M D Marcus M A Kalarchian and M D Levine

University of Pittsburgh, Pittsburgh, PA, USA

© 2005 Elsevier Ltd. All rights reserved.

In 1959, Stunkard noted three patterns of eating behavior in obese patients: night eating, binge eating, and eating without satiation. It was not until the 1980s that binge eating began to receive attention as a distinct clinical syndrome. Spitzer and colleagues proposed diagnostic criteria for binge eating disorder (BED) and subsequently evaluated them in two field trials. These initial investigations led to the inclusion of BED in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), of the American Psychiatric Association as an example of Eating Disorder Not Otherwise Specified (EDNOS) and as a proposed diagnostic category requiring further study. BED is characterized by persistent and recurrent episodes of binge eating without the regular use of inappropriate compensatory behaviors seen in bulimia nervosa (BN). Research on BED is still in an early stage, and the key features of the disorder and its relationship to other eating disorders, especially BN, nonpurging type, continue to be debated in the field.

This article discusses the assessment of BED, prevalence and risk factors, and comorbid conditions associated with BED. In addition, empirically supported treatments are reviewed, including guidelines for choice of treatment approach. Throughout the article, a biopsychosocial framework for understanding aberrant eating behavior is emphasized.

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