Bulimia nerwicowa nieograniczona
Diagnostyka i diagnoza

Bulimia nerwicowa nieograniczona (BED) jest najczęstszym zaburzeniem odżywiania, charakteryzującym się nawracającymi epizodami objadania się, podczas których pacjent spożywa w ciągu około 2 godzin ilość pokarmu znacznie przekraczającą normę, jednocześnie odczuwając brak kontroli nad jedzeniem. Kryteria diagnostyczne DSM-5 wymagają występowania epizodów co najmniej raz w tygodniu przez 3 miesiące, bez towarzyszących kompensacyjnych zachowań (np. przeczyszczania). Nasilenie BED klasyfikuje się na podstawie częstotliwości epizodów: łagodne (1-3/tydzień), umiarkowane (4-7/tydzień), ciężkie (8-13/tydzień) oraz skrajnie ciężkie (≥14/tydzień). Diagnostyka opiera się na szczegółowym wywiadzie klinicznym, ocenie psychiatrycznej (np. EDE, BES) oraz badaniach laboratoryjnych (m.in. glukoza na czczo, profil lipidowy, funkcje wątroby i tarczycy), które służą wykluczeniu innych schorzeń i ocenie powikłań. W diagnostyce różnicowej należy odróżnić BED od bulimii nerwicowej, jadłowstrętu psychicznego oraz zaburzeń współistniejących, takich jak depresja czy zaburzenia lękowe.

Diagnostyka bulimii nerwicowej nieograniczonej (Binge-eating disorder)

Bulimia nerwicowa nieograniczona (ang. Binge-eating disorder, BED) jest najczęstszym zaburzeniem odżywiania w Stanach Zjednoczonych i wielu innych krajach, dotykającym więcej osób niż jadłowstręt psychiczny i bulimia nerwicowa łącznie. Zaburzenie to zostało oficjalnie uznane jako odrębna jednostka chorobowa w piątej edycji Diagnostycznego i Statystycznego Podręcznika Zaburzeń Psychicznych (DSM-5) w 2013 roku, wcześniej znajdując się jedynie w załączniku DSM-IV jako stan wymagający dalszych badań.12

Kryteria diagnostyczne DSM-5

Zgodnie z kryteriami diagnostycznymi DSM-5, aby rozpoznać bulimię nerwicową nieograniczoną, pacjent musi spełniać następujące kryteria:12

  1. Nawracające epizody objadania się. Epizod objadania się charakteryzuje się obiema następującymi cechami:
    • Spożywanie w określonym czasie (np. w ciągu 2 godzin) ilości pożywienia zdecydowanie większej niż większość osób zjadłaby w podobnym czasie i w podobnych okolicznościach
    • Poczucie braku kontroli nad jedzeniem w trakcie epizodu (np. uczucie, że nie można przestać jeść lub kontrolować co i ile się je)
  2. Epizody objadania się wiążą się z co najmniej trzema z następujących objawów:
    • Jedzenie znacznie szybciej niż normalnie
    • Jedzenie aż do uczucia nieprzyjemnej pełności
    • Spożywanie dużych ilości pożywienia mimo braku fizycznego uczucia głodu
    • Jedzenie w samotności z powodu zażenowania ilością spożywanego pokarmu
    • Odczuwanie wstrętu do siebie, przygnębienia lub silnego poczucia winy po epizodzie
  3. Wyraźne cierpienie związane z epizodami objadania się
  4. Epizody objadania się występują średnio co najmniej raz w tygodniu przez okres 3 miesięcy
  5. Epizody objadania się nie są związane z regularnymi niewłaściwymi zachowaniami kompensacyjnymi (np. przeczyszczanie, głodzenie, nadmierne ćwiczenia) i nie występują wyłącznie w przebiegu jadłowstrętu psychicznego lub bulimii nerwiczej

Warto podkreślić, że waga lub wygląd ciała nie są częścią kryteriów diagnostycznych BED. Osoby z tym zaburzeniem mogą mieć nadwagę, otyłość lub normalną masę ciała.12

Klasyfikacja nasilenia zaburzenia

Zgodnie z DSM-5, nasilenie bulimii nerwicowej nieograniczonej jest klasyfikowane na podstawie częstotliwości epizodów objadania się:12

  • Łagodne: 1-3 epizody tygodniowo
  • Umiarkowane: 4-7 epizodów tygodniowo
  • Ciężkie: 8-13 epizodów tygodniowo
  • Skrajnie ciężkie: 14 lub więcej epizodów tygodniowo

W ICD-11 Światowej Organizacji Zdrowia klasyfikacja nasilenia zaburzenia jest podobna, z tym samym podziałem na kategorie w zależności od częstotliwości epizodów.1

Stan remisji

DSM-5 wyróżnia również stany remisji bulimii nerwicowej nieograniczonej:1

  • Częściowa remisja: Po wcześniejszej diagnozie, średnia częstotliwość epizodów objadania się zmniejsza się do mniej niż jednego epizodu tygodniowo przez dłuższy okres
  • Pełna remisja: Po wcześniejszej diagnozie, przez dłuższy okres nie są spełnione żadne kryteria

Proces diagnostyczny

Diagnostyka bulimii nerwicowej nieograniczonej jest procesem wieloetapowym, który powinien być przeprowadzony przez wykwalifikowanych specjalistów ochrony zdrowia.12

Wywiad kliniczny

Podstawowym narzędziem diagnostycznym jest szczegółowy wywiad kliniczny.1 Lekarz lub specjalista zdrowia psychicznego powinien przeprowadzić ocenę zachowań związanych z jedzeniem i nastawienia do jedzenia, wagi oraz kształtu ciała. Pytania zadawane podczas wywiadu mogą obejmować:12

  • Czy zjadasz o wiele większe ilości jedzenia niż zwykle lub jesz aż do uczucia dyskomfortu?
  • Czy czujesz, że tracisz kontrolę nad jedzeniem?
  • Czy kiedykolwiek jesz w tajemnicy?
  • Czy czujesz się przygnębiony, zawstydzony lub winny po jedzeniu?
  • Czy martwisz się swoją wagą?
  • Czy jesz szybciej niż normalnie?
  • Czy jesz duże ilości jedzenia, gdy nie czujesz fizycznego głodu?

Ważne jest, aby zbudować zaufanie i nawiązać dobry kontakt z pacjentem, szczególnie gdy nie dostrzega on problemu.1 Pacjenci z BED często odczuwają wstyd i poczucie winy związane z ich zachowaniami żywieniowymi, co może prowadzić do ukrywania objawów.1

Ocena psychiatryczna i psychologiczna

Ocena psychiatryczna i psychologiczna jest kluczowym elementem diagnostyki BED. Może obejmować:12

  • Ustrukturyzowane lub półustrukturyzowane wywiady kliniczne, takie jak Eating Disorder Examination (EDE)
  • Kwestionariusze samooceny, jak Eating Disorder Examination-Questionnaire (EDE-Q) lub Binge Eating Scale (BES)
  • Ocenę współistniejących problemów zdrowia psychicznego, takich jak depresja, zaburzenia lękowe czy zaburzenia osobowości
  • Ocenę dynamiki rodzinnej, szczególnie ważną u osób młodszych

Skala Objadania się (BES) jest narzędziem samooceny składającym się z 16 pozycji, które ocenia zarówno nasilenie, jak i częstotliwość epizodów objadania się. Całkowity wynik waha się od 0 do 46, przy czym wyższe wyniki korelują z częstszymi i poważniejszymi zachowaniami związanymi z objadaniem się.1

Badanie fizykalne i testy diagnostyczne

Lekarz powinien przeprowadzić pełne badanie fizykalne oraz zlecić odpowiednie badania, aby wykluczyć inne schorzenia i ocenić potencjalne powikłania zdrowotne związane z BED. Badania te mogą obejmować:123

  • Pomiar masy ciała (za zgodą pacjenta)
  • Badania krwi i moczu
  • Ocenę stężenia glukozy na czczo
  • Profil lipidowy (cholesterol całkowity, HDL, LDL, trójglicerydy)
  • Kwas moczowy
  • Funkcję tarczycy
  • Funkcję wątroby (enzymy wątrobowe)
  • Stężenie kreatyniny w surowicy
  • Ocenę układu sercowo-naczyniowego
  • Badanie elektrolitów i enzymów trzustkowych
  • Konsultację ze specjalistą zaburzeń snu, jeśli istnieją podejrzenia o współistniejące zaburzenia oddychania związane ze snem

Ważne jest, aby wyjaśnić pacjentom, że prawidłowe wyniki badania fizykalnego nie wykluczają zaburzeń odżywiania.1 Badania laboratoryjne mogą być całkowicie prawidłowe, ale ukierunkowane badania mogą pomóc wykluczyć choroby somatyczne i ocenić powikłania BED.1

Rozpoznanie różnicowe

Diagnoza różnicowa jest ważnym elementem procesu diagnostycznego, ponieważ pomaga odróżnić BED od innych zaburzeń o podobnych objawach.12

Inne zaburzenia odżywiania

Kluczowym elementem diagnozy różnicowej jest odróżnienie BED od innych zaburzeń odżywiania:12

  • Bulimia nerwicowa – w przeciwieństwie do BED, bulimia nerwicowa charakteryzuje się regularnymi zachowaniami kompensacyjnymi po epizodach objadania (np. wywoływanie wymiotów, używanie środków przeczyszczających, nadmierne ćwiczenia)
  • Jadłowstręt psychiczny – charakteryzuje się znacznym ograniczeniem przyjmowania pokarmów i intensywnym lękiem przed przybraniem na wadze
  • BED o niskiej częstotliwości i/lub ograniczonym czasie trwania – spełnia wszystkie kryteria BED, ale epizody objadania się występują rzadziej niż raz w tygodniu (niska częstotliwość) lub przez okres krótszy niż trzy miesiące (ograniczony czas trwania)1

Zaburzenia psychiatryczne

BED często współwystępuje z innymi zaburzeniami psychicznymi, które należy uwzględnić w diagnozie różnicowej:12

  • Zaburzenia depresyjne – depresja jest najczęstszym schorzeniem współistniejącym z zaburzeniami odżywiania
  • Zaburzenia lękowe, zwłaszcza fobia społeczna
  • Zaburzenia osobowości, szczególnie zaburzenie osobowości typu borderline
  • Zaburzenia związane z używaniem substancji

Schorzenia medyczne

Istnieje szereg schorzeń medycznych, które mogą naśladować zaburzenia odżywiania i należy je wykluczyć podczas diagnozy:12

  • Zaburzenia endokrynologiczne, takie jak choroby tarczycy
  • Zaburzenia gastroenterologiczne
  • Guzy mózgu
  • Cukrzyca
  • Choroby zapalne jelit

Znaczenie wczesnej diagnozy

Wczesna diagnoza i interwencja w przypadku BED są ściśle związane z lepszymi wynikami leczenia i mogą zapobiec przewlekłemu przebiegowi choroby oraz jej powikłaniom.123

Szybkie rozpoznanie jest szczególnie ważne ze względu na:123

  • Możliwość wcześniejszego rozpoczęcia odpowiedniego leczenia
  • Zapobieganie rozwojowi poważnych powikłań zdrowotnych
  • Zmniejszenie nasilenia objawów i czasu trwania zaburzenia
  • Poprawę jakości życia pacjenta
  • Zapobieganie przejściu w pełnoobjawowe BED w przypadku BED o niskiej częstotliwości i/lub ograniczonym czasie trwania

Według badań naukowych, zaburzenia odżywiania są drugim najśmiertelniejszym rozpoznaniem w klasyfikacji DSM, przy czym około połowa zgonów związana jest z samobójstwem. Śmiertelność w przypadku jadłowstrętu psychicznego wynosi 5-6%. Wczesne rozpoznanie zaburzenia odżywiania jest związane z lepszymi wynikami, co sprawia, że wczesna diagnostyka ma kluczowe znaczenie.1

Zespół diagnostyczny

Diagnoza BED jest często procesem multidyscyplinarnym, wymagającym współpracy różnych specjalistów ochrony zdrowia.12

Specjaliści zaangażowani w diagnozę

W proces diagnostyczny BED mogą być zaangażowani następujący specjaliści:123

  • Lekarz rodzinny (podstawowej opieki zdrowotnej) – często pierwsza osoba, do której zgłasza się pacjent; może przeprowadzić wstępną ocenę i skierować do odpowiednich specjalistów
  • Psychiatra – specjalista w diagnozowaniu i leczeniu zaburzeń psychicznych
  • Psycholog kliniczny – specjalista w ocenie psychologicznej i terapii
  • Internista/endokrynolog – ocena stanu somatycznego i potencjalnych powikłań
  • Dietetyk – ocena stanu odżywienia i nawyków żywieniowych

Rola lekarza rodzinnego w diagnozowaniu BED jest szczególnie ważna, ponieważ gabinet lekarza rodzinnego jest idealnym miejscem do wczesnej identyfikacji zaburzeń odżywiania i rozpoczęcia leczenia w odpowiednim czasie.1

Model opieki wielodyscyplinarnej

Po zdiagnozowaniu BED, lekarz powinien zebrać zespół specjalistów ochrony zdrowia, którzy najlepiej pomogą pacjentowi w procesie leczenia.1 Współpraca w ramach zespołu multidyscyplinarnego jest kluczowa dla skutecznego leczenia.12

Zespół terapeutyczny wspiera i współpracuje z każdym pacjentem, ocenia nasilenie objawów zaburzeń odżywiania i monitoruje postępy w procesie powrotu do zdrowia. Specjaliści formułują zalecenia i zapewniają zindywidualizowane interwencje terapeutyczne w celu zaspokojenia psychologicznych, medycznych i żywieniowych potrzeb pacjenta. Systemy wsparcia i dostawcy usług ambulatoryjnych mogą również być częścią zespołu terapeutycznego, aby promować trwałe zmiany poza środowiskiem leczniczym.1

Wyzwania diagnostyczne

Diagnozowanie BED może być trudne z kilku powodów, co prowadzi do niedodiagnozowania i opóźnień w leczeniu.12

Przeszkody w diagnozie

Istnieje kilka przeszkód, które mogą utrudniać diagnozę BED:123

  • Brak świadomości – osoby z BED mogą nie zdawać sobie sprawy, że mają prawdziwy problem medyczny, który można skutecznie leczyć
  • Wstyd i poczucie winy – pacjenci mogą wstydzić się swoich zachowań żywieniowych i niechętnie ujawniać je rodzinie, przyjaciołom czy pracownikom służby zdrowia
  • Brak wiedzy wśród lekarzy – wielu lekarzy i specjalistów zdrowia psychicznego otrzymuje niewielkie lub żadne szkolenie w zakresie diagnozowania i leczenia zaburzeń odżywiania
  • Postawy anty-tłuszczowe – powszechne uprzedzenia dotyczące wagi mogą wpływać na ocenę kliniczną
  • Współwystępowanie z innymi problemami zdrowotnymi – BED może być przesłonięte przez inne schorzenia, na które pacjent zwraca się po pomoc

Badania wykazują, że wśród respondentów spełniających kryteria diagnostyczne BED, tylko 3,2% otrzymało diagnozę od pracowników służby zdrowia.1

Specyficzne grupy pacjentów

Diagnoza BED może być szczególnie trudna w pewnych grupach pacjentów:12

  • Osoby z prawidłową masą ciała – BED może występować u osób z prawidłową masą ciała, co może prowadzić do przeoczenia diagnozy
  • Dzieci i młodzież – objawy mogą być trudniejsze do rozpoznania, a ocena musi uwzględniać specyfikę rozwojową
  • Osoby starsze – zaburzenia odżywiania mogą być błędnie przypisywane innym schorzeniom związanym z wiekiem
  • Mężczyźni – mogą być rzadziej diagnozowani ze względu na stereotypy związane z zaburzeniami odżywiania jako „problemami kobiecymi”

Konsekwencje diagnostyczne i zalecenia terapeutyczne

Po zdiagnozowaniu BED kluczowe jest określenie odpowiedniego planu leczenia dostosowanego do indywidualnych potrzeb pacjenta.12

Ocena nasilenia i współwystępujących chorób

Na podstawie wyników diagnozy należy określić:12

  • Nasilenie BED (łagodne, umiarkowane, ciężkie, skrajnie ciężkie)
  • Obecność współwystępujących zaburzeń psychicznych (np. depresja, zaburzenia lękowe)
  • Obecność powikłań medycznych (np. otyłość, nadciśnienie, cukrzyca, zaburzenia lipidowe)
  • Wpływ zaburzenia na funkcjonowanie psychospołeczne (w domu, w pracy, w relacjach społecznych)

Osoby z BED często zgłaszają pewien stopień upośledzenia funkcjonowania psychospołecznego, a 19% z nich zgłasza poważne upośledzenie.1

Zalecenia terapeutyczne

Na podstawie diagnozy i oceny nasilenia zaburzenia należy zaproponować odpowiednie metody leczenia. Do najczęściej zalecanych metod leczenia BED należą:123

  • Psychoterapia:
  • Farmakoterapia:
    • Leki przeciwdepresyjne, szczególnie selektywne inhibitory wychwytu serotoniny (SSRI)
    • Lisdeksamfetamina (Vyvanse) – zatwierdzona do leczenia BED, skuteczna w zmniejszaniu częstotliwości epizodów objadania się1
    • Leki hamujące apetyt, takie jak sibutramina, które mogą być związane przynajmniej z krótkoterminowym zmniejszeniem objadania się1
  • Interwencje żywieniowe i stylu życia
  • Leczenie behawioralne utraty wagi (BWL) – może być pomocne, choć nie zawsze jest wystarczające samo w sobie1

Metaanalizy potwierdzają skuteczność terapii poznawczo-behawioralnej (CBT) oraz terapii samokierowanej w leczeniu BED. CBT prowadzona przez specjalistę skuteczniej zmniejsza objadanie się i rezygnację z terapii niż samokierowana CBT w ciągu sześciu miesięcy oraz zapewnia znacznie lepsze wyniki niż terapie utraty wagi.1

Pacjenci, u których w pierwszym miesiącu leczenia następuje szybkie zmniejszenie zachowań związanych z objadaniem się, mają większe szanse na utrzymanie remisji, niezależnie od zastosowanej metody leczenia, niż pacjenci, u których to nie nastąpiło.1

Ustalenie poziomu opieki

Intensywność i środowisko leczenia zależą od nasilenia zaburzenia:123

  • Ambulatoryjne – dla większości pacjentów z łagodnym do umiarkowanego nasileniem BED bez poważnych powikłań medycznych
  • Intensywna opieka ambulatoryjna/programy dzienne – dla pacjentów wymagających bardziej intensywnego wsparcia, ale bez konieczności hospitalizacji
  • Leczenie stacjonarne/szpitalne – dla pacjentów z ciężkim BED i/lub poważnymi powikłaniami medycznymi

Kryteria przyjęcia do szpitala mogą obejmować: częstość akcji serca 40 lub mniej, ciśnienie krwi 80/50 lub mniej oraz ortostatyczne zmiany tętna wyższe niż 20 uderzeń na minutę lub ortostatyczną zmianę ciśnienia krwi większą niż 10 mmHg.1

Wczesna interwencja i odpowiedni poziom opieki mogą mieć znaczący wpływ na długoterminowe wyniki leczenia osób z BED. Ze względu na złożony charakter zaburzenia, najprawdopodobniej nie ustąpi ono samoistnie ani z czasem. Zaleca się jak najszybsze poszukiwanie odpowiedniego poziomu opieki w celu uzyskania najlepszych wyników.1

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Binge eating disorder – Wikipedia
    https://en.wikipedia.org/wiki/Binge_eating_disorder
    According to the World Health Organization’s ICD-11 classification of BED, the severity of the disorder can be classified as mild (1-3 episodes/week), moderate (4-7 episodes/week), severe (8-13 episodes/week) and extreme (14 episodes/week). […] Initially considered a subject for further research exploration, binge eating disorder was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1994 proposed a feature of an eating disorders. […] In 2013 it gained formal recognition as a psychiatric condition in the DSM-5. […] The disorder now has its own category under DSM-5, which outlines the signs and symptoms that must be present to classify a person’s behavior as binge eating disorder. […] Studies have confirmed the high predictive value of these criteria for diagnosing BED.
  • #1 Binge Eating Disorder – National Eating Disorders Association
    https://www.nationaleatingdisorders.org/binge-eating-disorder/
    Binge Eating Disorder (BED) became a new diagnostic category of eating disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013. BED is diagnosed when an individual engages in binge eating, on average, at least 1 day a week for 3 months. To be diagnosed with Binge Eating Disorder (BED) according to the DSM-5 TR, the following criteria must be met: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). The binge eating episodes are associated with three (or more) of the following: Eating much more rapidly than normal. Eating until feeling uncomfortably full. Eating large amounts of food when not feeling physically hungry. Eating alone because of feeling embarrassed by how much one is eating. Feeling disgusted with oneself, depressed, or very guilty afterward. Marked distress regarding binge eating is present. The binge eating occurs, on average, at least once a week for 3 months. The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
  • #1 Binge Eating Disorder Diagnosis: DSM 5 Criteria | Walden
    https://www.waldeneatingdisorders.com/what-we-treat/binge-eating-disorder/binge-eating-disorder-diagnosis/
    According to the DSM-5, diagnostic criteria for binge eating disorder include: […] The binge-eating episodes are associated with three (or more) of the following: […] Marked distress regarding binge eating is present. […] The binge eating occurs, on average, at least once a week for three months. […] The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, or avoidant/restrictive food intake disorder. […] It is extremely important to note that weight or appearance is not part of the diagnostic criteria for binge eating disorder. […] If your doctor suspects that you have binge eating disorder, they will typically run several exams and tests to help eliminate other medical explanations and check for any related complications. […] Based on the results of the exams and tests, an appropriate treatment program will be recommended for you or your family member/loved one.
  • #1 Binge eating disorder – Wikipedia
    https://en.wikipedia.org/wiki/Binge_eating_disorder
    One study found that the method for diagnosing BED is for a clinician who typically diagnose using the DSM-5 criteria or taking the Eating Disorder Examination. […] The DSM-5 characterizes diagnosis under several categories mild, moderate, severe, and extreme each determined by the number of binges the patient exhibits per week. Mild: 1-3 episodes per week, Moderate: 4-7 episodes per week, Severe: 8-13 episodes per week, Extreme: 14 or more episodes per week. […] Further, the remission states are classified under the following. Partial Remission: Following a previous diagnosis, the average frequency of binge eating episodes decreases to less than one episode per week for a sustained period of time. Full Remission: Following a previous diagnosis, none of the criteria have been met for a sustained period of time.
  • #1 Binge-eating disorder – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633
    To diagnose binge-eating disorder, your healthcare professional may recommend a mental health evaluation. This includes talking about your feelings and eating habits with a mental health professional. Look for a mental health professional with expertise in treating eating disorders. […] Your healthcare professional also may want you to have other tests to check for health problems that can be caused by binge-eating disorder. These may include high cholesterol, high blood pressure, heart problems, diabetes, GERD, poor nutrition, electrolyte imbalances and some sleep-related breathing disorders. Tests may include: […] A physical exam. With your permission, the exam may include getting your weight. […] Blood and urine tests. […] A visit with a sleep disorder specialist. […] Your healthcare professional or mental health professional is likely to ask you questions, such as: […] Do you eat much larger than usual amounts of food or eat until you’re uncomfortably full? […] Do you feel that your eating is out of control? […] Do you ever eat in secret? […] Do you feel depressed, ashamed or guilty about your eating? […] Are you concerned about your weight?
  • #1 Diagnosis of Eating Disorders in Primary Care | AAFP
    https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html
    The medical history is the most powerful tool for diagnosing eating disorders. […] All patients in high-risk categories for eating disorders should be screened during routine office visits. […] A number of comprehensive psychiatric interviews can be used to diagnose eating disorders, but these are impractical in the primary care setting. […] A positive response to any of these questions warrants further evaluation. […] When obtaining a history, it is important to establish trust and rapport with the patient, especially when the patient does not perceive a problem. […] Accurate weight measurements are important in diagnosing an eating disorder. […] It is important to explain to patients and their families that a normal physical examination does not rule out an eating disorder. […] Laboratory findings might be completely normal, but targeted laboratory testing can be helpful to rule out medical illness.
  • #1 Binge Eating Disorder > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/binge-eating-disorder
    Everyone overeats once in a while. But if you find yourself overeating at least once a week for at least three months, you may have binge eating disorder (BED). Binge eating is defined by two characteristics: eating an unusually large quantity of food during a short time period (two hours) and feeling a lack of control during each episode of overeating. […] The diagnosis of BED is made based on an interview with a clinician who asks questions to learn whether the patient meets the DSM-5 criteria for BED. There is no laboratory or blood test for diagnosing this psychiatric disorder. […] BED frequently goes unrecognized and undiagnosed. Key reasons include: People with BED may not realize they have a true medical problem that can be effectively treated. Many healthcare providers dont assess patients for BED because of a lack of knowledge or perhaps even discomfort with asking their patients about eating and weight concerns. Some people with BED are embarrassed and ashamed about their eating behaviors, and are therefore hesitant to disclose them to family, friends or health-care professionals. […] When clinicians ask patients with BED specifically about eating and weight concerns in a sensitive and non-judgmental manner, the conversation is often met with relief and disclosure.
  • #1 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    The need to accurately investigate the psychological symptoms and eating habits of the patient who tends to deny their own problem may require the use of structured or semi-structured interviews. […] The exploration of family dynamics is very important, especially for minors and patients living with the family. This is not only in the case of young patients who still live within the family, but also in adult patients with BED (or other partial disorders). […] The evaluation of the psychopathological characteristics of EDs in adolescence and pre-adolescence must be carried out with specific tools, among which the most recognized are (1) EDE—Eating Disorder Examination, for the evaluation of behavioral and psychological traits related to EDs; (2) CBCL—Child Behavior Checklist, for the evaluation of psychopathological symptoms and psychiatric comorbidity.
  • #1 Binge Eating Scale (BES) – Psychology Tools
    https://psychology-tools.com/test/binge-eating-scale
    The Binge Eating Scale (BES) is a self-report instrument developed to assess the presence and behavioral manifestations of Binge Eating Disorder (BED). […] Comprising 16 items, the BES evaluates both the severity and frequency of binge eating episodes, which are central in diagnosing and understanding the disorder. […] The total score ranges from 0 to 46, with higher scores correlating with more frequent and severe binge eating behaviors. […] Despite its widespread use, it is advisable for clinicians and researchers to use the BES alongside other diagnostic tools and interviews to ensure comprehensive assessment and accurate diagnosis.
  • #1 Eating Disorders
    https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/
    Binge-eating disorder is characterized by binge eating without inappropriate compensatory behaviors. […] The DSM5 also added binge-eating disorder as an eating disorder diagnosis, characterized by binge eating without inappropriate compensatory behaviors. […] Binge-eating disorder includes recurrent binge eating without associated compensatory weight control behaviors. […] The essential features of binge-eating disorder include distress regarding binge-eating episodes. […] Differential diagnosis for binge-eating disorder includes bulimia nervosa, obesity, and other psychiatric conditions such as bipolar and depressive disorders and borderline personality disorder. […] Bingeeating disorder differs from bulimia nervosa in that bingeeating disorder is not associated with compensatory weight loss behaviors that are present in bulimia nervosa.
  • #1 Binge Eating Disorder: Recognition, Diagnosis, and Treatment – Page 2
    https://www.medscape.com/viewarticle/431260_2
    Binge eating per se, without counteractive weight-reducing behaviors, was not identified as a major psychiatric disorder or problem until the recent inclusion of BED in the DSM-IV appendix. […] One of the major controversies regarding the diagnosis of BED includes its differentiation from nonpurging bulimia nervosa as currently defined in DSM-IV. Nonpurging bulimia nervosa involves fasting and excessive exercise as compensatory behaviors, as well as preoccupation with body shape and weight. […] Regardless of the appellation, it is clear from epidemiologic studies that a meaningful number of patients have clinically significant binge eating and related psychopathology, not complicated by purging, that warrants treatment. […] In the laboratory, BED patients have been shown to eat significantly more calories during a binge meal than non-BED obese patients.
  • #1 Binge Eating Disorder of Low Frequency and/or Limited Duration
    https://withinhealth.com/learn/articles/binge-eating-disorder-of-low-frequency-and-or-limited-duration
    Binge eating disorder (BED) is the most common eating disorder in the United States, affecting nearly 2.8 million people. […] Binge eating disorder of low frequency and/or limited duration is classified as an other specified feeding or eating disorder (OSFED) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the reference manual for mental health disorders published by the American Psychiatric Association (APA). A person with BED of low frequency and/or limited duration meets all the criteria of binge eating disorder, but their binge eating behaviors occur fewer than once a week (low frequency) or for fewer than three months (limited duration). […] When diagnosing low frequency or limited duration BED, a medical professional will often suggest a comprehensive psychological evaluation to understand a person’s emotions and thoughts around food and eating.
  • #1 Diagnosis of Eating Disorders in Primary Care | AAFP
    https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html
    Because family physicians serve as primary care providers for a large percentage of adolescents, they have an important role in diagnosing these disorders. […] The hallmark of anorexia is a refusal to maintain body weight at or above 85 percent of expected weight, as defined by age-appropriate body mass index charts. […] Bulimia is characterized by uncontrollable binge-eating episodes, often followed by purging behaviors such as vomiting or the use of laxatives. […] Both of the major eating disorders are characterized by a disturbance in the perception of body shape, which is closely tied to self-image. […] It is also important to aggressively treat patients who have traits of eating disorders but who do not meet the full criteria for anorexia or bulimia. […] A wide variety of medical problems can masquerade as eating disorders.
  • #1 Diagnosis of Eating Disorders in Primary Care | AAFP
    https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html
    Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant causes of morbidity and mortality among adolescent females and young women. […] Prompt diagnosis is linked to better outcomes. […] The family physician can play an important role in diagnosing these illnesses and can coordinate the multi-disciplinary team of psychiatrists, nutritionists, and other professionals to successfully treat patients with eating disorders. […] The family physician’s office is an ideal setting to identify eating disorders and initiate treatment in a timely fashion. […] This review focuses on recognition and diagnosis of eating disorders in primary care. […] Early diagnosis with intervention and earlier age at diagnosis are correlated with improved outcomes in patients who have eating disorders.
  • #1 Binge eating disorder (BED) | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/healthyliving/binge-eating-disorder
    Binge eating disorder (BED) is a serious mental health condition. […] Diagnosis and treatment of binge eating disorder […] If you think you (or someone you know) might have binge eating disorder, it is important that you see your doctor as soon as possible. The sooner you seek help, the sooner you can start to recover, and the more effective treatment can be. […] Once binge eating disorder is diagnosed, your GP will assemble a team of healthcare professionals who are best suited to help you. […] Research indicates that the most effective therapies for binge eating disorder include: Cognitive Behavioural Therapy Enhanced (CBT-E), Cognitive Behaviour Therapy Guided Self Help (CBT-GSH), Interpersonal Therapy (IPT).
  • #1 Red flags and diagnostic criteria for eating disorders – Norton Healthcare Provider Louisville, Ky.
    https://nortonhealthcareprovider.com/news/eating-disorder-diagnostic-criteria/
    Diagnosing eating disorders can be challenging because telltale behaviors typically are hidden, even from those closest to the patient, according to Andrea L. Krause, M.D., who heads the team involved with the medical stabilization of eating disorder patients at Norton Children’s Hospital. […] Eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are Binge eating disorder. […] Hospitalization is warranted if the heart rate is 40 or below, total blood pressure of 80/50 or less, and orthostatic changes in pulse higher than 20 beats per minute or orthostatic change in blood pressure greater than 10 mmHg. […] Eating disorders are the second deadliest DSM diagnosis, with about half the deaths coming from suicide. The mortality for anorexia is 5% to 6%. Early identification of an eating disorder is associated with better outcomes, making early diagnosis critical. […] “It can be very hard to overcome if the patient gets stuck in that state of starvation for years on end,” Dr. Krause said. “Early intervention is key.”
  • #1 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    The diagnosis is multidisciplinary and shared among the various professionals. The professional figures who must therefore participate in the assessment process and who carry out the diagnostic tests, necessary, at this stage, are the psychiatrist, internist, endocrinologist, clinical psychologist, and nutritionist. […] The medical diagnostic protocol should include clinical-anamnestic evaluation, physical examination, fasting blood glucose, serum lipid profile (total, HDL, and LDL cholesterol, triglycerides), uric acid, thyroid function, liver function (hepatic enzymes), serum creatinine, and cardiovascular assessment. […] In the assessment of BED, clinicians have many screening instruments, like specific questionnaires, to recognize and treat the eating disorder and not only comorbidities. To diagnose BED, clinicians must consider that it is different from simply overeating.
  • #1 What is Binge Eating Disorder? Signs, Symptoms & Treatments – The Renfrew Center
    https://renfrewcenter.com/services/binge-eating-disorder/
    Binge eating disorder is an eating disorder characterized by cycles of restriction and binge eating episodes. Symptoms of binge eating disorder include eating large amounts of food in a discrete period of time. This diagnosis may also include certain experiences such as eating rapidly, eating past fullness, eating to the point of discomfort, eating when not hungry and eating alone. People with binge eating disorder report feeling a loss of control when eating and intense distress about their condition. This distress may involve feelings of shame, guilt, and embarrassment. […] Individuals suffering from binge eating disorder deserve caring and professional evaluation, diagnosis and treatment. […] The treatment team supports and collaborates with each client, assesses the severity of the eating disorder symptoms, and monitors progress in the recovery process. They make recommendations and provide individualized treatment interventions to meet their client’s psychological, medical, and nutritional needs. Support systems and outpatient providers might also be part of the treatment team to promote sustainable change outside of the treatment setting.
  • #1 Binge Eating Disorder Diagnosis
    https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/do-i-have-a-binge-eating-disorder
    Diagnosing eating disorders can be challenging because secrecy, shame, and denial are part of them. So the disorder might not be noticed for a long time. In most cases, binge eating disorder is discovered when a person gets professional help with weight loss. Other times it is identified when the person sees a doctor for an obesity-related health problem, or a mental health problem like depression or anxiety that might be linked to the illness. […] If binge eating disorder is suspected, the doctor will likely start an evaluation by doing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose eating disorders, the doctor might use diagnostic tests, such as blood and urine tests and other laboratory procedures, to rule out physical illness as the cause of the symptoms. These tests may also help find the medical effects of an eating disorder, such as changes in digestive enzyme levels, liver functioning, or electrolytes (the normal salt concentrations in blood).
  • #1 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    Binge eating disorder (BED) is the most common eating disorder categorized in the DSM-V, but it is often not diagnosed in patients with obesity because it can be difficult to detect in these patients who often have altered eating patterns. […] In the diagnostic assessment of these patients, it is important to evaluate not only the clinical and nutritional status and the presence of medical comorbidities, but also the psychological signs and symptoms related to psychiatric comorbidities to define the appropriate diagnosis and the consequent level of treatment. […] Although today BED is the most common eating disorder, many patients are not diagnosed, and some studies report that clinicians can underdiagnose BED, as revealed in a survey where, among respondents who met the diagnostic criteria for BED, only 3.2% had a diagnosis by healthcare providers.
  • #1 Binge-eating disorder – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627
    Binge-eating disorder is a serious condition. It always involves feeling like you’re not able to stop eating. It also often involves eating much larger than usual amounts of food. […] But regularly feeling that eating is out of control and eating an unusually large amount of food may be symptoms of binge-eating disorder. […] Treatment for binge-eating disorder can help people feel more in control and balanced with their eating. […] If you have binge-eating disorder, you may be overweight or obese, or you may be at a healthy weight. […] Symptoms of binge-eating disorder vary but can include: Feeling that you don’t have control over your eating behavior, for example, you can’t stop once you start. […] A person with bulimia nervosa, another eating disorder, may binge and then vomit, use laxatives or exercise excessively to get rid of extra calories. This is not the case with binge-eating disorder.
  • #1 Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5 | BMC Psychiatry | Full Text
    https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0445-6
    Treatment choices should then be multidisciplinary, suited to cope with symptoms and comorbidities and also with the high drop-out rates and the low maintenance of achieved results typical of this disease. […] Primary goal of BED treatment is to achieve abstinence from binge eating, and afterward a sustainable weight loss. […] Nevertheless treatment should also target the increase and maintenance of motivation, the education to healthier eating and life styles, the modification of dysfunctional thoughts and habits, the increase of insight and abilities to deal with conflicts and negative emotions, the treatment of physical and psychiatric comorbidities and relapse prevention. […] Behavioral treatments (BWL), focused on diet and lifestyle modification, and borrowed by obesity treatment, have frequently been proposed as useful basic interventions for BED treatment that showed some appreciable results which are comparable to more complex therapies.
  • #1 Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5 | BMC Psychiatry | Full Text
    https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0445-6
    The clinical importance of BED is also related to its frequent comorbidity with obesity as well as complications of overweight and with psychiatric symptoms like depression and anxiety. […] The clinical relevance of BED, here underlined, highlights the importance of identifying appropriate and evidence based treatment strategies, in order to prevent this disorder to become chronic and complicated. […] We aimed to systematically identify and synthesize the recent evidences about BED diagnostic category with regards to its recent addition as an autonomous disease in DSM-5. […] The concept of binge eating as overeating without compensatory behaviors was introduced by Stunkard in 1959, and structured in the Nineties by Fairburn and Spitzer as specific syndrome, mentioned in DSM-IV-TR as a nosologic entity needing future definition.
  • #1 Binge eating disorder in adults: Overview of treatment – UpToDate
    https://www.uptodate.com/contents/binge-eating-disorder-in-adults-overview-of-treatment
    Binge eating disorder is more prevalent than either anorexia nervosa or bulimia nervosa, and is associated with numerous psychiatric and nonpsychiatric disorders. […] In addition, most patients report some degree of impairment in psychosocial functioning (home, work, personal life, or social life), and 19 percent report severe impairment. […] The phenomenon of binge eating was first described formally in 1959 in individuals with obesity. […] However, binge eating disorder was first formulated as a distinct diagnosis in the 1990s. […] This topic provides an overview of evaluating and treating patients for binge eating disorder. […] The use of cognitive-behavioral therapy to treat binge eating disorder is discussed separately, as is the diagnosis and treatment of anorexia nervosa, bulimia nervosa, and obesity.
  • #1 Eating Disorders in Primary Care: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0101/p22.html
    Binge-eating disorder is characterized by recurrent episodes of binge eating, which involves eating more food than peers in a short period accompanied by a perceived loss of control. […] Associated symptoms include eating faster than normal, eating until feeling uncomfortable, eating large quantities of food when not hungry, feeling bad due to embarrassment about eating behaviors, or experiencing negative emotions after eating. […] No behaviors to prevent weight gain are present, and these behaviors occur at least weekly for a minimum of three months, distinctly separate from anorexia nervosa or bulimia nervosa. […] An alternative diagnosis may include binge-eating disorder of low frequency and/or limited duration. […] Lisdexamfetamine (Vyvanse) can be effective in reducing binge-eating behaviors in persons with binge-eating disorder.
  • #1 Eating Disorders
    https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/
    Key features of bingeeating disorder include higher levels of overvaluation of body weight shape, increased rates of psychiatric comorbidity, and successful outcomes with evidence-based psychotherapy. […] Antidepressant medications, particularly SSRIs, have been shown to reduce bingeeating behavior, although it is unclear if this is a longterm effect. […] Another medication option is the appetitesuppressant sibutramine, which is associated with at least a shortterm reduction in binge eating, and is also associated with significant weight loss.
  • #1 Eating Disorders in Primary Care: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0101/p22.html
    Meta-analytic data support treatment with cognitive behavior therapy (CBT) and self-guided therapy for binge-eating disorder. […] In-person CBT more effectively decreases binge eating and therapy dropout than self-guided CBT at six months and confers markedly better outcomes than weight-loss therapies. […] Patients who exhibit a rapid decrease in binge-eating behaviors in the first month of treatment are more likely to have sustained remission, regardless of treatment modality, than patients who do not.
  • #1 Diagnosis of Eating Disorders in Primary Care | AAFP
    https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html
    Treatment intensity and setting depend on the severity of the illness. […] The family physician can and should be an integral member of that team. […] The prognosis of patients who have eating disorders is variable. […] Because of the severity of these illnesses and the improvement in outcomes when diagnosis occurs earlier, the family physician can play a crucial role in helping patients recover from eating disorders by detecting them at an early stage.
  • #1 What is Binge Eating Disorder? Signs, Symptoms & Treatments – The Renfrew Center
    https://renfrewcenter.com/services/binge-eating-disorder/
    Early intervention and the appropriate level of care can make a significant difference in the long-term recovery of those with binge eating disorder. Due to the complex nature of the disorder, it will not likely resolve on its own or with time. Seeking out the appropriate level of care as soon as possible is recommended for best outcomes.
  • #2 Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5 | BMC Psychiatry | Full Text
    https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0445-6
    The clinical importance of BED is also related to its frequent comorbidity with obesity as well as complications of overweight and with psychiatric symptoms like depression and anxiety. […] The clinical relevance of BED, here underlined, highlights the importance of identifying appropriate and evidence based treatment strategies, in order to prevent this disorder to become chronic and complicated. […] We aimed to systematically identify and synthesize the recent evidences about BED diagnostic category with regards to its recent addition as an autonomous disease in DSM-5. […] The concept of binge eating as overeating without compensatory behaviors was introduced by Stunkard in 1959, and structured in the Nineties by Fairburn and Spitzer as specific syndrome, mentioned in DSM-IV-TR as a nosologic entity needing future definition.
  • #2 Binge Eating Disorder Diagnosis: Screenings and Testing
    https://www.verywellhealth.com/binge-eating-disorder-diagnosis-5181755
    Binge eating disorder is diagnosed primarily through a discussion and evaluation of symptoms, but can involve physical examinations and diagnostic testing. […] To be diagnosed with binge eating disorder, a person must meet the following criteria: […] Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: […] The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). […] Binge-eating episodes are associated with three (or more) of the following: […] Marked distress regarding binge eating is present. […] The binge eating occurs, on average, at least one day a week for three months. […] The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.
  • #2 How Is Binge Eating Disorder Diagnosed? — Talkspace
    https://www.talkspace.com/mental-health/conditions/binge-eating-disorder/diagnosis/
    While its not unusual to occasionally overeat from time to time, people with binge eating disorder (BED) feel like they cant control how much they consume and will binge to the point of being ill. Approximately 1.25% of women and 0.42% of men are diagnosed with this condition, making it the most common eating disorder in the United States. […] If you have symptoms of binge eating disorder, you must take the steps to receive a proper diagnosis so you can get the care you need. […] Weight is not a criterion for a BED diagnosis. People of any weight or body shape may be diagnosed with the condition. Professionals look at numerous factors when determining how to diagnose binge eating disorder. […] BED is a mental health condition listed in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and there are exams and tests that are also a part of how binge eating is diagnosed.
  • #2 Binge eating disorder – Wikipedia
    https://en.wikipedia.org/wiki/Binge_eating_disorder
    One study found that the method for diagnosing BED is for a clinician who typically diagnose using the DSM-5 criteria or taking the Eating Disorder Examination. […] The DSM-5 characterizes diagnosis under several categories mild, moderate, severe, and extreme each determined by the number of binges the patient exhibits per week. Mild: 1-3 episodes per week, Moderate: 4-7 episodes per week, Severe: 8-13 episodes per week, Extreme: 14 or more episodes per week. […] Further, the remission states are classified under the following. Partial Remission: Following a previous diagnosis, the average frequency of binge eating episodes decreases to less than one episode per week for a sustained period of time. Full Remission: Following a previous diagnosis, none of the criteria have been met for a sustained period of time.
  • #2 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    The diagnosis is multidisciplinary and shared among the various professionals. The professional figures who must therefore participate in the assessment process and who carry out the diagnostic tests, necessary, at this stage, are the psychiatrist, internist, endocrinologist, clinical psychologist, and nutritionist. […] The medical diagnostic protocol should include clinical-anamnestic evaluation, physical examination, fasting blood glucose, serum lipid profile (total, HDL, and LDL cholesterol, triglycerides), uric acid, thyroid function, liver function (hepatic enzymes), serum creatinine, and cardiovascular assessment. […] In the assessment of BED, clinicians have many screening instruments, like specific questionnaires, to recognize and treat the eating disorder and not only comorbidities. To diagnose BED, clinicians must consider that it is different from simply overeating.
  • #2 Binge Eating Disorder Diagnosis
    https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/do-i-have-a-binge-eating-disorder
    You can be diagnosed with BED if you: […] Binge regularly — on average, at least once a week for at least three months […] Eat a large quantity of food (more than others would eat) in a short amount of time, such as two hours, while feeling like you cant stop or control how much youre eating […] Eat when youre not hungry […] Eat until you feel uncomfortably full […] Eat more quickly than usual […] Eat alone out of embarrassment […] Feel upset about your binges […] Feel guilty, depressed, or disgusted afterward. […] You may also: […] Feel angry, anxious, or worthless before the binge […] Adjust your schedule to make time for binges […] Hide, steal, or hoard food […] Diet, skip meals, or eat very little to make up for binges.
  • #2 Eating Disorders | NAMI
    https://www.nami.org/about-mental-illness/mental-health-conditions/eating-disorders/
    A person with an eating disorder will have the best recovery outcome if they receive an early diagnosis. […] If an eating disorder is believed to an issue, a doctor will usually perform a physical examination, conduct an interview and order lab tests. These will help form the diagnosis and check for related medical issues and complications. […] In addition, a mental health professional will conduct a psychological evaluation. They may ask questions about eating habits, behaviors and beliefs. There may be questions about a patient’s history of dieting, exercise, bingeing and purging. […] Symptoms must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to warrant a diagnosis. Each eating disorder has its own diagnostic criteria that a mental health professional will use to determine which disorder is involved. It is not necessary to have all the criteria for a disorder to benefit from working with a mental health professional on food and eating issues. […] Often a person with an eating disorder will have symptoms of another mental health condition that requires treatment. Whenever possible, it is best to identified and address all conditions at the same time. This gives a person comprehensive treatment support that helps ensure a lasting recovery.
  • #2 Binge Eating Disorder Diagnosis
    https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/do-i-have-a-binge-eating-disorder
    Diagnosing eating disorders can be challenging because secrecy, shame, and denial are part of them. So the disorder might not be noticed for a long time. In most cases, binge eating disorder is discovered when a person gets professional help with weight loss. Other times it is identified when the person sees a doctor for an obesity-related health problem, or a mental health problem like depression or anxiety that might be linked to the illness. […] If binge eating disorder is suspected, the doctor will likely start an evaluation by doing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose eating disorders, the doctor might use diagnostic tests, such as blood and urine tests and other laboratory procedures, to rule out physical illness as the cause of the symptoms. These tests may also help find the medical effects of an eating disorder, such as changes in digestive enzyme levels, liver functioning, or electrolytes (the normal salt concentrations in blood).
  • #2 How Is Binge Eating Disorder Diagnosed? — Talkspace
    https://www.talkspace.com/mental-health/conditions/binge-eating-disorder/diagnosis/
    An important component of how binge eating is diagnosed is ruling out other potential causes for destructive binging behaviors. […] Doctors may run a number of exams and tests before a diagnosis is made. […] At Talkspace, you can connect with a mental health professional online to get a diagnosis. […] Getting a binge eating disorder diagnosis online eliminates many of the barriers that prevent people from getting help. […] Once you have received a diagnosis, its critical to make sure you seek the appropriate treatment option for your condition so you can learn how to stop binge eating. […] Taking your diagnosis seriously can help you avoid negative health symptoms and can improve the chance of a positive outcome. […] In therapy, you can learn to identify what causes binge eating. […] Working with a therapist one-on-one can also help you process any guilt and shame associated with your binging. […] At Talkspace, you can connect with a therapist who knows how to diagnose binge eating disorder and provide you with treatment.
  • #2 Eating Disorders
    https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/
    Binge-eating disorder is characterized by binge eating without inappropriate compensatory behaviors. […] The DSM5 also added binge-eating disorder as an eating disorder diagnosis, characterized by binge eating without inappropriate compensatory behaviors. […] Binge-eating disorder includes recurrent binge eating without associated compensatory weight control behaviors. […] The essential features of binge-eating disorder include distress regarding binge-eating episodes. […] Differential diagnosis for binge-eating disorder includes bulimia nervosa, obesity, and other psychiatric conditions such as bipolar and depressive disorders and borderline personality disorder. […] Bingeeating disorder differs from bulimia nervosa in that bingeeating disorder is not associated with compensatory weight loss behaviors that are present in bulimia nervosa.
  • #2 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Eating-Disorders-Diagnosis.aspx
    Medical tests are advised to detect and rule out complications of eating disorders. […] Other disorders that mimic eating disorders include: […] Major depression is the most common comorbid condition among patients with anorexia. […] Anxiety disorders, especially social phobia, also are common. […] This has a prevalence of 30 percent among patients with eating disorders. […] This has prevalence is estimated at 12 to 18 percent in patients with anorexia and 30 to 70 percent in patients with bulimia.
  • #2 Diagnosis of Eating Disorders in Primary Care | AAFP
    https://www.aafp.org/pubs/afp/issues/2003/0115/p297.html
    Treatment intensity and setting depend on the severity of the illness. […] The family physician can and should be an integral member of that team. […] The prognosis of patients who have eating disorders is variable. […] Because of the severity of these illnesses and the improvement in outcomes when diagnosis occurs earlier, the family physician can play a crucial role in helping patients recover from eating disorders by detecting them at an early stage.
  • #2 What is Binge Eating Disorder? Signs, Symptoms & Treatments – The Renfrew Center
    https://renfrewcenter.com/services/binge-eating-disorder/
    Early intervention and the appropriate level of care can make a significant difference in the long-term recovery of those with binge eating disorder. Due to the complex nature of the disorder, it will not likely resolve on its own or with time. Seeking out the appropriate level of care as soon as possible is recommended for best outcomes.
  • #2 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    The exploration of family dynamics is very important, especially for minors and patients living with the family. This is not only in the case of young patients who still live within the family, but also in adult patients with BED (or other partial disorders). […] The diagnosis is multidisciplinary and shared among the various professionals. The professional figures who must therefore participate in the assessment process and who carry out the diagnostic tests, necessary, at this stage, are the psychiatrist, internist, endocrinologist, clinical psychologist, and nutritionist.
  • #2 What is Binge Eating Disorder? Signs, Symptoms & Treatments – The Renfrew Center
    https://renfrewcenter.com/services/binge-eating-disorder/
    Binge eating disorder is an eating disorder characterized by cycles of restriction and binge eating episodes. Symptoms of binge eating disorder include eating large amounts of food in a discrete period of time. This diagnosis may also include certain experiences such as eating rapidly, eating past fullness, eating to the point of discomfort, eating when not hungry and eating alone. People with binge eating disorder report feeling a loss of control when eating and intense distress about their condition. This distress may involve feelings of shame, guilt, and embarrassment. […] Individuals suffering from binge eating disorder deserve caring and professional evaluation, diagnosis and treatment. […] The treatment team supports and collaborates with each client, assesses the severity of the eating disorder symptoms, and monitors progress in the recovery process. They make recommendations and provide individualized treatment interventions to meet their client’s psychological, medical, and nutritional needs. Support systems and outpatient providers might also be part of the treatment team to promote sustainable change outside of the treatment setting.
  • #2 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    Binge eating disorder (BED) is the most common eating disorder categorized in the DSM-V, but it is often not diagnosed in patients with obesity because it can be difficult to detect in these patients who often have altered eating patterns. […] In the diagnostic assessment of these patients, it is important to evaluate not only the clinical and nutritional status and the presence of medical comorbidities, but also the psychological signs and symptoms related to psychiatric comorbidities to define the appropriate diagnosis and the consequent level of treatment. […] Although today BED is the most common eating disorder, many patients are not diagnosed, and some studies report that clinicians can underdiagnose BED, as revealed in a survey where, among respondents who met the diagnostic criteria for BED, only 3.2% had a diagnosis by healthcare providers.
  • #2 What Is Binge Eating Disorder? Symptoms, Causes, Diagnosis, Treatment, and Prevention
    https://www.everydayhealth.com/binge-eating-disorder/guide/
    Binge eating disorder is typically diagnosed based on a persons symptoms and eating habits. […] Additionally, doctors may perform a physical exam, recommend a psychological evaluation, or run other medical tests if the disorder is suspected. […] Whether they appear fat, thin, or normal weight, most people with BED never get treated, says Ellen Fitzsimmons-Craft, PhD, a psychologist and an associate professor of psychiatry at Washington University School of Medicine in St. Louis. […] One reason, shockingly, is that most doctors and many mental health professionals get little or no training in how to detect or treat any eating disorders. […] If you havent been taught about eating disorders, you wont know what to look for and you wont spot it, says Dr. Warren, who also blames undertreatment on a widespread anti-fat attitude. […] A persons prognosis depends on many factors. […] The good news is that people with BED have a greater chance of remission compared with those who struggle with other eating disorders.
  • #2 Diagnosing Eating Disorders in Children & Adolescents | NYU Langone Health
    https://nyulangone.org/conditions/eating-disorders-in-children-adolescents/diagnosis
    A doctor determines during the evaluation if a person is troubled by weight gain or the prospect of being fat, even though he or she is thin. […] For a doctor to diagnose binge eating disorder, a person must repeatedly eat unusually large amounts of food in a relatively short period of time and feel that those binges are beyond his or her control. At least three of the following factors must also be present: eating rapidly, eating to the point of uncomfortable fullness, eating when not hungry, eating in shame or in secret and feeling disgusted, depression, or feeling ashamed after eating. […] The behavior must occur at least once a week for a period of six months. Binge eating is not associated with inappropriate methods to compensate for overeating, such as self-induced vomiting.
  • #2 Binge eating disorder in adults: Overview of treatment – UpToDate
    https://www.uptodate.com/contents/binge-eating-disorder-in-adults-overview-of-treatment
    Binge eating disorder is more prevalent than either anorexia nervosa or bulimia nervosa, and is associated with numerous psychiatric and nonpsychiatric disorders. […] In addition, most patients report some degree of impairment in psychosocial functioning (home, work, personal life, or social life), and 19 percent report severe impairment. […] The phenomenon of binge eating was first described formally in 1959 in individuals with obesity. […] However, binge eating disorder was first formulated as a distinct diagnosis in the 1990s. […] This topic provides an overview of evaluating and treating patients for binge eating disorder. […] The use of cognitive-behavioral therapy to treat binge eating disorder is discussed separately, as is the diagnosis and treatment of anorexia nervosa, bulimia nervosa, and obesity.
  • #2 Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5 | BMC Psychiatry | Full Text
    https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0445-6
    BED patients frequently refer to a constant polarization of thoughts on weight control, diet and binge-avoidance, showing worst eating control, higher fear of weight gain, and higher body-shape dissatisfaction than non-BED obese individuals. […] The majority of binge episodes typically occur in less than 2 hours, with a clinical and psychopathological importance which is related to objective food intake. […] Loss of control is a core feature associated with higher depression, higher body dissatisfaction and poorer related quality of life. […] The peculiar food choice that patients make during binge episodes has been related to the hypothesis of a hedonic deprivation. […] The treatment of BED, as for EDs in general, is influenced by his etiological background, constituted of a complex interaction of heritable, psychological and environmental factors that should be taken into account in treatment planning.
  • #2 Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5 | BMC Psychiatry | Full Text
    https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0445-6
    According to literature data, also with regards to systematic reviews and meta-analysis, psychotherapies are the most validated and effective treatments for BED. […] Cognitive-Behavioral Therapies (CBT) are the most evaluated and developed psychological intervention for treating BED. […] Pharmacological therapy in BED is specifically focused on the reduction of eating impulsiveness, binges and negative feelings, constituting a co-cause and a complication of eating symptoms. […] It has been noticed a statistically significant drug action on short-term binge remission and also on weight loss, although this does not hold significant at longer follow-up. […] Bariatric surgery is a recommended treatment for severe obesity (BMI 40 or BMI 35 with comorbid conditions) according to current guidelines, while it is not mentioned among evidence-based BED treatments. […] Despite its recent inclusion in DSM-5 as an autonomous disease, further research is needed on BED diagnosis and treatment strategies, through larger samples and longer follow-up times.
  • #3 Screening, Diagnosis, and Treatment of Patients with Binge Eating Disorder and Obesity: What the Endocrinologist Needs to Know
    https://www.mdpi.com/2673-396X/5/1/6
    The diagnosis is multidisciplinary and shared among the various professionals. The professional figures who must therefore participate in the assessment process and who carry out the diagnostic tests, necessary, at this stage, are the psychiatrist, internist, endocrinologist, clinical psychologist, and nutritionist. […] The medical diagnostic protocol should include clinical-anamnestic evaluation, physical examination, fasting blood glucose, serum lipid profile (total, HDL, and LDL cholesterol, triglycerides), uric acid, thyroid function, liver function (hepatic enzymes), serum creatinine, and cardiovascular assessment. […] In the assessment of BED, clinicians have many screening instruments, like specific questionnaires, to recognize and treat the eating disorder and not only comorbidities. To diagnose BED, clinicians must consider that it is different from simply overeating.
  • #3 Red flags and diagnostic criteria for eating disorders – Norton Healthcare Provider Louisville, Ky.
    https://nortonhealthcareprovider.com/news/eating-disorder-diagnostic-criteria/
    Diagnosing eating disorders can be challenging because telltale behaviors typically are hidden, even from those closest to the patient, according to Andrea L. Krause, M.D., who heads the team involved with the medical stabilization of eating disorder patients at Norton Children’s Hospital. […] Eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are Binge eating disorder. […] Hospitalization is warranted if the heart rate is 40 or below, total blood pressure of 80/50 or less, and orthostatic changes in pulse higher than 20 beats per minute or orthostatic change in blood pressure greater than 10 mmHg. […] Eating disorders are the second deadliest DSM diagnosis, with about half the deaths coming from suicide. The mortality for anorexia is 5% to 6%. Early identification of an eating disorder is associated with better outcomes, making early diagnosis critical. […] “It can be very hard to overcome if the patient gets stuck in that state of starvation for years on end,” Dr. Krause said. “Early intervention is key.”
  • #3 Binge Eating Disorder | National Alliance for Eating Disorders
    https://www.allianceforeatingdisorders.com/binge-eating-disorder/
    An estimated 3.5% of women, 2% of men, and 30% to 40% of those seeking weight loss treatments can be clinically diagnosed with Binge Eating Disorder. […] For a complete guide to DSM-5 Diagnosis Criteria for Binge Eating Disorder, visit the NCBI Website. […] A life in complete recovery is possible. If you or a loved one is struggling with Binge Eating Disorder, you dont have to go through this alone. […] Early detection and intervention may increase the likelihood of recovery.
  • #3 Who can diagnose binge eating disorder ADHD-BED Integrated®
    https://adhd.clinic/news-research/who-can-diagnose-binge-eating-disorder/
    Binge Eating Disorder (BED) is typically diagnosed through a comprehensive evaluation by a licensed medical and/or mental health professional, based on the diagnostic guidelines provided by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). […] The DSM-V states that a diagnosis of BED would require that patient has recurrent binge-eating episodes involving eating excessive amounts of food that is abnormal for the average person within a discrete a period of time. These binge-eating episodes must occur at least one day a week, and have been occurring for at least a duration of 3 months. […] BED can be diagnosed by licensed healthcare providers like your family doctor (general practitioner or paediatrician), or mental health professionals like psychiatrists and psychologists.
  • #3 Binge Eating Disorder Diagnosis
    https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/do-i-have-a-binge-eating-disorder
    Diagnosing eating disorders can be challenging because secrecy, shame, and denial are part of them. So the disorder might not be noticed for a long time. In most cases, binge eating disorder is discovered when a person gets professional help with weight loss. Other times it is identified when the person sees a doctor for an obesity-related health problem, or a mental health problem like depression or anxiety that might be linked to the illness. […] If binge eating disorder is suspected, the doctor will likely start an evaluation by doing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose eating disorders, the doctor might use diagnostic tests, such as blood and urine tests and other laboratory procedures, to rule out physical illness as the cause of the symptoms. These tests may also help find the medical effects of an eating disorder, such as changes in digestive enzyme levels, liver functioning, or electrolytes (the normal salt concentrations in blood).
  • #3 Eating Disorders in Primary Care: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0101/p22.html
    Meta-analytic data support treatment with cognitive behavior therapy (CBT) and self-guided therapy for binge-eating disorder. […] In-person CBT more effectively decreases binge eating and therapy dropout than self-guided CBT at six months and confers markedly better outcomes than weight-loss therapies. […] Patients who exhibit a rapid decrease in binge-eating behaviors in the first month of treatment are more likely to have sustained remission, regardless of treatment modality, than patients who do not.
  • #3
    https://www.aedweb.org/resources/about-eating-disorders
    Individuals with eating disorders may not recognize the seriousness of their illness and/or may be ambivalent about changing their eating or weight control behaviors. […] Medical stabilization, nutritional rehabilitation to achieve weight restoration and address nutrient deficiencies, management of refeeding and its potential complications, and interruption of purging/compensatory behaviors should be the immediate goals of treatment for all individuals with eating disorders.

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