By Nikita Katz, MD, PhD
Binge eating disorder is an illness that resembles bulimia nervosa. Like bulimia, the disorder is characterized by episodes of uncontrolled eating or binging—occurring, on average, at least once a week for three months, according to DSM-5. However, binge eating disorder differs from bulimia because its sufferers do not purge their bodies of excess food.
Individuals with binge eating disorder feel that they lose control of themselves when eating. While they commonly eat fewer meals than people without eating disorders. When they do eat, they eat rapidly, consuming large quantities of food and do not stop until they are uncomfortably full. When binging, they typically do so alone because they feel embarrassed by how much they are eating, and they tend to feel disgusted with themselves, depressed, or very guilty afterward. Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations.
Binge eating disorder is found in about two percent of the general population—more often in women than men. Recent research shows that binge eating disorder occurs in about 30 percent of people participating in medically supervised weight-control programs.
Because people with binge eating disorder are usually overweight, they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Research at the National Institutes of Health and elsewhere has shown that individuals with binge eating disorder have high rates of co-occurring psychiatric illnesses, especially depression.
Cognitive behavioral therapy and interpersonal therapy are the treatments found to produce the greatest degree of remission in patients with binge eating disorder. Also, there can be improvements in specific eating-disorder psychopathology, associated psychiatric problems such as depression and psychosocial functioning.
Epidemiology of Eating Disorders
Estimates of the incidence or prevalence of eating disorders vary depending on the sampling and assessment methods.
- Eating disorders have generally been recognized as affecting a narrow population of Caucasian adolescent or adult young women from developed Western countries. In recent years, data are steadily accumulating to document that:
- The prevalence of anorexia nervosa and bulimia nervosa in children and younger adolescents is unknown.
- Approximately 0.5–1 percent of adolescents suffer from anorexia nervosa and 1–5 percent suffer from bulimia nervosa. Female college students are at highest risk of the latter.
- An estimated 85 percent of eating disorders have their onset during adolescence.
- Estimates of the lifetime prevalence of bulimia nervosa among women have ranged from 1.1 to 4.2 percent. Some studies suggest that the prevalence of bulimia nervosa in the United States may have decreased slightly in recent years.
- The reported lifetime prevalence of anorexia nervosa among women has ranged from 0.5 percent for narrowly defined to 4 percent for more broadly defined anorexia nervosa.
- Estimates of the male-female prevalence ratio range from 1:5 to 1:10 (although 19-30 percent of younger patient populations with anorexia nervosa are male).
- An estimated five million Americans suffer from eating disorders at any given time, including approximately 5 percent of women and <1 percent of men with either anorexia nervosa, bulimia nervosa, or binge eating disorder.
- eating disorders have become more common in pre-pubertal children and women in middle and late adulthood in such countries
- ethnic and racial minority groups in these countries are vulnerable to eating disorders, and
- there is nothing uniquely “Western” about eating disorders, which are a global health problem.