Binge eating disorder is characterized by the consumption of large amounts of food with a feeling of loss of control (bingeing). Bingeing is not followed by attempts to rid the body of the excess food consumed (purging).

• Binge eating disorder is more common among people who are obese.
• People eat large amounts rapidly, do not purge, and are very distressed by their behavior.
• Doctors base the diagnosis on people's description of their behavior.
• Weight-loss programs and the weight-loss drug sibutramineSome Trade Names
  MERIDIA
  may help control weight, cognitive-behavioral therapy may help control the binges, and a selective serotonin reuptake inhibitor (a type of antidepressant) may do both.

Overall, about 3.5% of women and 2% of men have binge eating disorder. But the disorder becomes more common with increasing body weight. In some weight reduction programs, 30% of obese people have the disorder.

Most people with binge eating disorder are obese, and the disorder contributes to their consumption of excessive calories. In contrast, most people with bulimia nervosa have a normal or near-normal weight, and most people with anorexia nervosa are thin. People with binge eating disorder are older than those with anorexia nervosa or bulimia nervosa, and nearly half are men.

Did You Know? Nearly half of the people with binge eating disorder are men. About half of obese people with binge eating disorder are depressed.

Symptoms

People eat a much larger amount of food than most people would eat in a similar time under similar circumstances. During and after a binge, people feel as if they lost control. Bingeing occurs in episodes, as opposed to constant overeating. They may also do the following:

• Eat much more rapidly than normal
• Eat until they feel uncomfortably full
• Eat large amounts of food when they do not feel hungry
• Eat alone because they are embarrassed
• Feel disgusted, depressed, or guilty after overeating

People with binge eating disorder are distressed by it, especially if they are trying to lose weight. Among people who are obese, about 50% of those with the disorder are depressed compared with fewer than 5% of those without the disorder.

Diagnosis

Technically, the diagnosis is confirmed when people report binges on 2 days a week for at least 6 months with a feeling of no control over eating. But doctors may diagnose the disorder without this information when people's description of their behavior and symptoms strongly suggest it.

Treatment

Most people are treated in conventional behavioral weight reduction programs. Although these programs pay little attention to binge eating specifically, people tend to accept this because they are usually more concerned about their weight than about their binge eating. Conventional weight reduction programs are effective in not only producing weight loss but also in helping control binge eating. Binge eating apparently does not limit weight loss in these programs.

The following treatments may help:

• Cognitive-behavioral therapy can help control binge eating but has little effect on body weight.
• Sibutramine, a weight-loss drug, helps people lose weight and slightly reduces the number of binges.
• Selective serotonin reuptake inhibitors (a type of antidepressant), such as fluoxetineSome Trade Names
  PROZAC
  , can control binge eating and weight, but stopping the drug is frequently followed by a return to binge eating.
• Self-help groups that follow the principles of Alcoholics Anonymous (such as Overeaters Anonymous and Food Addicts Anonymous) are widespread, but their effectiveness is uncertain.
• Surgery may be done to treat obesity, but its effects on binge eating are unclear.

Last full review/revision June 2008 by Albert J. Stunkard, MD