Binge eating disorder: clinical features and treatment of a new diagnosis

This review will describe the diagnostic criteria for the recently proposed diagnosis of binge eating disorder and provide an overview of its prevalence, clinical characteristics, and treatment approaches. Studies indicate that binge eaters represent a substantial proportion (18-46%) of the obese in weight control programs. Normal-weight patients with bulimia nervosa, obese binge eaters, and obese nonbinge eaters appear to represent three distinct populations, with obese nonbinge eaters showing the least psychological disturbance and patients with bulimia nervosa exhibiting the most. Preliminary findings indicate that obese binge eaters may be more likely than nonbinge eaters to drop out of treatment when treated by conventional weight loss programs, although weight losses achieved by binge eaters and nonbinge eaters who finish treatment do not differ significantly. Treatment programs that focus on the disturbed eating behavior appear to be effective to some degree in reducing binge eating frequency and related pathology, but patients tend to relapse after completion of treatment. Operationalized criteria such as the proposed DSM-IV criteria for binge eating disorder could facilitate coordinated research on binge eaters who do not meet criteria for bulimia nervosa.