of the following features: eating much more rapidly than normal; eating until feeling un- comfortably full; eating large amounts of food when not feeling physically hungry; eating alone because of feeling embarrassed by how much one is eating; and feeling disgusted with oneself, depressed, or very guilty afterward (Criterion B).
Individuals with binge—eating disorder are typically ashamed of their eating problems and attempt to conceal their symptoms. Binge eating usually occurs in secrecy or as incon- spicuously as possible. The most common antecedent of binge eating is negative affect.
to body weight, body shape, and food; and boredom. Binge eating may minimize or mit- igate factors that precipitated the episode in the short-term, but negative self-evaluation and dysphoria often are the delayed consequences.
Binge-eating disorder occurs in normal—weight/overweight and obese individuals. It is re- liably associated with overweight and obesity in treatment-seeking individuals. Never- theless, binge-eating disorder is distinct from obesity. Most obese individuals do not engage in recurrent binge eating. In addition, compared with weight-matched obese indi- viduals without binge-eating disorder, those with the disorder consume more calories in laboratory studies of eating behavior and have greater functional impairment, lower qual- ity of life, more subjective distress, and greater psychiatric comorbidity.
Twelve-month prevalence of binge-eating disorder among U.S. adult (age 18 or older) fe- males and males is 1.6% and 0.8%, respectively. The gender ratio is far less skewed in binge- eating disorder than in bulimia nervosa. Binge-eating disorder is as prevalent among fe- males from racial or ethnic minority groups as has been reported for white females. The disorder is more prevalent among individuals seeking weight—loss treatment than in the general population.
Little is known about the development of binge-eating disorder. Both binge eating and associated with increased body fat, weight gain, and increases in psychological symptoms.
Binge eating is common in adolescent and college-age samples. Loss-of-control eating or episodic binge eating may represent a prodromal phase of eating disorders for some indi- viduals.
Dieting follows the development of binge eating in many individuals with binge- eating disorder. (This is in contrast to bulimia nervosa, in which dysfunctional dieting usually precedes the onset of binge eating.) Binge-eating disorder typically begins in ad- olescence or young adulthood but can begin in later adulthood. Individuals with binge- eating disorder who seek treatment usually are older than individuals with either bulimia nervosa or anorexia nervosa who seek treatment.
Remission rates in both natural course and treatment outcome studies are higher for binge-eating disorder than for bulimia nervosa or anorexia nervosa. Binge-eating disorder appears to be relatively persistent, and the course is comparable to that of bulimia nervosa in terms of severity and duration. Crossover from binge-eating disorder to other eating disorders is uncommon.
Genetic and physiological. Binge—eating disorder appears to run in families, which may reﬂect additive genetic inﬂuences.
Binge-eating disorder occurs with roughly similar frequencies in most industrialized countries, including the United States, Canada, many European countries, Australia, and
New Zealand. In the United States, the prevalence of binge-eating disorder appears com- parable among non-Latino whites, Latinos, Asians, and African Americans.
Functionai Consequences of Binge-Eating Disorder
Binge-eating disorder is associated with a range of functional consequences, including so- cial role adjustment problems, impaired health-related quality of life and life satisfaction, increased medical morbidity and mortality, and associated increased health care utiliza- tion compared with body mass index (BMI)—matched control subjects. It may also be as- sociated with an increased risk for weight gain and the development of obesity.