Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5

Abstract

IntroductionBinge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies.MethodsWe identified studies published in the last 6 years searching the MeSH Term “binge eating disorder”, with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct.ResultsA total of 233 studies were found and, among them, 71 were selected and included in the review.ReviewAlthough Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy.ConclusionsDespite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.

An Explorative Analysis of Binge Eating Disorder Impulsivity among Obese Candidates to Bariatric Surgery

“…The differences of impulsivity between obese BED and obese non-BED are not yet clearly defined above all because many studies compare BED to the obese population in general without any distinction of the type of food-intake [17]. Furthermore, there are few studies that consider the difference between BED and binge behaviour [5,18]. The latter can be a symptom of psychiatric or genetic disorders such as bipolar disorder, schizophrenia, Prader Willi and its characteristics can belong to the primary psychopathology or be related to craving [19][20][21][22][23][24].…”

“…Researchers stress that excessive concerns about food, body shape and weight, associated with higher depression, higher body dissatisfaction and poorer related quality of life are considered markers of BED [3,4]. However, loss of control provoked by impulsivity is the feature determining binge behaviour [5,6]. Impulsivity can be described as "swift action without forethought or conscious judgment" [7].…”

Obesity and Psychiatric Disorders in a Sample of Obese Candidates for Bariatric Surgery in Campania Region

“…Many studies underline the major frequency of BED in bariatric surgery population [31][32][33][34]. Its rate is increasing among obese and overweight population even if it is not related to BMI determining physical effects that lead to high socio-economic impact.…”

Effectiveness of Multidisciplinary Intervention in Obese Women with Binge Eating Disorder

“…On this purpose, the education to healthier eating and life styles, and the modification of dysfunctional thoughts and habits are essentials. The most evaluated and developed intervention for BED includes behavioral (BT) and Cognitive-Behavioral Therapies (CBT) [11,12]. Behavioral treatments, focused on diet and lifestyle modification, and caloric restrictions should be moderate, and a normal or hypo caloric diet seems to be the best strategy to prevent bingeing.…”