Eating
Binge-Eating Disorder
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Binge-Eating Disorder
, Binge Eating, Compulsive Overeating, Overeating
See Also
Obesity
Eating Disorder
Diagnosis
Binge-Eating Disorder (DSM-5)
Recurrent Binge Eating (eating more than peers in a 2 hour period) with a sense of loss of control
No behaviors to prevent weight gain
Contrast with
Bulimia Nervosa
Weekly behaviors (>=3 months)
Fast eating, uncomfortable after eating, eating large quantities when not hungry
Embarrassed about Overeating
Findings
Compulsive Overeating
Uncontrolled consumption of large food amounts
Eat for relief, comfort, nurturing
Stress
Boredom
Fear
Loneliness
Plan the Next meal while eating this one
Eat more than you want, or out of control with food
Binge Eating
Excessive intake per 2 hour period
Grazing
Large food intake throughout day, no planned meals
Guilt and fear about not being able to stop eating
Eat until feeling uncomfortably full
Surreptitious eating
Eating alone because of shame about excessive eating
Sense of being fat or obese, or fear of becoming so
Sought help or attempted methods to control weight
Strict dieting or
Fastin
g
Self-induced
Vomiting
Laxative
s or
Diuretic
s
Diet pills
Vigorous
Exercise
Frequent weight fluctuations exceeding 10 pounds
Differential Diagnosis
Bulimia Nervosa
(contrast with no compensatory purging in binge-eating)
Management
Binge-Eating cessation
Cognitive Behavioral Therapy
is preferred behavioral intervention
Self help programs may also assist management
Manage comorbid
Major Depression
Selective Serotonin Reuptake Inhibitor
s (
SSRI
)
Sertraline
,
Citalopram
and
Escitalopram
have most evidence for use
Weight Reduction
(in combination with
Cognitive Behavioral Therapy
)
See
Obesity Management
Orlistat
Grilo (2005) Biol Psychiatry 57:1193-1201 [PubMed]
Sibutramine
Appolinario (2003) Arch Gen Psychiatry 60:1109-16 [PubMed]
Other agents to control binging and also assist with weight loss
Topiramate
Zonisamide
Other agents
Lisdexamfetamine
(
Vyvanse
)
Consider in adults with >3 days of Binge Eating per week, refractory to other agents
Postulated to act at
Dopamine
-based reward centers
Dosing starts at 30 mg daily and titrate weekly to 50 to 70 mg daily
(2015) Presc Lett 22(3):17
References
Klein (2021) Am Fam Physician 103(1): 22-32 [PubMed]
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