Characteristics of binge eating disorder in relation to diagnostic criteria

Abstract

The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria.

The Significance of Overvaluation of Shape or Weight in Binge‐Eating Disorder: Results from a National Sample of U.S. Adults

“…In summary, these findings, derived from a large nationally representative sample of U.S. adults, suggest that the presence of overvaluation in BED signals greater severity (i.e., in this case, greater functional impairment) and therefore warrants consideration as a diagnostic specifier in future editions of the DSM . Research with clinical and community samples has found that overvaluation provides more robust information about severity of BED than the new DSM‐5 severity specifier based on binge‐eating frequency.…”

“…Grilo argued, however, that overvaluation should not be a required criterion, as it would exclude a significant proportion of persons with BED with clinically meaningful concerns . This position has received continued support .…”

Bariatric Surgery and Binge Eating Disorder: Should Surgeons Care About It? A Literature Review of Prevalence and Assessment Tools

“…Binge eating symptoms were first noted in 1959 by psychiatrist Albert Stunkard when describing the abnormal eating pattern of a 30-year-old salesman (6) , but the American Psychiatric Association has only recently recognized BED as a formal category of psychiatric disorder (7) . There is a wide spectrum of clinical manifestations of eating behaviors, from overeating and gluttony to variable binge symptoms until full Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) BED-criteria are met (8) . Therefore, the diagnosis of BED is challenging, due to its complexity and variability in phenotypic presentation (9) .…”

Cyfip1 haploinsufficiency increases compulsive-like behavior and modulates palatable food intake: Implications for Prader-Willi Syndrome

“…An increase in marble burying can predict BE 67,68 and thus, our results suggest that human genetic polymorphisms affecting CYFIP1 expression could modulate OC behavior and risk for eating disorders 41,42 . OC behaviors are associated with both BE 37,38 and PWS hyperphagia 40 . However, in our 1 4 studies, there was no clear relationship between OC-like behaviors and PF intake.…”