Public and Healthcare Professionals’ Knowledge and Attitudes toward Binge Eating Disorder: A Narrative Review

Abstract

Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress in the absence of inappropriate compensatory behaviors for weight control. BED is prevalent in men and women, is associated with elevated psychosocial and functional impairment, and is associated strongly with obesity and related medical comorbidities. The aim is to provide a brief, state-of-the-art review of the major and recent findings to inform educational and awareness campaigns, stigma reduction interventions, as well as current clinical practice and future research. A narrative approach was used to synthesize emerging literature on the public and healthcare professionals’ knowledge and attitudes toward individuals with BED in comparison to other eating disorders (EDs) or mental illness. A total of 13 articles were reviewed. Nine studies investigated community samples and four studies investigated healthcare professionals. The reviewed literature suggested that BED is perceived by the public as less impairing, less severe, and “easier-to-treat” than other EDs. Attitudes and beliefs reflecting perceived blameworthiness and lack of self-discipline were ascribed to vignettes with BED. Community studies indicated a low level of public awareness that BED constitutes a discreet eating disorder. The literature on healthcare professionals’ knowledge and attitudes toward BED remains very limited. The few existing studies suggest encouraging trends in recognition and diagnostic accuracy, yet there remains a need for increased clinical awareness of BED-associated medical complications and knowledge of full BED diagnostic criteria.

Identification of Binge Eating Disorder Criteria: Results of a National Survey of Healthcare Providers

“…Consistent with previous studies (Herman et al., ; Reas, ), the majority of providers were unfamiliar with the new DSM‐5 diagnostic criteria for BED. Few general healthcare providers (11.8%) or psychiatrists (23.5%) had formal training in BED assessment and diagnosis.…”

“…Data on healthcare providers' identification of core features of BED are limited. Most previous studies that examined providers' knowledge of the disorder used dichotomous categorizations based on the presence or absence of BED criteria (Hudson et al, 2007;Kornstein, 2017;Kornstein, Kunovac, Herman, & Culpepper, 2016;Reas, 2017). However, patients presenting with eating disorders are likely to report more nuanced behaviors, and they may not spontaneously disclose binge eating because of guilt or shame (Becker, Hadley Arrindell, Perloe, Fay, & Striegel-Moore, 2010).…”

Results of disseminating an online screen for eating disorders across the U.S.: Reach, respondent characteristics, and unmet treatment need

“…These results are in line with other published work suggesting a wide treatment gap for individuals with eating disorders (Eisenberg et al, ; Hudson et al, ; Kazdin et al, ). The undertreatment of BED in particular is also notable, suggesting that, in line with other work, individuals with BED may be even less likely to be identified by providers or to themselves recognize their symptoms as something in need of treatment compared to individuals with other eating disorders (Reas, ).…”

What prevents young adults from seeking help? Barriers toward help‐seeking for eating disorder symptomatology

“…The finding that participants from the BED and OED groups were more likely to endorse the barrier “If I need help, I will turn to my friends” may indicate a preference for informal support at their current stage. Despite the elevated psychosocial and functional impairment associated with BED (Pawaskar, Witt, Supina, Herman, & Wadden, 2017), there is a perception in the community that BED symptoms are less impairing, less severe, and easier to treat (Anderson, Gratwick‐Sarll, Bentley, Harrison, & Mond, 2016; Reas, 2017), which may have contributed to a preference for more informal, low intensity resources among the BED group. For OED participants with low symptoms and even for some participants from the BED group, the endorsement of help‐seeking from friends may also accurately reflect their current lack of need for treatment.…”