Food for thought: do you ask about eating?

Citrome, Leslie

doi:10.1111/ijcp.12845

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…A simpler approach would be to ask patients routinely about loss of control over eating. 53 Clinicians already routinely ask about appetite and change in weight when conducting health examinations. It is not unduly burdensome to then ask, "Have you ever eaten more than you intended?"…”

Section: Recognizing and Diagnosing Binge Eating Disordermentioning

confidence: 99%

Binge eating disorder revisited: what’s new, what’s different, what’s next

Citrome

2019

CNS Spectr.

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Binge eating disorder (BED) is the most common type of eating disorder. According to the most recent data available, the estimated lifetime prevalence of BED among US adults in the general population is 0.85% (men 0.42% and women 1.25%). Among psychiatric treatment populations, prevalence is several-fold higher. Although many people with BED are obese (BMI ≥ 30 kg/m2), roughly half are not. In the DSM-5, BED is defined by recurrent episodes of binge eating (eating in a discrete period of time, an amount of food larger than most people would eat in a similar amount of time under similar circumstances and a sense of lack of control over eating during the episode), occurring on average at least once a week for 3 months, and associated with marked distress. BED often goes unrecognized and thus untreated; in one study, 344 of 22,387 (1.5%) survey respondents met DSM-5 criteria for BED, but only 11 out of the 344 had ever been diagnosed with BED by a health-care provider. Psychiatric comorbidities are very common, with most adults with BED also experiencing anxiety disorders, mood disorders, impulse control disorders, or substance use disorders, suggesting that clinicians have patients in their practice with unrecognized BED. Multiple neurobiological explanations have been suggested for BED, including dysregulation in reward center and impulse control circuitry. Additionally, there is interplay between genetic influences and environmental stressors. Psychological treatments such as cognitive behavioral interventions have been recommended as first line and are supported by meta-analytic reviews; however, access to such treatments may be limited because of local availability and/or cost, and these treatments generally lead to little to no weight loss, although successfully eliminating binge eating can protect against future weight gain. Routine medication treatments for anxiety and depression do not necessarily ameliorate the symptoms of BED, but there are approved and emerging medication options, lisdexamfetamine and dasotraline, respectively, that specifically address the core drivers behind binge eating, namely obsessive thoughts and compulsive behaviors regarding food, resulting in marked decreases in binge eating behaviors as well as weight loss.

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Section: Recognizing and Diagnosing Binge Eating Disordermentioning

confidence: 99%

Binge eating disorder revisited: what’s new, what’s different, what’s next

Citrome

2019

CNS Spectr.

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“…In last month's editorial, I encouraged clinicians to include one additional sentence in their standard line of questions regarding appetite, essentially “have you ever eaten more than you intended?” followed up with “did you feel like it wasn't easy to stop?” This was based on the observation that many people with eating disorders, especially binge eating disorder (BED), are undiagnosed, resulting in their psychiatric and non‐psychiatric comorbidities remaining suboptimally managed. In this issue of the International Journal of Clinical Practice , Lydecker et al .…”

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confidence: 99%

More food for thought: preferred words

Citrome

2016

Int J Clin Pract

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Binge Eating Disorder: A Psychiatrist's Commentary on Clinical Considerations

Citrome

2021

Clinical Therapeutics

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Purpose: Of the 3 major eating disorders, anorexia nervosa, bulimia nervosa, and binge eating disorder (BED), BED is the most common and exists in the practices of most primary care and psychiatric clinicians. However, BED often goes unrecognized and thus untreated.Methods: Reviewed in this commentary are the basic elements in the diagnosis of BED, demographic and clinical characteristics, screening options, the importance of comorbidities, pathophysiology, and available treatments.Findings: Psychological treatments, including cognitive-behavioral therapy, interpersonal therapy, and behavioral weight loss, have been recommended as first-line options and are supported by several different meta-analytic reviews. Lisdexamfetamine is currently the only medication approved by the US Food and Drug Administration for the treatment of BED. Effect sizes for lisdexamfetamine versus placebo for response, remission, and avoidance of relapse in BED are robust, but its use may be limited by tolerability. This is also the case for topiramate, an anticonvulsant that has been used "off-label" to treat BED.Implications: Additional medication choices approved by the US Food and Drug Administration for the treatment of BED are needed. Moving forward, opportunities to leverage modern technology to broaden access to treatment are highly desirable.

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Food for thought: do you ask about eating?

Cited by 3 publications

References 14 publications

Binge eating disorder revisited: what’s new, what’s different, what’s next

Binge eating disorder revisited: what’s new, what’s different, what’s next

More food for thought: preferred words

Binge Eating Disorder: A Psychiatrist's Commentary on Clinical Considerations

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