The Most Common Eating Disorder

binge eating disorder counselingIn the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or EDNOS (eating disorders not otherwise specified).

EDNOS, formerly called atypical eating disorder, refers to behavior or eating patterns that are characteristic of some or all eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder and compulsive overeating.

The most well-known eating disorders are probably anorexia nervosa and bulimia nervosa (often called “anorexia” and “bulimia” respectively). However, there are other food-related disorders, like avoidant/restrictive food intake disorder, body image disorders and food phobias.

Binge Eating Disorder

The most common eating disorder in the United States is binge eating disorder (BED). It is a severe, life-threatening disorder characterized by 1) recurrent episodes of eating large quantities of food (typically very quickly and with the result of discomfort);  2) feeling of a loss of control during the binge; and 3)  experiencing shame, distress or guilt afterwards.

BED is one of the newest eating disorders formally recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM5). Before most editions, BED was listed as a subtype of EDNOS. The diagnostic criteria for BED are:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge eating episodes are associated with three (or more) of the following:
  • Eating much more rapidly than normal.
  • Eating until feeling uncomfortably full.
  • Eating large amounts of food when not feeling physically hungry.
  • Eating alone because of feeling embarrassed by how much one is eating.
  • Feeling disgusted with oneself, depressed, or very guilty afterward.
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for 3 months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Onset of BED

BED usually begins in the late teens or early 20s, although onset can occur in young children and older adults. Approximately 40 percent of individuals with BED are male. Research into the association between BED and food addiction has recently received greater attention, in part due to the similarities between BED and the behavioral indicators of addiction, such increased compulsivity, diminished control over consumption, and continued excessive consumption despite negative consequences.

Randi Fredricks, Ph.D.

References

Hudson JI, Hiripi E, Pope HG Jr, and Kessler RC. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3):348-58.

Stice E & Bohon C. (2012). Eating Disorders. In Child and Adolescent Psychopathology, 2nd Edition, Theodore Beauchaine & Stephen Linshaw, eds. New York: Wiley.

Wade, T. D., Keski-Rahkonen A., & Hudson J. (2011).Epidemiology of eating disorders. In M. Tsuang and M. Tohen (Eds.), Textbook inPsychiatric Epidemiology (3rd ed.) (pp. 343-360). New York: Wiley.

Westerberg, D. P., & Waitz, M. (2013). Binge-eating disorder. Osteopathic Family Physician, 5(6), 230-233.