Binge Eating Disorder (BED) - New diagnostic category

Binge Eating Disorder (BED) is a proposed new diagnostic criteria in the DSM-IV, cited as an example of an eating disorder Not Otherwise Specified (NOS). The phrase Binge Eating was introduced over 35 years ago to describe problematic behavior found in a subgroup of overweight individuals, and as a subgroup of Bulimia Nervosa. The defining characteristics of BED patients are consumptions of an objectively large amount of food in discrete time periods, a lack of control during eating episodes and a lack of compensatory behavior binge. BEDs affect approximately 30% of obese individuals seeking treatment. The binge eaters represent a distinct subgroup among the obese with higher prevalence of comorbid psychiatric disturbances, as well as higher rates of eating pathology, as compared to normal obese women. Several researches suggested that individuals use binge eating as a means of coping with emotional distress. In addition, the binge eating disorder represents a distinct subgroup among bulimia nervosa with lower comorbid psychiatric disturbances, eating pathology and purging behavior. The present paper will review this proposed syndrome and will discuss the question of whether it is a distinct subgroup of obese patients or a distinct subgroup of bulimia nervosa patients, or a new diagnostic category. This diagnostic dilemma is discussed in light of clinical and empirical literature. Clinical and therapeutic implications are presented and ideas for future research are proposed.