Risk of Binge Eating Disorder in Patients With Non-Alcoholic Fatty Liver Disease Screened for Metabolic Features

Abstract

Purpose - Very few data exist on the association between non-alcoholic fatty liver disease (NAFLD) and eating disorders. The study was aimed to evaluate the presence of binge eating disorder (BED), frequently associated with obesity, in NAFLD subjects screened for the features of metabolic syndrome. Methods - Demographic, clinical investigation, anthropometric measurements and laboratory were collected in 129 patients with NAFLD (34.1% males; age, 53.7 years; BMI, 34.4 kg/m2) addressed by general practitioners to a hospital-based unit of metabolic disorders. The risk of binge eating was tested by the binge eating scale (BES); values in the range 17-26 were considered “possible” BED, values > 26 were considered “probable” BED. Hepatic steatosis and fibrosis were tested by surrogate biomarkers and imaging (transient elastography). Calorie intake and lifestyle were self-assessed by questionnaires. Results - Possible BED was present in 17.8% of cases, probable BED in another 7.6%, and were neither associated with gender, obesity class, diabetes, features of metabolic syndrome, nor with presence and severity of hepatic steatosis and fibrosis. Also steatosis grade by CAP and fibrosis stage by liver stiffness did not correlate with BES. However, an association was present between the daily caloric intake and “possible” BED (odds ratio, 1.14; 95% confidence interval, 1.05-1.24; “probable” BED, 1.21; 1.07-1.37), after adjustment for confounders. Conclusion - Binge eating, as scored by BES, is present in a significant proportion of NAFLD cases screened for metabolic disorders. It may impact behavioral treatment, reducing the chance of weight loss without systematic psychological support.