Binge Eating Disorder: More Common than Suspected?

Community-based studies have generally shown that about 2% of the general population, or 1 to 2 million adults, have problems with binge eating. A recent study among women seeking treatment for binge eating suggested that binge eating disorder, or BED, may be more common than suspected (Eating Behaviors 2003;3:295).

Nearly 85% of 592 women seeking treatment for binge eating or weight loss reported binge eating (consistent with the DSM-IV definition of a binge). The women were recruited through advertisements and then interviewed by telephone. The women were from 19 to 67 years of age (mean age: 44.7 years). Most were Caucasian, college-educated, and married. Seventy-four percent were obese (BMI >30), and 0.2% were underweight (BMI<18.5). Most reported becoming overweight before they were 19-years-old.

Thirty-three percent of the women (200) met the DSM-IV criteria for BED, 11% (65) met criteria for non-binge eating disorder (NBED), and 55% (328) met criteria for subclinical binge eating disorder (SBED). Among those with SBED, 8.7% tried to control their weight with self-induced vomiting; 24.7% used diuretics, 12.2% used laxatives, and 12.2% regularly used diet pills.

How did those with BED differ?

According to the authors, women diagnosed with BED had higher BMIs, had become overweight at an early age, and reported more unhealthy methods of trying to control weight than did non-BED women. Women with BED also reported more current and past depression and suicidal ideation than did NBED women. Mothers of women with BED also were more often overweight than were mothers of NBED women, but there were no differences in weight of fathers or parental eating disorders between the two groups.

Two characteristics required for a binge include consumption of a large quantity of food in a short time and feelings of loss of control. Two situations seemed to precede binge-eating episodes: stress and boredom. However, a large number of women could not explain why they binge-ate.

Limitations of the study

The authors point out that their study results might be limited by the fact that the women were interviewed by telephone only, and suggest that future

studies could be improved by adding a second phase of assessment to confirm the diagnosis of BED. The results may also be limited by the inherent bias that exists in recalling retrospective information about age overweight, number of pounds overweight and parental weight status and psychological makeup. In addition, the participants responded to ads for a treatment study of binge eating or weight loss, and the recruitment advertisements may have influenced the subjects. The authors note that the prevalence of BED was more similar to samples of clinic-based treatment samples than community-based samples. Finally, the authors admitted that they weren’t able to accurately categorize women in the SBED group as having BN or subthreshold BN because they failed to ask the relevant diagnostic questions to all of the women in the sample.

The authors note that their findings highlight the need to further investigate the relationship between binge eating and depression among women, to better understand whether depression precedes or follows binge eating. This information might be helpful in the development of interventions to target both binge eating and depression among women in treatment and community settings.