Correlates and impact of DSM-5 binge eating disorder, bulimia nervosa and recurrent binge eating: a representative population survey in a middle-income country

Abstract

Purpose Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual’s health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country. Methods The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18–60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020. Results Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment. Conclusion As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL.

The clinical significance of binge eating among older adult women: an investigation into health correlates, psychological wellbeing, and quality of life

“…Overall, our findings are consistent with prior research in the general population suggesting that clinical levels of BE are associated with distress and impairment, including poorer health-related QOL [18,54,[59][60][61]. Of note, constructs within health-related QOL (e.g., physical function, social engagement, vitality) are particularly important to evaluate as health outcomes for older adults [62].…”

Management of eating disorders for people with higher weight: clinical practice guideline

“…It is not well understood by the broader medical community that eating disorders among people of higher weight are just as serious and life threatening (from medical complications and selfharm) as eating disorders among people at lower weight. In addition, eating disorders at any weight are associated with a high level of psychological distress and psychopathology [18][19][20]. In reviewing the literature for this guideline, it is notable that the bias applies in both directions.…”

“…Majority are uncommon (< 20% prevalence estimates) a Common (20-30%) prevalence estimates in BED from Udo and Grilo [47]. Whilst diabetes, cardiovascular and metabolic conditions such as hypertension are also associated with a high BMI with or without an eating disorder, data were corrected for BMI in a later study [18] where similar findings to Udo and Grilo were found; similar findings have also been reported in two studies of children of associations between metabolic syndrome and binge-eating status [110,111] It is important to note that binge eating, loss of control, grazing or emotional eating are not the only or even predominant eating behaviours experienced among people with higher weight [2,122]. Dietary restriction and other disordered behaviours (e.g., use of laxatives, purging, driven or compulsive exercise, dietary supplements use or abuse) are also frequently present among people with higher weight [2].…”

Beyond screening in primary practice settings: Time to stop fiddling while Rome is burning

“…Simplification of the target population may increase recognition in this group but does mean that many people with significant problems with disordered eating will be missed. In addition, if primary care practitioners have gaps in their understanding, yet the care system relies on their clinical suspicion of an eating disorder to enact interview questions, screening will remain biased towards those who fit cultural stereotypes of eating disorders i.e., young, thin, affluent females (Becker et al, 2010; Gordon et al, 2002), while other vulnerable populations, such as those experiencing food insecurity (Hazzard et al, 2020) or living with higher weight (Appolinario et al, 2022) will be missed.…”