Woman Sitting Inside a Binge Eating Disorder Fast Food Box

Binge eating disorder (BED)

Consumes Her

But no one knows she's suffering

Binge Eating Disorder (BED) is a neuropsychiatric condition that has been shown to significantly impact a patient's life, both work and personal interactions.1,2 The burden of BED is bigger than the binge. From compulsive eating behaviors to obsessive thoughts around food,3-5 people with BED may be stuck in a damaging and repetitive cycle of planning, secrecy, bingeing, and shame, isolating them from the people and things they care about most.1

For future updates and information about BED, join BurdenofBED.

People with BED may suffer in silence and secrecy1

BED is the most common eating disorder among adults in the US7

According to one survey,a


~ 97 %


OF ADULTS WHO MET
DIAGNOSTIC CRITERIA


FOR BED


DID NOT RECEIVE


A FORMAL DIAGNOSIS6,a

People with BED may suffer in silence and secrecy1

BED is the most common eating disorder among adults in the US.7

Lifetime Prevalance of Eating Disorders - Binge Eating Disorder Bar Chart

Patients don't talk about it. And health care professionals don't hear about it.9 Many people with BED also suffer from other psychiatric disorders, such as bipolar disorders, depressive disorders, and anxiety disorders.1 One or more of these patients may already be in your practice.

Patients don't talk about it. And health care professionals don't hear about it.9 Many people with BED also suffer from other psychiatric disorders, such as bipolar disorders, depressive disorders, and anxiety disorders.1 One or more of these patients may already be in your practice.

Patients don't talk about it. And health care professionals don't hear about it.9 Many people with BED also suffer from other psychiatric disorders, such as bipolar disorders, depressive disorders, and anxiety disorders.1 One or more of these patients may already be in your practice.

How many patients like her do you think you may see in your practice every day? Find out more about identifying BED in your patients.

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aFrom participants in the 2012 and 2013 National Health and Wellness Survey, 3% of respondents (11/344) who reported symptoms within the last 12 months that were consistent with DSM-5 criteria for BED had ever received a formal diagnosis.6

BED may have a negative impact on a person's life2,b

People with BED may be trapped by their compulsive eating behavior and obsessive thoughts around food,3-5 which results in secrecy and isolation. And the consequences have been shown to extend into many facets of their personal lives, from work to personal interactions.2

The burden of bed is not limited to the binge2

Arrows Pointing Down Image

REDUCED WORK
PERFORMANCE

Red Heart Broken Image

RELATIONSHIP
DISTRESS

Public Distress Image

PUBLIC
DISTRESS

Physical Limitations Image

PHYSICAL
LIMITATIONSc

Reduced Self Esteem Image

REDUCED
SELF-ESTEEM

bData from a study of treatment-seeking obese individuals with and without BED compared on QOL scores using the Impact of Weight on Quality of Life (IWQOL-Lite) questionnaire
cPhysical limitations were not found to be statistically significant. P=0.095

~ 79 % %

of adults with lifetime BED

also met the lifetime DSM-IV criteria for one other psychiatric disorder.10,d

And for most patients, the struggle is more than BED

Many people with BED also suffer from other psychiatric disorders.1 In fact, you may already be seeing these patients for other disorders which may include bipolar disorders, depressive disorders, and anxiety disorders.1

~ 49 % %

of adults with lifetime BED

also met the lifetime DSM-IV criteria for 3 or more other psychiatric disorders.10,d

dIn a National Comorbidity Survey Replication of 9,282 adults over the age 18 in the US, BED was found to be present in people with these other disorders; anxiety, mood disorders, impulse-control disorders, and substance use disorders (comorbidity rates ranged from 6.5% to 65.1%).10

It's more than psychiatric comorbidities

While patients may have psychiatric comorbidities, other physical disorders may also exist. Hypertension, high cholesterol, arthritis, sleep problems, high triglycerides, and diabetes may be additional challenges faced by people with BED.8,e

eData from the national epidemiologic survey on alcohol and related conditions III (NESARC-III), that examined lifetime prevalence of comorbid somatic conditions across DSM-5 lifetime AN, BN, BED and no-specific ED.

BED is NOT a matter of willpower

No single cause for BED has been identified; however, contributing factors may include genetic, physiological,1 and neurobiological influences.11-13 And simple willpower cannot effectively counterbalance these circumstances. The underlying cause is unknown.

Brain

Emerging Science on the Neurobiology of BED

BED is thought to be characterized by both compulsive eating behaviors and obsessive thoughts around food.3-5 Certain regions of the brain and neurotransmitters are thought to play key roles in impulse control and modulation of goal-directed behaviors such as feeding and satiety. Possible dysregulation of neural mechanisms in patients with BED may lead to their compulsive eating behaviors and thoughts related to food.13,14

Brain

BED is bigger than the binge

Compulsive eating behaviors and obsessive thoughts around food are what may characterize BED3-5

Compulsive Behaviors, Episode, and Obsessive Thoughts of Binge Eating Disorder triggers compulsive-urges planning binge-episode physical-discomfort distress-guilt isolation BED Cycle Graphic emotional-triggers compulsive-urges planning binge-eating physical-discomfort distress-guilt isolation BED Cycle Graphic emotional-triggers compulsive-urges planning binge physical-discomfort distress-guilt isolation BED Cycle Graphic emotional-triggers compulsive-urges planning binge-episode physical-discomfort distress-guilt isolation BED Cycle Graphic physical-discomfort binge distress-guilt isolation emotional-triggers compulsive-urges planning BED Cycle Graphic emotional-triggers distress-guilt physical-discomfort binge-episode planning compulsive-urges isolation BED Cycle Graphic distress-guilt physical-discomfort binge isolation emotional-triggers compulsive-urges planning BED Cycle Graphic physical discomfort distress-guilt isolation binge-episode emotional-triggers compulsive-urges planning
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Symptoms of Binge Eating Disorder

The DSM-5 lists specific criteria designed to aid physicians in diagnosing patients who have BED.1

A diagnosis of BED may be characterized by the presence of these criteria1:

turkey burger muffin

Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  1. Eating an amount of food in a discrete period of time (eg, within any 2-hour period) that is definitely larger than what most people would eat in a similar period of time under similar circumstances

  2. A sense of lack of control over eating during the episode (eg, a feeling that one cannot stop eating or control what or how much one is eating)

thought exclaimation

Binge eating episodes include at least 3 of these:

  1. Eating much more quickly than usual

  2. Eating so much food that it makes the person feel uncomfortably full

  3. Eating a lot of food even if the person isn’t physically hungry

  4. Eating in secret because the person feels ashamed or embarrassed about how much they are eating

  5. A feeling of guilt, disgust, or depression after a binge eating episode

thought cloud

The patient has significant distress about their binge eating episodes

once per week calendar

A binge eating episode takes place at least once a week for 3 months

no purging

The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

Have that conversation with your patient

Careful probing about BED symptoms may help patients feel more comfortable, so they don't shut the conversation down.

For tips to start that discussion with your patients, download the Conversation Starter now.

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Doctor Wearing White Coat Sitting at Desk

Uncovering Binge Eating Disorder

Test Your knowledge against your peers!

This activity contains 4 True/False questions and 4 multiple-choice questions about Binge Eating Disorder (BED).
Each correct answer earns you points. Answer as quickly as you can to earn additional points.
Your answers will be displayed on the leaderboard in front of you if you make it into the top 10.

All fields required.

TRUE or FALSE

BED is a neuropsychiatric disorder with specific diagnostic criteria.

BED has been shown to be the most prevalent eating disorder in a nationally representative sample of U.S. adults.

TRUE or FALSE

According to the DSM-5, if a patient meets the full criteria for BED and a major depressive episode or bipolar disorder, both diagnoses can be given.

According to the DSM-5, there are clinical features that differentiate BED from bulimia nervosa, which is also associated with recurrent episodes of binge eating.

Question 1

In the DMS-5, BED is defined as recurrent episodes of binge eating that, on average, occur:

Question 2

According to the DMS-5, binge eating disorder episodes may be associated with:

Question 3

According to the DMS-5, binge eating is characterized by:

Question 4

In a sample of U.S. adults who participated in the National Health and Wellness Survey, _____ of adults who reported having BED also reported they had never been diagnosed with BED by a health care provider.

Your results are in!

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What are your experiences with BED?

We would appreciate your input. Please take a minute to complete our 3-question survey.

Question 1

Which psychiatric comorbidity do you see most among patients with BED in your practice?

Based on your experience, how many patients do you suspect may be suffering from BED in your practice?

How do you start the discussion if you suspect your patient may be struggling with binge eating disorder? (Select the most accurate response.)

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REFERENCES:

  1. American Psychiatric Association. Binge eating disorder. In: Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Association; 2013:350-353.

  2. Rieger E, Wilfley DE, Stein RI, Marino V, Crow SJ. A comparison of quality of life in obese individuals with and without binge eating disorder. Int J Eat Disord. 2005;37(3):234-240.

  3. Deal LS, Wirth RJ, Gasior M, et al. Validation of the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating. Int J Eat Disord. 2015;48(7):994-1004.

  4. McElroy SL, Phillips KA, Keck PE, Jr. Obsessive compulsive spectrum disorder. J Clin Psychiatry. 1994;55(10) suppl:33-51.

  5. Beglin SJ, Fairburn CG. What is meant by the term “binge”? Am J Psychiat. 1992;149(1):123-124.

  6. Cossrow N, Pawaskar M, Witt EA, et al. Estimating the prevalence of binge eating disorder in a community sample from the United States: comparing DSM-IV-TR and DSM-5 criteria. J Clin Psychiatry. 2016;77(8):e968-e974.

  7. Udo T, Grilo CM. Prevalence and correlates of DSM-5–defined eating disorders in a nationally representative sample of U.S. adults. Biol Psychiatry. 2018;84(5):345-354.

  8. Udo T, Grilo CM. Psychiatric and medical correlates of DSM-5 eating disorders in a nationally representative sample of adults in the United States. Int J Eat Disord. 2019;52(1):42-50.

  9. Kornstein SG, Keck PE Jr, Herman BK, Puhl RM, Wilfley DE, DiMarco ID. Communication between physicians and patients with suspected or diagnosed binge eating disorder. Postgrad Med. 2015;127(7):661-670.

  10. Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348-358.

  11. Perani D, Garibotto V, Gorini A, et al. In vivo PET study of 5HT2A serotonin and D2 dopamine dysfunction in drug-naive obsessive-compulsive disorder. Neuroimage. 2008;42(1):306-314.

  12. Hesse S, Müller U, Rullmann M, et al. The association between in vivo central noradrenaline transporter availability and trait impulsivity. Psychiatry Res Neuroimaging. 2017;267:9-14.

  13. Kessler RM, Hutson PH, Herman BK, Potenza MN. The neurobiological basis of binge-eating disorder. Neurosci Biobehav Rev. 2016;63:223-238.

  14. Balodis IM, Molina ND, Kober H, et al. Divergent neural substrates of inhibitory control in binge eating disorder relative to other manifestations of obesity. Obesity. 2013;21(2):367-377.