December 26, 2012


Binge eating disorder (BED)

People with binge eating disorder (BED) binge pretty much like people with bulimia. And they feel just as bad afterward. But they aren’t driven toward purging behaviors. More likely, they become engaged in cycling between periods of bingeing and periods of rigid dieting. For some, this keeps their weight in a normal range. Other people with BED gain weight and may even become obese.

Estimates are that anywhere from 3 to 8 in 100 people in the United States have BED. According to a 1998 survey in the Annals of Behavioral Medicine, as many as 40 percent of the people with BED are men.

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), published by the American Psychiatric Association, provides the guidelines used by mental health professionals and insurance companies to diagnose various psychological disorders.

For those of you who are interested in where binge eating disorder stands as an official diagnosis, DSM-IV currently stashes BED in a category of eating disorders called “not otherwise specified,” while the people who decide these things are working on whether to give it equal status with anorexia and bulimia (the most likely outcome). The following list paraphrases how the DSM-IV defines binge eating disorder:

Bingeing: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

• Eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
• A sense of lack of control over your eating during the episode (for example, a feeling that you can’t stop eating or control what or how much you’re eating)

Typical aspects of a binge episode: The binge eating episodes are associated with three or more of the following:

• Eating much more rapidly than normal
• Eating until you feel uncomfortably full
• Eating large amounts of food when you’re not feeling physically hungry
• Eating alone because you’re embarrassed by how much you’re eating
• Feeling disgusted with yourself, depressed, or very guilty after overeating

Unlike the anorexic person, the person with BED feels something is wrong: Marked distress regarding binge eating is present.

Frequency: The binge eating occurs, on average, at least 2 days per week for 6 months. (Note: Current research shows there’s no difference between once-weekly bingers and those who meet this twice-weekly standard.)

The bingeing isn’t part of anorexia or bulimia: The binge eating is not associated with the regular use of inappropriate compensatory behaviors (for example, purging, fasting, or excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

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