BED is a recently described condition,[8] which was required to distinguish binge eating similar to that seen in bulimia nervosa but without characteristic purging.
Individuals who are diagnosed with bulimia nervosa and binge eating disorder exhibit similar patterns of compulsive overeating, neurobiological features of dysfunctional cognitive control and food addiction, and biological and environmental risk factors.
[14] Regarding cognitive abilities, individuals showing severe binge eating symptoms may experience small dysfunctions in executive functions.
[19] Those with BED are also at risk of Non-alcoholic fatty liver disease,[20][21] menstrual irregularities such as amenorrhea,[4] and gastrointestinal problems such as acid reflux and heartburn.
When under a strict diet that mimics the effects of starvation, the body may be preparing for a new type of behavior pattern, one that consumes a large amount of food in a relatively short period of time.
[33] "In the U.S, it is estimated that 3.5% of young women and 30% to 40% of people who seek weight loss treatments, can be clinically diagnosed with binge eating disorder.
[35] ICD-11 may contain a dedicated entry (6B62), defining BED as frequent, recurrent episodes of binge eating (once a week or more over a period of several months) which are not regularly followed by inappropriate compensatory behaviors aimed at preventing weight gain.
[39] One study claims that the method for diagnosing BED is for a clinician to conduct a structured interview using the DSM-5 criteria or taking the Eating Disorder Examination.
[41] Counselling and some medication, such as certain stimulants (e.g. lisdexamfetamine), selective serotonin reuptake inhibitors (SSRIs), and GLP-1 receptor agonists, may help those affected by BED.
[45][46] Medical reviews of randomized controlled trials have established that lisdexamfetamine, administered at doses between 50 and 70 mg, is safe and effective for treating BED.
[sources 1] These reviews consistently report significant reductions in the number of binge eating days and episodes per week.
[46][47] Lisdexamfetamine is a pharmacologically inert prodrug that confers its therapeutic effects for BED after conversion to its active metabolite, dextroamphetamine, which acts in the central nervous system.
[44] Dextroamphetamine increases the activity of dopamine and norepinephrine in prefrontal cortical regions that regulate cognitive control of behavior.
[43][44][45] By enhancing the ability to exert cognitive control over behavior, dextroamphetamine helps patients with BED override prepotent feeding responses that precede binge eating episodes.
[45][47][49] Lisdexamfetamine, like all pharmaceutical amphetamines, possesses direct appetite suppressant effects, which may be therapeutically beneficial for BED and its associated comorbidities.
[46][47] Neuroimaging studies involving BED-diagnosed participants suggest that long-term neuroadaptations in dopaminergic and noradrenergic systems resulting from lisdexamfetamine treatment may play a role in the sustained improvements in eating behavior regulation observed even after discontinuation of the drug.
[54] GLP-1 receptor agonist medications such as semaglutide (Ozempic), dulaglutide (Trulicity), and liraglutide (Saxenda) have been used for treating BED in recent years.
Often prescribed for lowering appetite and subsequent weight loss in obese and diabetic patients, they can successfully stop or reduce obsessive thoughts about food, binging urges, and other impulsive behaviors.
[55][56][57][58] Some users of these drugs have reported a major, sudden improvement in what is colloquially known as "food noise" – constant, unstoppable thoughts about eating despite not being physically hungry – which can be a symptom of BED.
[62] The goal of CBT is to interrupt binge-eating behaviour, learn to create a normal eating schedule, change the perception around weight and shape and develop positive attitudes about one's body.
[62] Other treatments for BED include lifestyle interventions like weight training, peer support groups, and investigation of hormonal abnormalities.
The main physical health consequences of this type of eating disorder are brought on by the weight gain resulting from calorie-laden bingeing episodes.
[50] The limited amount of research that has been done on BED shows that rates of binge eating disorder are fairly comparable among men and women.
[71] Due to limited and inconsistent information and research on ethnic and racial differences, prevalence rates are hard to determine for BED.
[75] Furthermore, associated factors such as food insecurity and environmental stress have been shown to contribute to higher rates of eating disorders, such as BED, in these populations.
[74] Researchers have been called on to reframe eating-related disorders to better fit low socioeconomic status populations and improve future investigations.
[77] The prevalence of BED is lower in Nordic countries compared to Europe in a study that included Finland, Sweden, Norway, and Iceland.
[78] In a study that included Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela, the point prevalence for BED was 3.53 percent.
Little is known if this discrepancy is an indicator of later onset of body image distortion in males or a consequence of female-centric diagnostic frameworks for eating disorders.
[71] Researchers have been called on to address this gap by advancing methods of "identification, assessment, classification, and treatment" for eating disorders in a male-specific context, specifically in young men.