Bulimia nervosa. Binge-eating disorder has recurrent binge eating in common with bu- limia nervosa but differs from the latter disorder in some fundamental respects. In terms of clinical presentation, the recurrent inappropriate compensatory behavior (e.g., purging, driven exercise) seen in bulimia nervosa is absent in binge-eating disorder. Unlike in- dividuals with bulimia nervosa, individuals with binge-eating disorder typically do not show marked or sustained dietary restriction designed to inﬂuence body weight and shape between binge-eating episodes. They may, however, report frequent attempts at dieting. Binge-eating disorder also differs from bulimia nervosa in terms of response to treat- ment. Rates of improvement are consistently higher among individuals with binge-eating disorder than among those with bulimia nervosa.
Obesity. Binge—eating disorder is associated with overweight and obesity but has several key features that are distinct from obesity. First, levels of overvaluation of body weight and shape are higher in obese individuals with the disorder than in those without the disorder. Second, rates of psychiatric comorbidity are significantly higher among obese individuals with the disorder compared with those without the disorder. Third, the long-term successful outcome of evidence-based psychological treatments for binge- eating disorder can be contrasted with the absence of effective long-term treatments for obesity.
Bipolar and depressive disorders. Increases in appetite and weight gain are included in the criteria for major depressive episode and in the atypical features specifiers for de- pressive and bipolar disorders. Increased eating in the context of a major depressive epi- sode may or may not be associated with loss of control. If the full criteria for both disorders are met, both diagnoses can be given. Binge eating and other symptoms of disordered eat- ing are seen in association with bipolar disorder. If the full criteria for both disorders are met, both diagnoses should be given.
Borderline personality disorder. Binge eating is included in the impulsive behavior cri- terion that is part of the definition of borderline personality disorder. If the full criteria for both disorders are met, both diagnoses should be given.
Binge-eating disorder is associated with significant psychiatric comorbidity that is com- parable to that of bulimia nervosa and anorexia nervosa. The most common comorbid dis- orders are bipolar disorders, depressive disorders, anxiety disorders, and, to a lesser degree, substance use disorders. The psychiatric comorbidity is linked to the severity of binge eating and not to the degree of obesity.
307.59 (F50.8)
This category applies to presentations in which symptoms characteristic of a feeding and eating disorder that cause clinically significant distress or impairment in social, occupation- al, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the feeding and eating disorders diagnostic class. The other spec- ified feeding or eating disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific feeding and eating disorder. This is done by recording “other specified feeding or eating disorder” followed by the specific reason (e.g., “bulimia nervosa of low frequency”).
Examples of presentations that can be specified using the “other specified" designation include the following: 1. Atypical anorexia nervosa: All of the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual’s weight is within or above the normal range.
2. Bulimia nervosa (of low frequency andlor limited duration): All of the criteria for bulimia nervosa are met, except that the binge eating and inappropriate compensatory behaviors occur, on average, less than once a week and/or for less than 3 months.