Binge eating disorder and obesity

Binge eating disorder (BED) was included in the DSM IV as a proposed diagno stic category for further study and as an example for an eating disorder no t otherwise specified (EDNOS). BED is characterized by recurrent episodes o f binge eating in the absence of regular compensatory behavior such as vomi ting or laxative abuse. Related features include eating until uncomfortably full, eating when not physically hungry, eating alone and feelings of depr ession or guilt. BED is associated with increased psychopathology including depression and personality disorders. Although BED is not limited to obese individuals, it is most common in this group and those who seek help do so for treatment of overweight rather than for binge eating. In community sam ples, the prevalence of BED has been found to be 2-5%, in individuals who s eek weight control treatment the prevalence is 30%. BED is more equal in ge nder ratio than bulimia nervosa. Eating disorder treatments such as cogniti ve behavior therapy (CBT) or interpersonal psychotherapy (IPT) improve bing e eating with abstinence rates of about 50%. Antidepressants are also effec tive in reducing binge eating, though less so than psychotherapy. Standard weight loss treatments including bariatric surgery do not seem to exacerbat e binge eating problems. Thus, both eating disorder and obesity treatments seem to be beneficial in BED. However, it is recommended today that treatme nt should first be directed at the disordered eating and associated psychop athology.