Binge Eating Disorder: Identification and Management

Binge eating disorder is a new diagnostic entity that refers to a pattern of recurrent binge eating episodes without the regular use of compensatory behaviors. Effective identification and management of binge eating disorder is important because of the distress experienced by individuals with the problem and because of the impact that binge eating disorder can have on physical health, particularly through its relationship with obesity. Identification can be facilitated with basic awareness of the demographic, behavioral, and psychological correlates of binge eating disorder, and by routinely asking patients appropriate questions. Research on treatment of binge eating disorder is still in its infancy, but we provide empirically based treatment recommendations. We describe a stepped-care approach for managing binge eating disorder in health care settings. Low-intensity interventions include physical activity, pure self-help, and nutritional counseling or self-help behavioral weight loss. Middle-intensity options are guided self-help and brief cognitive-behavioral therapy. Lastly, high-intensity treatments include group or individual psychotherapy, structured behavioral weight loss programs, and medication. Research findings on the effectiveness of self-help treatments for bulimia nervosa and binge eating disorder raise hope for the possibility of managing binge eating problems in nonspecialty, primary care settings.