binge eating disorder

Etiology

• bulimia nervosa
• depression
• impulsive behavior
• hyperphagia
• idiopathic

Epidemiology

• probably the most common eating disorder.
• 2% of population
• 10-15% of people who are mildly obese & who try to lose weight have binge eating disorder
• even more common in people who are severely obese
• female/male ratio 3/2
• affects blacks as often as whites (no data onother ethnic groups)

Clinical manifestations

most of us overeat from time to time; however people with serious binge eating problems often:

• feel their eating is out of control
• eat what most people would think is an unusually large amount of food
• eat much more quickly than usual during binge episodes
• eat until so full they are uncomfortable
• eat large amounts of food, even when they are not really hungry
• eat alone because they are embarrassed about the amount of food they eat
• feel disgusted, depressed, or guilty after overeating.

Complications

• increased risk of obesity (RR=1.9)
• obesity & binge eating disorder increase risk of
  • diabetes mellitus
  • hypertension
  • hypercholesterolemia
  • gallbladder disease
  • heart disease
  • certain types of cancer
• increase risk of depression (RR=2.3)
• overeating & binge eating in adolescence is a predictor for future use of marijuana & other drugs Maagement
• cognitive-behavioral therapy teaches people how to
  • keep track of their eating
  • change their unhealthy eating habits
  • change the way they act in tough situations
• interpersonal psychotherapy helps people
  • look at their relationships with friends and family
  • make changes in problem areas
• pharmaceutical therapy
  • antidepressants may be helpful
    • sibutramine
    • sertraline may be useful for night binging
    • fluoxetine
  • topiramate
  • lisdexamfetamine (Vyvanse) (FDA-approved)
• patient education

More general terms

• eating disorder
• impulse control disorder

More specific terms

• bulimia nervosa