kullanmak için kullanışlı yöntemler olduğunu belirtmiştir. Bu derlemede, tıkınırcasına yeme bozukluğu ve Tip 2 Diabetes Mellitus arasındaki ilişki, görülme sıklığı, metabolik etkileri ve tanıda kullanılabilecek araçlar incelenmiştir.

A community-based feasibility randomized controlled study to test food-specific inhibitory control training in people with disinhibited eating during COVID-19 in Italy

PurposeThe aim of this study was to expand the evidence on the feasibility and impact of food-specific inhibitory control training in a community sample of people with disinhibited eating.MethodsRecruitment and data collection were conducted during the COVID-19 outbreak, in Italy. Ninety-four adult individuals with disinhibited eating were randomised to one of two conditions: App-based food-specific inhibitory control training or waiting list. Participants were assessed at baseline, end of intervention (2 weeks following baseline) and follow-up (one week later). The assessment measures included questionnaires about eating behaviour and mood.ResultsSeventy-three percent of the sample reported a diagnosis of binge eating disorder, and 20.4% a diagnosis of bulimia nervosa. Retention rates were 77% and 86% for the food-specific inhibitory control training and the waiting list conditions, respectively. Almost half of the participants allocated to the training condition completed the “recommended” dose of training (i.e., 10 or more sessions). Those in the training condition reported lower levels of wanting for high-energy dense foods (p < 0.05), a trend for lower levels of perceived hunger (p = 0.07), and lower levels of depression (p < 0.05). Binge eating symptoms, disinhibition, wanting for high-energy dense foods, stress and anxiety were significantly lower at end of intervention, compared to baseline (p < .05).ConclusionFindings corroborated the feasibility of food-specific inhibitory control training, and its impact on high-energy dense foods liking. The study expands the evidence base for food-specific inhibitory control training by highlighting its impact on perceived hunger and depression. The mechanisms underlying these effects remain to be clarified.Level of evidenceLevel I, Evidence obtained from at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.

Psychofarmacological approach for Binge- eating disorders

IntroductionBinge-eating disorder (BED), is one of the most common eating disorder. Treatment aims to reduce binge-eating frequency and disordered eating–related cognitions, improve metabolic health and weight, and regulate mood (in patients with coexisting depression or anxiety)ObjectivesThe aim of this study was to examine the efficacy of lisdexamfetamine dimesylate in a simple of 50 women with a binge eating disorder diagnosis compare with selective serotonin reuptake inhibitorMethodsTwo groups were made, one with lisdexamfetamine and the other with selective serotonin reuptake inhibitor (fluoxetine). 20 women were in each group (total n=40). The doses depend of the binge symptoms and rates were from 30 to 70md/day for lisdexamfetamine and for fluoxetine the doses were from 20 to 60mg/day.ResultsBinge behaviors decreased with a 50mg/day dose of lisdexamfetamine. The 70mg/day doses present also less binge behaviors but also more adverse events. The 30mg/day doses did not decrease binge-eating behaviors.ConclusionsLisdexamfetamine is the first pharmacological agent to receive FDA approval for use in adults with moderate to severe binge eating disorder. This study supports further assessment of lisdexamfetamine as a treatment option for decreasing binge eating behavior and also symptoms associated such as anxiety and obsessive and compulsive features in adults.Increased efficacy with increasing dosages of lisdexamfetamine suggests a dose-response relationship until 50mg/day. Women with a dose of 50mg/day of lisdexamfetamine report less adverse event, more adherence to treatment and improve their eating behaviors.DisclosureNo significant relationships.

The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment.

The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment.

Examining the Clinical Correlates of Overeating and Binge-Eating Behaviors Among U. S. Veterans

Pressure to meet U.S. military weight requirements during service may predispose some service members to develop psychiatric disorders such as eating disorders or unhealthy eating behaviors, which may persist after military discharge. Specifically, research examining U.S. military veterans has found that in weight management programs, veterans with binge-eating behaviors have shown poor treatment outcomes. Overall, previous research suggests that veterans experience considerable and persistent disordered eating problems, and in addition may experience a higher prevalence of disordered eating in comparison to the general U.S. population. Research on Post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans is needed as this group frequently presents with high rates of medical and psychiatric disorders. The current study used clinician-administered structured interviews to examine relationships between psychiatric, health, and demographic variables in a sample of Post-9/11 OEF/OIF/OND veterans with binge-eating or overeating behavior or neither. This article presents secondary analyses of the baseline phase from data obtained for the Survey of the Experiences of Returning Veterans. Using structured phone interviews, we cross-sectionally examined patterns of medical comorbidities between sociodemographic, health, eating, and psychiatric variables in 846 recently deployed U.S. veterans with binge-eating behaviors (reporting both overeating and loss of control [LOC] eating), overeating behaviors (overeating without LOC), or healthy controls (absence of any disordered eating). Study procedures were approved by the Department of Veterans Affairs (VA) Institutional Review Boards, and informed consent was obtained from the participants. A series of chi-square and analysis of variance tests revealed significant bivariate between-group differences in sociodemographic, health, eating, and psychiatric variables. Variables with significant group differences (P < .05) were entered into a multinomial logistic regression to examine relationships between psychiatric, health, and eating factors and binge-eating severity. Results of the multinomial logistic regression analysis showed that women relative to men were less likely to overeat. When comparing the binge-eating group and controls, higher body mass index was associated with higher odds of binge eating. Furthermore, for the overeating group in comparison to controls, fasting behavior was associated with higher odds of overeating. For the psychiatric variables, the binge-eating and overeating groups were associated with higher rates of compulsive buying when compared to healthy controls. Additionally, the overeating group was associated with higher rates of alcohol dependence. Lastly, binge-eating and overeating behaviors were positively associated with specific psychiatric and health comorbidities. Further research is needed to inform the development of effective treatments for disordered eating problems, as evidenced by an anticipated increase of veterans entering the VA healthcare system and the high rate of binge eating observed in our study and prior research in Post-9/11 veterans. Moreover, our study findings suggest the relevance of screening veterans for compulsive buying. This study was limited by its relatively small sample which only examined disordered eating behaviors. Future studies could simultaneously explore binge-eating behaviors and binge-eating disorder diagnoses in larger samples. Study strengths include a diverse sample of Post-9/11 veterans with sizable female representation.

Getting a head start: identifying pretreatment correlates associated with early weight loss for individuals participating in weight loss treatment.

NCT01558297.

'Impaired Autonomy and Performance' predicts binge eating disorder among obese patients.

The present study examined the predictive value of early maladaptive schema (EMS) domains on the diagnosis of binge eating disorder (BED). Seventy obese patients seeking treatment for weight loss were recruited and allocated to either group 1 (obese) or group 2 (BED-obese) according to clinical diagnosis. Both groups underwent psychometric assessment for EMS (according to the latest four-factor model), eating and general psychopathologies. Logistic regression analysis was performed on significant variables and BED diagnosis. In addition to showing higher values on all clinical variables, BED-obese patients exhibited significantly higher scores for all four schema domains. Regression analysis revealed a 12-fold increase in risk of BED with 'Impaired Autonomy and Performance'. Depression did not account for a higher risk. Impaired Autonomy and Performance is associated with BED in a sample of obese patients. Schema therapy should be considered a potential psychotherapy strategy in the treatment of BED. Level III, case-control study.

Determinants of Binge Eating Symptoms in Children with Overweight/Obesity

Examining binge eating symptoms before the diagnosis of binge eating disorder in children with obesity could provide important information on prevention of future eating disorders. We examined the prevalence and multilevel determinants of three binge eating symptoms: (1) sneaking, hiding, or hoarding food; (2) eating in the absence of hunger, and (3) inhibition or embarrassment when eating in front of others among 817 children aged 5-12 years old with overweight/obesity receiving primary care in eastern Massachusetts. We examined the associations of child and parent/household characteristics with the prevalence ratios (PRs) of these three binge eating symptoms. Approximately one-third of parents reported that their children would sneak, hide, or hoard food; 40% ate large amounts in the absence of hunger; and 8% were inhibited/embarrassed when eating in front of others. In multivariate analyses, greater screen time was associated with a higher prevalence of sneaking, hiding, or hoarding (PR 1.06, 95% CI: 1.01-1.11). We found that children with severe obesity (PR 1.50, 95% CI: 1.24-1.81 vs. nonsevere obesity) had higher prevalence of eating in the absence of hunger. Increased hours of screen time were associated with higher prevalence of eating in the absence of hunger, (PR: 1.07, 95% CI: 1.03-1.11), whereas longer sleep duration (PR: 0.90, 95% CI: 0.82-0.99) was associated with lower prevalence of eating in the absence of hunger. Eating in the absence of hunger was the most common symptom in our sample and was associated with screen time and sleep. ClinicalTrials.gov NCT01537510.

Diagnosis of Binge Eating Disorder (BED) using DSM-IV-TR and DSM-5

DSM-5 may be the latest in the Diagnostic Manual of Mental Disorders posted by the American Psychiatric Association introduces changes that are important within the analysis system for eating disorders which gets better the capability for clinicians to reach a precise diagnosis and will hopefully result in better reimbursement from insurers. Probably the most significant enhancement together with the DSM 5 is the fact that Binge Eating Disorder (BED) is relocated from the obscurity of an appendix in the DSM IV to becoming specified in the DSM 5 as a full fledged diagnosis which parallels the various other primary eating disorders.

Eating Disorders and Obesity: A Comprehensive Handbook . 3rd ed. by Kelly D. Brownell and B. Timothy Walsh (review)

issn 0362-4021 © 2018 Eastern Group Psychotherapy Society group, Vol. 42, No. 1, Spring 2018 65 1 Correspondence should be addressed to Fran Weiss, LCSW-R, BCD, DCSW, CGP, 121 West 82nd Street, Suite 2B, New York, NY 10024. E-mail: biddoc@franweiss.com. Book Review Eating Disorders and Obesity: A Comprehensive Handbook. 3rd ed. Edited by Kelly D. Brownell and B. Timothy Walsh. New York: Guilford Press, 2017, 690 pp. Reviewed by Fran Weiss1 Articles abound in the popular media on weight loss techniques, food addiction, and eating disorders. We have a serious problem at hand! The World Health Organization has identified childhood obesity as one of the most serious global public health challenges of the twenty-first century. By 2020, the number of overnourished children will exceed the number who are undernourished (p. 355). Obesity is a global issue. In the United States, more than one-third of adults (34.9%) and approximately 17% of children are obese. Anorexia nervosa has the highest mortality rate among mental disorders. There are alarmingly few empirically supported treatments. Similarly, we have no perfect prevention or effective treatment for bulimia nervosa. The newly accepted Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM–5; American Psychiatric Association, 2013) diagnosis of binge eating disorder does not apply to all those who are obese, yet it is more prevalent than anorexia nervosa or bulimia nervosa. The term food addiction is controversial but surfaces as a popular branding attempt, although is an unproven entity in the obesity research field. For practitioners in the eating disorder and obesity fields, this handbook separates fact from fiction and provides the most up-to-date, state-of-the-art clinical and scientific information. Six hundred fifty pages long, it is not a book for the faint of heart. The format is an academic style but is very readable. It consists of 108 chapters based on current research and science, written by the most recognized academicians, clinicians, and researchers. Each chapter spans approximately four to eight pages and has relevant references. The book is well organized, and the reader can easily find specific 66 weiss topics of interest. However, reader beware: the content is extremely interesting—you will end up reading more than anticipated. To my surprise, I read all 650 pages in a short period! The handbook offers three broad sections with multiple subsections. The first section describes the foundations of the field, such as the regulation of body weight, and lists the contributory psychological and social factors. In the second section, the authors focus on the clinical characteristics, epidemiology, etiology, treatment, and prevention of eating disorders. Finally, in the third section, the reader learns about obesity, its clinical characteristics, epidemiology, etiology, treatment, and prevention . In my opinion, therapists can easily apply the recommended treatment for each of the eating disorders to group psychotherapy. In sum, the information garnered here is central for anyone who treats this population—individually or in groups. This third edition notes the long-standing scientific and clinical gap between the two distinct fields of eating disorders and obesity, which have existed side by side but have never integrated. The clinical bridge between anorexia, the eating disorder diagnosed for the longest time, bulimia nervosa, and obesity may now be closed with the shared clinical underpinnings of binge eating disorder. The editors argue that an improved exchange of information between the two fields could expand the knowledge of both. Apparently, the prior editions of this handbook called for a better connection between these fields. In this third edition, the editors acknowledge that the fields still stand apart but hope that the growing focus and understanding of the working mechanisms of the brain in eating disorders and obesity may bring them closer together. The exciting new information gathered in this edition generates hope for a population that is exceedingly difficult to treat. Two distinguished experts in the field edited the handbook: Kelly D. Brownell, PhD, is an authority on obesity whose focus is on food policy. He was director of the Rudd Center for Food Policy and Obesity at Yale and is currently dean of the Sanford School of Public Policy at Duke University. Timothy Walsh...

199 - The EDE-Q in a Population of Adolescents with Obesity: Comparing Cognitions and Behaviors in Adolescents with Obesity Based on the Presence or Absence of a Binge Eating Disorder Diagnosis

Purpose: Individuals with obesity often have disordered eating behaviors and cognitions. However, little is known about whether there is a difference in their cognitive patterns based on the presence or absence of a Binge Eating Disorder (BED) diagnosis. The primary aims of this study were to: 1. examine the self-reported eating disorder-related cognitions and behaviors in a care-seeking adolescent population with obesity; and 2. compare the eating disorder-related cognitions and behaviors of those with and without BED. A secondary aim of this study was to explore differences in eating disorder-related cognitions and behaviors based on race/ethnicity.

Guided Self-help for Eating Disorders: A Systematic Review and Metaregression.

Evidence-based self-help is a recommended first stage of treatment for mild-moderate eating disorders. The provision of guidance enhances outcome. The literature evaluating exclusively 'guided' self-help (GSH) has not been systematically reviewed. The aim was to establish the effectiveness of GSH for reducing global eating disorder psychopathology and abstinence from binge eating, compared with controls. Results were pooled using random effects meta-analysis and heterogeneity explored using metaregression. Thirty randomised controlled trials met the inclusion criteria. Results showed an overall effect of GSH on global eating disorder psychopathology (-0.46) and binge abstinence (-0.20). There was strong evidence for an association between diagnosis of binge eating disorder and binge abstinence. Current interventions need to be adapted to address features other than binge eating. Further research is required to help us understand the effectiveness of GSH in children and young people, invariably high dropout rates and how technology can enhance interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients

BackgroundPsychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. ObjectivesExamine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory−2 – Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes. SettingCleveland Clinic Bariatric and Metabolic Institute Methods446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients’ mean presurgical BMI was 49.14 kg/m2 [SD = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling. ResultsOlder patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes. ConclusionPreoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes.

Binge-eating disorder: emerging treatments for a new diagnosis.

This review provides an update on the new Diagnostic and Statistical Manual (DSM) diagnosis of binge-eating disorder (BED) by presenting diagnostic criteria, associated risk factors and co-morbidities, and tools for assessment. An update on the currently available evidence-based treatments for adolescent BED is provided to help with the coordination of treatment planning for identified patients with this condition. BED is now officially included in the DSM. Research with youth has begun to show improvement from treatments such as cognitive behavioral therapy, previously shown to be useful in adults. BED is common and often begins during youth. The availability of diagnostic criteria, along with increasing knowledge about the condition and available treatments, is expected to result in improved identification and management in younger patients.

A primer on binge eating disorder diagnosis and management.

Binge eating disorder (BED) is the most common eating disorder, with an estimated lifetime prevalence of 2.6% among U.S. adults, yet often goes unrecognized. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BED is defined by recurrent episodes of binge eating (eating in a discrete period of time an amount of food larger than most people would eat in a similar amount of time under similar circumstances and a sense of lack of control over eating during the episode), occurring on average at least once a week for 3 months, and associated with marked distress. It can affect both men and women, regardless if they are at normal weight, overweight, or obese, and regardless of their ethnic or racial group. Psychiatric comorbidities are very common, with 79% of adults with BED also experiencing anxiety disorders, mood disorders, impulse control disorders, or substance use disorders; almost 50% of persons with BED have ≥ 3 psychiatric comorbidities. Multiple neurobiological explanations have been proffered for BED, including dysregulation in reward center and impulse control circuitry, with potentially related disturbances in dopamine neurotransmission and endogenous μ-opioid signaling. Additionally, there is interplay between genetic influences and environmental stressors. Psychological treatments such as cognitive behavioral interventions have been recommended as first line and are supported by meta-analytic reviews. Unfortunately, routine medication treatments for anxiety and depression do not necessarily ameliorate the symptoms of BED; however, at present, there is one approved agent for the treatment of moderate to severe BED-lisdexamfetamine, a stimulant that was originally approved for the treatment of attention deficit hyperactivity disorder.

Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5.

IntroductionBinge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies.MethodsWe identified studies published in the last 6 years searching the MeSH Term “binge eating disorder”, with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct.ResultsA total of 233 studies were found and, among them, 71 were selected and included in the review.ReviewAlthough Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy.ConclusionsDespite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.