Binge Eating, the New Psychiatric Disorder
US researchers from Harvard University conducted the first national survey of eating disorders and they published the results in the journal Biological Psychiatry. The study have described binge eating disorder as a major public health burden.
Binge eating is not yet officially classified as a psychiatric disorder, but it may be more common than the two eating disorders now recognized, anorexia and bulimia nervosa.
Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable overeating. During such binges, a person rapidly consumes an excessive amount of food. Most people who have eating binges feel ashamed or depressed about their overeating. Eating binges can be followed by so-called compensatory behaviour, acts by which the person tries to compensate for the effects of overeating through purging (induced vomiting or laxative abuse), fasting and heavy exercising.
The survey of more than 2,900 men and women found a prevalence in the general population of:
- 0.6 percent for anorexia,
- 1 percent for bulimia and
- 2.8 percent for binge-eating disorder.
Experts not involved in the study called it significant and commented it:
“This is probably the best study yet conducted of the frequencies of eating disorders in American households,” “It confirms that anorexia nervosa and bulimia are uncommon but serious illnesses, especially among women,” “It also finds that many more individuals, especially those with significant obesity, are troubled by binge eating, and underscores the need to better understand this problem.”
Binge eating disorder is not considered a definitive diagnosis like anorexia and bulimia. Rather, it is one of a number of categories requiring further study. Some suspect that establishing binge eating disorder as a psychiatric diagnosis is merely an attempt by psychiatrists or drug companies to “medicalize” what would otherwise be considered simply ordinary, if unfortunate, human behavior.
Marlene B. Schwartz, the director of research and school programs at the Rudd Center for Food Policy and Obesity at Yale, who had no role in the study, said binge-eating disorders were “not a matter of just eating too much every now and then.” “The diagnosis of binge-eating disorder requires the feeling that you can’t stop,” Dr. Schwartz said. “And it’s that loss of control that makes it a psychiatric disorder different from someone just overindulging every now and then.”
A diagnosis of anorexia requires a refusal to maintain at least 85 percent of normal weight and a distinctly distorted view of one’s weight or body shape. Bulimia is characterized by recurrent episodes of binge eating at least twice a week for three months and then compensating for the behavior, usually by self-induced vomiting or abuse of laxatives and other medicines.
Eating disorders are commonly accompanied by other psychiatric illnesses. In the survey, more than half of the people with bulimia had major depression, 50 percent had phobias and more than one-third had a substance abuse disorder. Over all, more than 94 % of people with bulimia, 56 percent of those with anorexia and 79 percent of those with binge-eating disorder had at least one other psychiatric diagnosis.
Dr. Hudson said the most significant limitation of the study was its basis on self-reports, explaining that people tend to underreport their problems with eating disorders. So the true prevalence, he said, is probably higher than reported.
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