Objective: To estimate binge eating disorder (BED) prevalence according to DSM-5 and DSM-IV-TR criteria in US adults and to estimate the proportion of individuals meeting DSM-5 BED criteria who reported being formally diagnosed. Methods: A representative sample of US adults who participated in the National Health and Wellness Survey were asked to respond to an Internet survey (conducted in October 2013). Assessments included 3-month, 12-month, and lifetime BED prevalence based on DSM-5 and DSM-IV-TR criteria and demographics, psychiatric comorbidities, and self-esteem (Rosenberg Self-Esteem Scale).Descriptive statistics are provided. Prevalence estimates were calculated using poststratification sampling weights. Results: Of 22,397 respondents, 344 (women, n = 242; men, n = 102) self-reported symptoms consistent with DSM-5 BED symptom criteria. The 3-month, 12-month, and lifetime DSM-5 prevalence estimates (95% CIs) projected to the US population were 1.19% (1.04%-1.37%), 1.64% (1.45%-1.85%), and 2.03%(1.83%-2.26%), respectively. The 12-month and lifetime projected DSM-IV-TR prevalence estimates were 1.15% (1.00%-1.32%) and 1.52% (1.35%-1.70%), respectively. Of respondents meeting DSM-5 BED criteria in the past 12 months, 3.2% (11/344) reported receiving a formal diagnosis. Compared with non-BED respondents, respondents meeting DSM-5 BED criteria in the past 12 months were younger (mean ± SD age = 46.01 ± 14.32 vs 51.59 ± 15.80 years; P < .001), had a higher body mass index (mean ± SD = 33.71 ± 9.36 vs 27.96 ± 6.68 kg/m 2 ; P < .001), and had lower self-esteem (mean ± SD score = 16.47 ± 6.99 vs 23.33 ± 6.06; P < .001).
Conclusions: DSM-5 BED criteria resulted in higher BEDprevalence estimates than with DSM-IV-TR criteria. Most BED respondents did not report being formally diagnosed, indicating an unmet need in BED recognition and diagnosis. J Clin Psychiatry 2016;77(8)
Binge eating disorder (BED), the general symptomatology of which was recognized as early as 1959, 1 was included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) as a diagnosis for further study in the early 1990s.2-4 However, it did not receive official recognition as a distinct eating disorder until its inclusion in DSM-5 in 2013. 5 According to DSM-5 diagnostic criteria for BED (Table 1), binge eating must occur at least once a week for ≥ 3 months. These episodes are characterized by the consumption, in a discrete period of time, of a larger amount of food than is typical for most people under similar circumstances, by a sense of lack of control over eating, and by marked distress about binge eating. 5 Unlike bulimia nervosa (BN) and anorexia nervosa (AN), BED is not associated with recurrent inappropriate compensatory behaviors (eg, purging or excessive exercise).
5In the DSM-5, the binge episode frequency criterion was reduced from the DSM-IV Text Revision (DSM-IV-TR) criterion of ≥ 2 days per week for ≥ 6 months, 6 but other criteria were unchanged. Therefore, individuals previously not me...
