Binge Eating Disorder Flashcards
DSM-5 Binge-Eating Disorder Diagnostic Criteria
A. Binge eating disorder is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.
B. Binge-eating episodes are associated with 3 or more of the following over the course of time:
● Eating much more rapidly than normal
● Eating until feeling uncomfortable full
● Eating large amounts of food when not feeling physically hungry
● Eating alone because of feeling embarrassed about how much someone is eating
● Feeling disgusted with one-self, depressed, or guilty afterwards
C. Marked distress regarding binge eating is present
D. The binge eating occurs, on average, at least once a week for 3 months
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa
Severity
● Mild: 1-3 episodes per week
● Moderate: 4-7 episodes per week per week
● Severe: 8-13 episodes
● Extreme: 14+ episodes per week
Associated Features
● Occurs in normal weight or over weight individuals
● Associated with obesity, but distinct
● Most obese individuals do not engage in recurrent binge-eating
Prevalence
● 12-month prevalence (18 years old+)
○ 1.6% females and .8%males
● More prevalent with individuals seeking weight-loss treatment than in the general population because they’re trying to do well but slip
Development and Course
● Little known about development. More common in adolescents and college-age samples, however binge eating can occur in childhood without excessive consumption
● Dieting follows binge-eating – different from Bulimia
● Remission rates higher than for Bulimia and Anorexia
● Cross-over between other eating disorders is uncommon
● Culture: occurs with similar frequencies in most industrialized countries
● Functional Consequences:
○ Social role adjustment problems
○ Impaired health quality of life & satisfaction
○ Increased medical morbidity & mortality
○ May be associated with increased risk for weight gain and development of obesity
Comorbidity
● Similar to Anorexia and Bulimia
● Lesser degrees of substance use
● Severity is linked to the severity of binge-eating and not the degree of obesity
Implications
● Educate personnel & staff
● Students
○ Provide info about social norms (educate before puberty)
○ Promote moderate exercise regimens
○ Illustrate age height/ weight ratios
● Parents
● Psycho-education & resources for treatments
● Acceptance of child disorders
● Establish reasonable expectations
● Develop security & trust
● Assessment & direct instruction
● Refer out for serious cases
● Collaborate with multi-disciplinary team
● Flexibility- class scheduling, attendance, & monitoring of eating/health
● Accommodations
Assessment
Assessment of Eating Disorders- ALL
● Medical evaluation**
○ Not where you do an IQ test; paid by for school and results get to schools; however most schools can’t treat this
● Attention to risk factors (age, family history, weight reduction/ fear of gain, binge eating, concern with weight, body & shape, ego deficits & perceptual disturbances)
● 4 general areas for assessment
○ Self-regulation
○ Interpersonal skills & relationships
○ Self-esteem
○ Distorted beliefs & cognitions
● Social History & Assessment tools
○ Questionnaires assess specific eating behaviors & attitudes, medical/treatment histories, self-injurious behaviors
○ Interviews
● Associated features / comorbid conditions
● Willingness to change
● Eating behaviors
● Nutrition
● Comorbid conditions and personality
Assessment Considerations
● Many times do not self-refer / ambivalent about treatment
● Hide weight loss or maladaptive behaviors
● Confidentiality & disclosure
Etiology
FOR ALL EATING DISORDERS Individual factors ○ Norepinephrine & serotonin abnormalities ○ Childhood sexual abuse ○ Negative life events ○ Low self-esteem ○ Perfectionism ○ Need for control ○ Internalization of the thin ideal ○ Mood disturbances / emotional regulation ○ Early dieting or food restriction ○ Physiological tendencies ● Disturbed Familial characteristics ○ Lack of emotional validation ○ Focus on image or appearance
Binge-Eating Disorders
● Binge eating disorder was approved for inclusion in DSM-5 as its own category of eating disorder
● Intended to increase awareness of the substantial differences between binge eating disorder and the common phenomenon of overeating
● This was a controversial addition
○ Is this part of the over-medicalization of behavior?
