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Understanding Binge Eating Disorders

What is binge-eating disorder?

Binge-eating disorder (BED), although not a formal diagnosis, is a description of a pattern of eating that is characterized by a feeling of loss of control during eating episodes often reported by overweight children and adolescents.  Specific markers of BED include:

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    a)  food-seeking in the absence of hunger (e.g., after a full meal)
    b)  a sense of loss of control while eating (i.e., youth agreement with statements such as, "When I start to eat, I just can't stop.")
  2. Binge episodes are associated with one or more of the following:
    a)  food-seeking in response to negative emotion (e.g., sadness,   boredom, restlessness)
    b)  food-seeking as a reward
    c)  sneaking or hiding food
  3. Symptoms persist over a period of three months
  4. Eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise, laxative or diuretic use)  

It seems that a feeling of loss of control while eating may be the most important factor, above and beyond the actual amount of food eaten by children and adolescents, when considering whether the BED description is appropriate.  

How many overweight kids and adolescents engage in binge eating?

Depending on the method used to assess the frequency of BED, the number of children and adolescents that exhibit binge eating varies widely.  Nonetheless, what seems clear is that although only very few overweight children and adolescents meet full criteria for BED (i.e., 1%-6%), many, many more report problematic binge-eating behavior, especially those who are seeking treatment for the problem with their weight.  In fact, up to 40% of overweight children and adolescents report that they have experienced a feeling of loss of control while eating an unusually large amount of food.

Do boys engage in binge eating?

Unlike other eating disorders, like anorexia nervosa and bulimia nervosa (which affect girls almost exclusively), males appear to comprise a substantial proportion of the BED population. Nonetheless, estimates are that females are 1.5 times more likely than males to have BED. 

Who is at risk for developing binge eating?

Childhood obesity is one of the primary risk factors for the later development of BED.  In addition, although much more research needs to be done in this area, there is some preliminary evidence that binge eating occurs in response to negative emotional states.  Thus, overweight youth with high levels of negative emotion and a lack of adaptive strategies for managing it may be at risk of developing binge eating as a coping mechanism.  Second, body dissatisfaction and dieting have also been offered as possible risk factors for the development of binge eating.


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