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Kerwin ME, Berkowitz RI. Feeding and Eating Disorders: Ingestive Problems of Infancy, Childhood, and Adolescence. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.1996.12085821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Robert I. Berkowitz
- Philadelphia Child Guidance Center and University of Pennsylvania School of Medicine
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Brugnera A, Lo Coco G, Salerno L, Sutton R, Gullo S, Compare A, Tasca GA. Patients with Binge Eating Disorder and Obesity have qualitatively different interpersonal characteristics: Results from an Interpersonal Circumplex study. Compr Psychiatry 2018; 85:36-41. [PMID: 29960139 DOI: 10.1016/j.comppsych.2018.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Patients with Binge Eating Disorder (BED) and obesity experience distressing relationships, which could trigger negative affect and over-eating. To date no studies compared the interpersonal profiles and prototypicality of both groups using the Interpersonal Circumplex. METHOD A sample of 177 patients with BED (mean age: 41.0 ± 12.5 years; 11.3% males), 321 obese non-BED adults (mean age: 44.5 ± 13.4 years; 28% males), and 108 normal weight adults (mean age: 37.3 ± 9.6 years; 52.77% males) completed the Inventory of Interpersonal Problems (IIP-32), and scales of binge eating and psychological distress at one time-point. RESULTS Compared to normal weight and obese participants, those with BED reported higher levels of interpersonal problems on all circumplex dimensions, except for Vindictive, with small to medium effects. All groups had highly prototypical profiles. Both obese and normal weight adults had very similar interpersonal profiles characterized by predominant friendly-dominant themes. On the contrary, those with BED had predominant friendly-submissive themes. Patients with BED reported significantly higher levels of psychological distress and binge eating severity, compared to the other two groups. Greater Domineering, Cold, Socially Inhibited and Non-Assertive scale scores, and lower Vindictive scale scores significantly predicted higher binge eating and psychological distress, regardless of group membership. DISCUSSION Findings lend support to an interpersonal model of binge eating and to the presence of qualitative differences between patients with obesity and BED. Finally, results suggest some strategies for the clinical management of BED focused on non-assertion and problems with experiences and expression of anger.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Rachel Sutton
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Salvatore Gullo
- Department of Psychology, University "N. Cusano", Rome, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Agras WS, Fitzsimmons-Craft EE, Wilfley DE. Evolution of cognitive-behavioral therapy for eating disorders. Behav Res Ther 2017; 88:26-36. [PMID: 28110674 DOI: 10.1016/j.brat.2016.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 01/20/2023]
Abstract
The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders.
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Affiliation(s)
- W Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
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Developmental disruption by binge-eating disorder and bulimia nervosa: critical windows for detection and intervention. Epidemiol Psychiatr Sci 2014; 23:43-5. [PMID: 24054093 PMCID: PMC6998285 DOI: 10.1017/s204579601300053x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Grucza RA, Przybeck TR, Cloninger CR. Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiatry 2007; 48:124-31. [PMID: 17292702 PMCID: PMC1924970 DOI: 10.1016/j.comppsych.2006.08.002] [Citation(s) in RCA: 263] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 06/29/2006] [Accepted: 08/14/2006] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Diagnostic criteria for binge eating disorder (BED) appear in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as "criteria for further study." Few epidemiological studies of BED have been conducted. Our aim was to describe the prevalence and correlates of BED, as assessed by the Patient Health Questionnaire (PHQ) in a community sample. METHOD Descriptive epidemiology from a survey of 910 randomly ascertained participants residing in the greater metropolitan area of St Louis, Mo. RESULTS Sixty individuals (6.6%) screened positive for current BED, as assessed by the PHQ (BED+). Men were as likely to screen positive as women. BED+ subjects were at substantially elevated odds for depression, generalized anxiety disorder, panic attacks, and past suicide attempts; individuals with obesity who screened negative for BED (BED-) were not at elevated odds for these syndromes. BED+ subjects, but not other obese individuals, exhibited substantially lower scores on measures of mental health-related quality of life. Personality traits associated with BED symptoms included high Novelty Seeking, high Harm Avoidance, and low Self-directedness. Personality and psychiatric profiles in obese, BED- individuals were closer to those for normal-weight, BED- individuals, suggesting that BED is distinct from typical obesity. BED+ subjects reported mean body mass index of 34.1, more than 6 units above BED- subjects. CONCLUSION PHQ-BED criteria are associated with substantial impairment, psychiatric comorbidity, and obesity and effectively discriminate obese individuals with psychological problems from obese subjects without similar problems. BED may be considerably more prevalent than other eating disorders and equally prevalent among men and women.
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Affiliation(s)
- Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Fairburn CG, Bohn K. Eating disorder NOS (EDNOS): an example of the troublesome "not otherwise specified" (NOS) category in DSM-IV. Behav Res Ther 2005; 43:691-701. [PMID: 15890163 PMCID: PMC2785872 DOI: 10.1016/j.brat.2004.06.011] [Citation(s) in RCA: 275] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2004] [Accepted: 06/18/2004] [Indexed: 12/27/2022]
Abstract
The "Not Otherwise Specified" (NOS) category within DSM-IV is designed for disorders of clinical severity that are not specified within broad diagnostic classes. "NOS" diagnoses are intended to be residual categories and they tend to be neglected by researchers. This can be inappropriate. The problems associated with certain NOS diagnoses are well illustrated by "Eating Disorder NOS" (sometimes termed EDNOS), which is the most common category of eating disorder encountered in routine clinical practice yet it has barely been studied. Indeed, there has been no research on its treatment. Interim and longer-term conceptual and practical solutions to the anomalous status of eating disorder NOS are proposed including the creation of a new diagnosis termed "mixed eating disorder". Several of these solutions are of relevance to NOS categories in general. All the solutions should fulfil criteria for clinical utility.
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Pouncey C. Why does psychiatry need to define ”mental disorder”? REVISTA LATINOAMERICANA DE PSICOPATOLOGIA FUNDAMENTAL 2004. [DOI: 10.1590/1415-47142004003010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Yanovski SZ. Binge eating disorder and obesity in 2003: could treating an eating disorder have a positive effect on the obesity epidemic? Int J Eat Disord 2003; 34 Suppl:S117-20. [PMID: 12900992 DOI: 10.1002/eat.10211] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The purpose of this paper is to explore the relationship between binge eating disorder (BED) and obesity. METHODS Recent literature relating to the etiology, risk factors, pathophysiology, and treatment of binge eating disorder was reviewed. RESULTS The data suggest that binge eating may be a contributor to the development of obesity in susceptible individuals. Although eating disorders treatment in the absence of obesity treatment does not result in large weight losses, amelioration of binge eating does result in small weight losses and decreased weight regain over time. DISCUSSION Our challenge in the future is to understand better the ways in which BED and obesity co-exist, and to find treatment strategies that will relieve the distress and dysfunction due to this disordered eating while enhancing appropriate weight loss or preventing further weight gain.
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Affiliation(s)
- Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892-5450, USA.
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Devlin MJ, Goldfein JA, Dobrow I. What is this thing called BED? Current status of binge eating disorder nosology. Int J Eat Disord 2003; 34 Suppl:S2-18. [PMID: 12900982 DOI: 10.1002/eat.10201] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although binge eating has been recognized as a clinically relevant behavior among the obese for more than four decades, the concept of binge eating disorder (BED) as a distinct psychiatric diagnosis is of much more recent origin. This article presents four ways of conceptualizing BED: a distinct disorder in its own right, as a variant of bulimia nervosa, as a useful behavioral subtype of obesity, and as a behavior that reflects psychopathology among the obese. It also summarizes the evidence supporting and disconfirming each model. METHOD The literature subsequent to the development of DSM-IV regarding the reliability and validity of BED and related conditions was reviewed selectively. RESULTS The preponderance of the evidence suggests that BED differs importantly from purging bulimia nervosa and that BED is not a strikingly useful behavioral subtype of obesity. DISCUSSION Further study is needed to definitively determine the validity of BED as a distinct eating disorder.
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Affiliation(s)
- Michael J Devlin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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Abstract
OBJECTIVE Current controversy exists regarding the status of binge eating disorder (BED) as a diagnostic entity. A critique of the literature is provided to address the question of whether BED represents a clinically significant syndrome. METHOD The scientific evidence is considered through addressing five questions that are key in evaluating the clinical utility of any mental disorder. RESULTS Individuals with BED meaningfully differ from individuals without eating disorders, and share important similarities to, yet are distinct from, individuals with anorexia nervosa (AN) and bulimia nervosa (BN). BED is associated with co-occurring physical and mental illnesses, as well as impaired quality of life and social functioning. Questions about the course of the disorder and the optimal treatment regimen for the syndrome need to be explored further. DISCUSSION BED's distinctive combination of core eating disorder psychopathology, and other co-occurring physical and psychiatric conditions, impaired psychosocial functioning, and overweight constitute an eating disorder of clinical severity and a significant public health problem.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Cooper Z, Fairburn CG. Refining the definition of binge eating disorder and nonpurging bulimia nervosa. Int J Eat Disord 2003; 34 Suppl:S89-95. [PMID: 12900989 DOI: 10.1002/eat.10208] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The diagnostic concept of binge eating disorder (BED) was introduced in response to the clinical observation of Stunkard (1959) that some people with obesity have recurrent episodes of binge eating. We suggest that the DSM-IV concept of BED has resulted in the recruitment of heterogeneous research samples, amongst which are some people with BED, as described by Stunkard, some with bulimia nervosa, some with other types of eating disorder, and some with no eating disorder. We consider the difficulties distinguishing BED from other forms of overeating, especially in patients with obesity, and from nonpurging bulimia nervosa. We propose revised diagnostic criteria for BED and bulimia nervosa that are designed to minimize these problems.
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Affiliation(s)
- Zafra Cooper
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Dingemans AE, Bruna MJ, van Furth EF. Binge eating disorder: a review. Int J Obes (Lond) 2002; 26:299-307. [PMID: 11896484 DOI: 10.1038/sj.ijo.0801949] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2000] [Revised: 03/14/2001] [Accepted: 11/07/2001] [Indexed: 11/09/2022]
Abstract
Binge eating disorder (BED) is a new proposed eating disorder in the DSM-IV. BED is not a formal diagnosis within the DSM-IV, but in day-to-day clinical practice the diagnosis seems to be generally accepted. People with the BED-syndrome have binge eating episodes as do subjects with bulimia nervosa, but unlike the latter they do not engage in compensatory behaviours. Although the diagnosis BED was created with the obese in mind, obesity is not a criterion. This paper gives an overview of its epidemiology, characteristics, aetiology, criteria, course and treatment. BED seems to be highly prevalent among subjects seeking weight loss treatment (1.3-30.1%). Studies with compared BED, BN and obesity indicated that individuals with BED exhibit levels of psychopathology that fall somewhere between the high levels reported by individuals with BN and the low levels reported by obese individuals. Characteristics of BED seemed to bear a closer resemblance to those of BN than of those of obesity.A review of RCT's showed that presently cognitive behavioural treatment is the treatment of choice but interpersonal psychotherapy, self-help and SSRI's seem effective. The first aim of treatment should be the cessation of binge eating. Treatment of weight loss may be offered to those who are able to abstain from binge eating.
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Affiliation(s)
- A E Dingemans
- Robert-Fleury Stichting, National Centre for Eating Disorders, Leidschendam, The Netherlands.
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Thaw JM, Williamson DA, Martin CK. Impact of altering DSM-IV criteria for anorexia and bulimia nervosa on the base rates of eating disorder diagnoses. Eat Weight Disord 2001; 6:121-9. [PMID: 11589414 DOI: 10.1007/bf03339761] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The diagnostic criteria used to define eating disorders have been the focus of debate for many years. The primary aim of this study was to evaluate the impact of altering DSM-IV diagnostic criteria upon the base rates of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS). Five controversial criteria were systematically modified and the impact of these changes on base rates of full-syndrome and partial-syndrome eating disorders was assessed in 193 patients referred to two specialty eating disorder clinics. Modification of a single criterion resulted in relatively small changes in base rates of AN and BN, whereas modification of the two severity criteria led to more substantial changes. These findings have significant implications for future modifications of the DSM classification.
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Affiliation(s)
- J M Thaw
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge 70808, USA
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Striegel-Moore RH, Cachelin FM, Dohm FA, Pike KM, Wilfley DE, Fairburn CG. Comparison of binge eating disorder and bulimia nervosa in a community sample. Int J Eat Disord 2001; 29:157-65. [PMID: 11429978 DOI: 10.1002/1098-108x(200103)29:2<157::aid-eat1005>3.0.co;2-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined the relationship between binge eating disorder (BED), a newly proposed eating disorder, and bulimia nervosa (BN). METHOD Three groups recruited from the community were compared: women with BED (n = 150), women with purging BN (n = 48), and women with nonpurging BN (n = 14). RESULTS The three groups did not differ significantly in education, weight or shape concern, and current or lifetime prevalence of nine major mental disorders. Women with BED, compared with women with purging BN, were older, less likely to have a history of anorexia nervosa, and less likely to have been treated for an eating disorder. Obesity was more commonly associated with BED than with either subtype of BN. DISCUSSION Our results lend some support to BED as an eating disorder distinct from purging BN. More research is needed to clarify the position of nonpurging BN relative to BED and purging BN.
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Affiliation(s)
- R H Striegel-Moore
- Department of Psychology, Wesleyan University, Middletown, Connecticut, USA.
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Ricca V, Mannucci E, Moretti S, Di Bernardo M, Zucchi T, Cabras PL, Rotella CM. Screening for binge eating disorder in obese outpatients. Compr Psychiatry 2000; 41:111-5. [PMID: 10741889 DOI: 10.1016/s0010-440x(00)90143-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The prevalence of binge eating disorder (BED) in clinical samples of obese patients is controversial, and sensitive diagnostic protocols for use in routine clinical practice need to be further defined. Three hundred forty-four obese (body mass index [BMI] > or =30 kg/m2) patients were studied with the Structured Clinical Interview for DSM-III-R to investigate the lifetime prevalence of mental disorders. The current prevalence of BED was assessed using DSM-IV criteria. Eating attitudes and behavior were investigated with the Bulimic Investigation Test, Edinburgh (BITE) and the Binge Eating Scale (BES). The Beck Depression Inventory (BDI) and Spielberg's State-Trait Anxiety Inventory (STAI) were also applied. The prevalence of BED was 7.5%. Patients with BED had a higher BMI compared with obese patients without BED. Differences in the lifetime prevalence of mental disorders in patients with and without BED were not statistically significant. Using the BES as a screening instrument for BED with a threshold of 17, the sensitivity was 84.8%, specificity 74.6%, positive predictive value 26.2%, and negative predictive value 97.9%. Using the BITE with a threshold of at least 10, the sensitivity was 91%, specificity 51.4%, positive predictive value 71.8%, and negative predictive value 98.2%. The BITE can be a valid alternative to the BES as a screening method for BED in obese patients.
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Affiliation(s)
- V Ricca
- Department of Neurologic and Psychiatric Sciences, University of Florence, Italy
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Williamson DA, Martin CK. Binge eating disorder: a review of the literature after publication of DSM-IV. Eat Weight Disord 1999; 4:103-14. [PMID: 11234238 DOI: 10.1007/bf03339725] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Binge eating disorder (BED) is a syndrome marked by recurrent episodes of binge eating, in the absence of the regular use of inappropriate compensatory behaviors. Since the inclusion of BED in DSM-IV as a Diagnostic Category in Need of Further Research, a great deal of research has been conducted. This paper reviews research on BED since publication of DSM-IV in 1994. We conclude that questions about the definition of BED persist. Furthermore, recent studies which have strictly used the DSM-IV definition of BED have found that the full syndrome is found in less than 3% of obese adults seeking weight loss treatment and occurs in less than 1% of the general adult population. Binge eating is a common symptom associated with obesity, however. BED may be conceptualized as a psychiatric syndrome or it may be viewed as a behavioral symptom associated with obesity. We conclude that clarification of this conceptual issue is needed if research on BED is to progress.
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Affiliation(s)
- D A Williamson
- Louisiana State University, Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Vamado PJ, Williamson DA, Bentz BG, Ryan DH, Rhodes SK, O'Neil PM, Sebastian SB, Barker SE. Prevalence of binge eating disorder in obese adults seeking weight loss treatment. Eat Weight Disord 1997; 2:117-24. [PMID: 14655834 DOI: 10.1007/bf03339961] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Binge eating has been identified as a common problem in samples of obese persons. Earlier studies found that approximately 30% of participants presenting for weight loss treatment could be diagnosed with Binge Eating Disorder (BED). This study investigated the prevalence of BED using the Questionnaire on Eating and Weight Patterns (QEWP) and the Interview for the Diagnosis of Eating Disorders (IDED) in a sample of 468 obese adults seeking weight loss treatment at two research facilities. The study found that only a small percentage of the participants met Diagnostic and Statistical Manual for Mental Disorders, 4th Revision (DSM-IV) diagnostic criteria for BED using either the IDED (1.3%) or QEWP (7.3%). A larger percentage of the sample (10.7% based on the IDED and 20.5% based on the QEWP) reported binge eating, but did not endorse all criteria necessary to warrant a diagnosis of BED. The primary finding of the study was that the prevalence of BED in treatment seeking obese adults was much lower than was reported in previous studies. Also, there was significant discrepancy in prevalence rates of BED as defined by self-report and interview assessment methods, with the interview method yielding lower estimates of prevalence. These findings suggest that the prevalence of BED may be lower than estimates of earlier reports. We recommend that future studies of BED use reliable and valid interview methods and that this research focus on more diverse populations, including men and a variety of racial and ethnic groups.
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Affiliation(s)
- P J Vamado
- Louisiana State University, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA
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Basdevant A, Le Barzic M, Lahlou N, Pouillon M, Brillant M, Guy-Grand B. Correlates of Binge Eating Disorder in French Women. EUROPEAN EATING DISORDERS REVIEW 1997. [DOI: 10.1002/(sici)1099-0968(199706)5:2<115::aid-erv194>3.0.co;2-i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- R H Striegel-Moore
- Wesleyan University, Department of Psychology, Middletown, Connecticut 06459-0408, USA.
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Kenardy J, Arnow B, Agras WS. The aversiveness of specific emotional states associated with binge-eating in obese subjects. Aust N Z J Psychiatry 1996; 30:839-44. [PMID: 9034475 DOI: 10.3109/00048679609065053] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to examine the hypothesis that non-purge-related binge-eating in obesity is maintained by a 'trade-off' in which a highly aversive emotional state is exchanged for a less aversive state. METHOD Ninety-eight obese binge-eaters meeting the DSM-IV criteria for binge-eating disorder were contrasted with 65 non-binge-eating controls on their perceived distress associated with negative mood states usually experienced before and after binges. RESULTS Binge-eaters reported significantly greater distress and lower tolerance of negative mood compared to controls. Furthermore, when compared with controls, binge-eaters reported that emotions typically reported before binges (e.g. anger) were more aversive than those reported after (e.g. guilt). CONCLUSIONS These results were interpreted as supporting the 'trade-off' theory and have implications for the treatment of binge-eating disorder.
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Affiliation(s)
- J Kenardy
- Department of Psychology, University of Queensland, Brisbane, Australia
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Abstract
The patient presenting with binge-eating disorder requires a detailed clinical assessment that takes into account behavioral, somatic, and psychological aspects of the disorder. Treatment selection depends on the patient's particular goals. Antidepressant medications and CBT are effective, at least in the short term, in suppressing binge eating and reducing depressive symptoms. Fluoxetine may, in addition, promote short-term weight loss, which is more likely to be maintained if medication is administered in the context of behavior therapy. Preliminary study suggests that behavior therapy may be designed to promote weight loss, even in the absence of medication treatment, without undermining binge cessation. Appetite suppressant medications clearly promote weight loss, but their use in suppressing binge eating has yet to be studied specifically. Further study is needed in several areas including the feasibility and efficacy of treatment approaches that combine medication and psychotherapy, the efficacy of individual versus group psychotherapy, the long-term outcome of various forms of treatment, and the clinical features that predict favorable response to different treatment modalities.
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Affiliation(s)
- M J Devlin
- Eating Disorders Research Unit, New York State Psychiatric Institute, New York, USA
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Garfinkel PE, Lin E, Goering P, Spegg C, Goldbloom DS, Kennedy S, Kaplan AS, Woodside DB. Purging and nonpurging forms of bulimia nervosa in a community sample. Int J Eat Disord 1996; 20:231-8. [PMID: 8912035 DOI: 10.1002/(sici)1098-108x(199611)20:3<231::aid-eat2>3.0.co;2-p] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Recent consensus on the subclassification of the eating disorder bulimia nervosa into purging and nonpurging forms is examined in the context of a large psychiatric epidemiological survey in Ontario, Canada. METHOD Among a sample of 8,116 individuals, 62 met criteria for bulimia nervosa. Of these, the 17 who were of the purging subtype could be distinguished from the nonpurging group on a variety of parameters of comorbidity, family history, and childhood environment. RESULTS The purging subtype was distinguishable on the basis of early age of onset, and high rates of affective disorders and anxiety and alcoholism, sexual abuse, and parental discord. DISCUSSION The data support the taxonomy and point to the need for better understanding of the meaning of purging behavior.
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Affiliation(s)
- P E Garfinkel
- Department of Psychiatry, Clarke Institute of Psychiatry, Toronto, Ontario, Canada
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Hay PJ, Fairburn CG, Doll HA. The classification of bulimic eating disorders: a community-based cluster analysis study. Psychol Med 1996; 26:801-812. [PMID: 8817715 DOI: 10.1017/s003329170003782x] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There is controversy over how best to classify eating disorders in which there is recurrent binge eating. Many patients with recurrent binge eating do not meet diagnostic criteria for other of the two established eating disorders, anorexia nervosa or bulimia nervosa. The present study was designed to derive an empirically based, and clinically meaningful, diagnostic scheme by identifying subgroups from among those with recurrent binge eating, testing the validity of these subgroups and comparing their predictive validity with that of the DSM-IV scheme. A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Four subgroups among the sample were identified using a Ward's cluster analysis. The first subgroup had either objective or subjective bulimic episodes and vomiting or laxative misuse; the second had objective bulimic episodes and low levels of vomiting or laxative misuse; the third had subjective bulimic episodes and low levels of vomiting or laxative misuse; and the fourth was heterogeneous in character. This cluster solution was robust to replication. It had good descriptive and predictive validity and partial construct validity. The results support the concept of bulimia nervosa and its division into purging and non-purging subtypes. They also suggest a possible new binge eating syndrome. Binge eating disorder, listed as an example of Eating Disorder Not Otherwise Specified within DSM-IV, did not emerge from the cluster analysis.
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Affiliation(s)
- P J Hay
- Department of Psychiatry, University of Oxford
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Grissett NI, Fitzgibbon ML. The clinical significance of binge eating in an obese population: support for bed and questions regarding its criteria. Addict Behav 1996; 21:57-66. [PMID: 8729708 DOI: 10.1016/0306-4603(95)00039-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The present study examined the prevalence of binge eating disorder (BED) among 192 obese individuals seeking treatment in a university-based eating disorders program. Subjects responded to a self-report questionnaire on the presence and severity of binge eating and were divided into two groups: (a) 48 non-binge eaters and (b) 144 binge eaters, 72 of whom met criteria for BED. Binge eaters reported earlier onset of obesity, higher levels of psychopathology, and less competence in relation to weight control. Comparison between the 72 individuals diagnosed with BED and the 72 binge eaters not meeting BED criteria indicated that the former group evidenced more severe binge eating and a higher level of depression. Given the differences across a range of psychological variables between binge eaters and non-binge eaters, these findings support the clinical and research value of BED as a new diagnostic category. However, they also indicate that severity of binge eating, regardless of frequency and associated behavioral features, is the most important distinguishing characteristic. Further research is needed to determine the most appropriate threshold for BED diagnosis.
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Affiliation(s)
- N I Grissett
- Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, IL 60611, USA
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Garfinkel PE, Kennedy SH, Kaplan AS. Views on classification and diagnosis of eating disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 1995; 40:445-56. [PMID: 8681268 DOI: 10.1177/070674379504000805] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To highlight developments in the taxonomy of eating disorders since Russell's original description of bulimia nervosa (BN) in 1979 and through 3 versions of the Diagnostic and Statistical Manual. METHOD Criteria for anorexia nervosa (AN), BN and binge eating disorder (BED) are systematically described. RESULTS While criteria for AN remain largely unchanged between DSM-III-R and DSM-IV, the subclassification of binge/purge and restricter subgroups endorses previous research findings. For BN, the definition of "binge" has occupied considerable attention both in quantitative and qualitative terms. The arbitrary choice of 2 episodes per week as a minimum frequency is also discussed in light of recent data from the Ontario Health Supplement. A third eating disorder, BED, is now included in the appendix of DSM-IV under Eating Disorders--Not Otherwise Specified category. The potential overlap between this disorder and nonpurging BN is discussed. Finally, the relationship between eating disorders and other psychiatric disorders including depression, schizophrenia, obsessional, and conversion disorders is considered as well as the continuum from preoccupation with weight to eating disorder. CONCLUSION While significant advances have been made in understanding and classifying eating disorders during the past 15 years, further empirical work is necessary to clarify areas of uncertainty.
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Affiliation(s)
- P E Garfinkel
- Department of Psychiatry, University of Toronto, Ontario
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O'Kearney R, Gertler R, Conti J, Duff M. Disturbances of weight control behaviours and psychological functioning in individuals presenting to an outpatient eating disorder unit: A descriptive study. EUROPEAN EATING DISORDERS REVIEW 1995. [DOI: 10.1002/erv.2400030204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nangle DW, Johnson WG, Carr-Nangle RE, Engler LB. Binge eating disorder and the proposed DSM-IV criteria: psychometric analysis of the Questionnaire of Eating and Weight Patterns. Int J Eat Disord 1994; 16:147-57. [PMID: 7987349 DOI: 10.1002/1098-108x(199409)16:2<147::aid-eat2260160206>3.0.co;2-p] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Proposed binge eating disorder (BED) diagnostic criteria were investigated to provide necessary psychometric characteristics and explore their utility in assessment. One hundred four subjects (52 self-referred bingers, 52 comparison subjects) completed an initial administration of the Questionnaire of Eating and Weight Patterns (QEWP). The results supported the ability of the two core BED criteria (i.e., episodic overeating, loss of control) to discriminate between clinical and nonclinical binge eaters. Thirty-nine of the self-referred and 40 of the comparison subjects completed a second QEWP administration 3 weeks later. Results indicated that the BED diagnosis was moderately stable over the 3-week interval (kappa = .58, combined sample). Using self-monitoring data completed by the self-referred subjects, predictive efficiency analyses indicated that the QEWP was able to identify both high and low probability binge eaters. Implications of the findings for the definition, assessment, and utility of the BED diagnosis are discussed.
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Affiliation(s)
- D W Nangle
- Department of Psychological Science, Ball State University, Muncie, Indiana
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Antony MM, Johnson WG, Carr-Nangle RE, Abel JL. Psychopathology correlates of binge eating and binge eating disorder. Compr Psychiatry 1994; 35:386-92. [PMID: 7995032 DOI: 10.1016/0010-440x(94)90280-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The present study examined the psychopathology associated with binge eating disorder (BED), a new diagnostic category proposed for DSM-IV to classify patients with significant binge eating problems in the absence of purging. Self-report measures of psychopathology (e.g., depression, anxiety) and body image disturbance were administered to 72 women who prospectively (1) met criteria for BED (DSM-IV criteria), (2) reported frequent bingeing but did not meet BED criteria, and (3) denied problems with eating. Subjects satisfying BED criteria reported higher levels of psychopathology than normals on all measures and subclinical binge eaters scored between these two groups, but they were closer to subjects without eating problems. The pattern of results was essentially unchanged when corrected for weight. BED subjects and subclinical binge eaters were less satisfied with their bodies than were normal controls. These findings suggest that BED is not only characterized by frequent bingeing, but more importantly is associated with elevated psychopathology. Overall, these results lend support to the diagnostic criteria proposed for BED.
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Affiliation(s)
- M M Antony
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson 39216-4505
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