Binge eating disorder: disorder or marker?

To describe the evidence for the constellation of symptoms known as binge eating disorder (BED) and to evaluate the utility of this diagnosis.

Examination of the definition, prevalence, psychiatric comorbidity, and treatment of BED through a selective review of the literature.

The objective definition of a binge (its size and duration) remains problematic. Persons with BED have extensive comorbid psychopathology. Pharmacologic treatments effectively reduce binge eating, but only somewhat more than placebos, whereas psychotherapeutic treatments reduce binge eating, but do not produce weight loss. Traditional behavioral weight loss programs produce both weight loss and decreases in binge eating. The course of BED is variable and often remits with nonspecific attention or during wait-list conditions.

Although there is consensus on the criteria for BED, its great variability limits the implications that can be drawn from its diagnosis, and it may be most useful as a marker of psychopathology.