DSM binge eating disorder Flashcards
(7 cards)
diagnostic criteria
Diagnostic criteria:
A: Recurrent episodes of binge-eating. An episode of binge-eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B: The binge-eating episodes are associated with 3 (or more) of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty afterward
C: marked distress regarding binge-eating is present.
D: The binge-eating occurs, on average, at least once a week for 3 months.
E: The binge-eating is not associated with the recurrent use of inappropriate compensatory behaviour as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
It is also necessary to specify the state of the current remission:
- In partial remission needs to be specified after full criteria for binge-eating disorder were previously met, binge-eating occurs at an average frequency of less than one episode per week for a sustained period of time.
- In full remission needs to be specified after full criteria for binge-eating disorder were previously met, and none of the criteria have been met for a sustained period of time.
We also need to specify the current severity. The minimum level of severity is based on the frequency of episodes of binge-eating. The level of severity may be increased to reflect other symptoms and the degree of functional disability:
- Mild: 1–3 binges per week.
- Moderate: 4–7 binges per week.
- Severe: 8–13 binges per week.
- Extreme: 14 or more binges per week.
other symptoms
Binge-eating disorder occurs in normal-weight/overweight and obese individuals. It is reliably associated with overweight and obesity in treatment-seeking individuals. Nevertheless, binge-eating disorder is distinct from obesity. Most obese individuals do not engage in recurrent binge-eating. Bingeing usually occurs in secrecy and as in BN the most common antecedent is negative affect.
prevalence
The 12-month prevalence of binge-eating disorder is 1.6% for females and 0.8% for males. The gender ratio is less skewed compared to the eating disorders (ED) mentioned above. It is more prevalent in individuals who seek weight loss treatment.
In the USA, the prevalence of BED appears comparable across ethnoracial groups. Binge-eating disorder has a roughly similar prevalence in most high-income industrialized countries.
Development and course
Little is known about the development of binge-eating disorder. Both binge-eating and loss-of-control eating without objectively excessive consumption occur in children and are associated with increased body fat, weight gain, and increases in psychological symptoms.
Dieting follows the development of binge-eating in many individuals with binge-eating disorder. Remission rates in both natural course and treatment outcome studies are higher for binge-eating disorder than for bulimia nervosa or anorexia nervosa.
It typically begins in adolescence or young adulthood but can also start in later adulthood. Individuals that seek treatment are usually older compared to individuals with BN and AN. Remission rates are also higher than in AN or BN. A crossover from BED to other eating disorders is uncommon.
BED appears to run in families, which may reflect additive genetic influences.
Suicidal ideation can occur.
functional consequences
Binge-eating disorder is associated with a range of functional consequences, such as social role adjustment problems, impaired health-related quality of life and life satisfaction, increased medical morbidity and mortality, and associated increased health care utilization compared with body mass index (BMI).
Differential diagnosis:
- Bulimia nervosa: The recurrent compensatory behaviour seen in BN is absent in BED. Binge-eating disorder also differs from bulimia nervosa in terms of response to treatment. Rates of improvement are consistently higher among individuals with binge-eating disorder than among those with bulimia nervosa.
- Obesity: Levels of overvaluation of body weight are higher in obese individuals with the disorder than those without. Rates of psychiatric comorbidity are higher among obese individuals with the disorder. The outcome of treatments for BED is more often successful than the treatment of obesity in individuals with comorbid obesity and binge-eating disorder.
- Bipolar and depressive disorders: Increases in appetite and weight gain are included in the criteria for major depressive episode and in the atypical features specifiers for depressive and bipolar disorders. If the full criteria for both disorders are met, both diagnoses can be given.
- Borderline personality disorder: Binge eating is included in the impulsive behaviour criterion that is part of the definition of borderline personality disorder. If the full criteria for both disorders are met, both diagnoses should be given.
Comorbidity
Binge-eating disorder is associated with significant psychiatric comorbidity that is comparable to that of bulimia nervosa and anorexia nervosa. Most common comorbidities are Bipolar disorder, depressive disorder, anxiety disorder and to a lesser degree substance use.
