Binge Eating

Binge eating disorder, also referred to as compulsive overeating, is a recently recognized eating disorder. It is characterized by repeated episodes of uncontrolled eating where the bingeing does not stop until the person is uncomfortably full. This disorder is similar to bulimia nervosa; however, people with binge eating disorder usually do not purge their bodies of the excessive food they consume. Table I highlights the diagnostic criteria for binge eating disorder.

According to the National Diabetes and Digestive Kidney Diseases (NIDDK) of the National Institutes of Health (NIH), approximately 2%, or 4 million Americans, have binge eating disorder. About 10 to 15% of people who are mildly obese have this disorder. The ratio of females to males with binge eating disorder is 3:2.35 Approximately one-quarter to one-third of individuals attending weight loss clinics meet the criteria for binge eating disorder.21 People who become overweight at a younger age and those who lose and gain back weight frequently (the socalled yo-yo diet) are more likely to have binge eating disorder.

The etiology of binge eating disorder is unknown. Depression may be associated with this condition, but it is not known whether depression causes binge eating or is a consequence of compulsive overeating. The presence of nonspecific risk factors for psychiatric disorders, such as adverse childhood experiences and parental depression, as well as a predisposition to obesity appear to increase the likelihood of developing binge eating disorder.21

Individuals who are obese and have binge eating disorder tend to eat large amounts of foods that are high in fats and sugars. As a result, they are at risk for Type 2 diabetes mellitus, high blood pressure and cholesterol, kidney disease and/or failure, gallbladder disease, cardiovascular disease, cancer, menstrual irregularities, depression, suicidal thoughts, and substance abuse.36

Assessment and diagnosis of binge eating disorder includes thorough health, weight, and diet histories. Physical examination—noting height, weight, calculated body mass index (BMI), blood pressure, and waist circumference measurements (for obese individuals)— should be performed. Laboratory testing should be based on historical and physical examination findings.