Binge-Eating Disorder

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Causes & Diagnosis

It is not at all clear what causes binge-eating disorder. It's estimated that up to half of all people with the disorder have a history of depression, but it's not clear whether the depression is a cause or an effect of the eating disturbance, or if it's even related.

Most people with binge-eating disorder have a history of dieting, and many of them are in weight-control programs. So there seems to be some sort of link between dieting and binge-eating, though it's not at all clear what that link is.

Researchers are also investigating if variations in brain chemicals or metabolism (how the body burns calories) could have anything to do with binge-eating.

Diagnosis

Binge-eating disorder is listed as a mental disorder according to the American Psychiatric Association's DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). According to the manual, the criteria for diagnosing binge-eating disorder are:

• Repeated episodes of binge eating. A binge involves eating a larger-than-normal amount of food in a discrete period of time (for example, within a 2-hour period). The circumstances also define binge behavior. Someone who eats a huge amount of food at a holiday dinner or wedding, for example, is not necessarily binging. Feasting is an important part of many celebrations. Someone who is binging feels out of control; they aren't able to stop eating.
• The binges are associated with three or more of the following:
  • eating more quickly than normal;
  • eating until feeling uncomfortably full;
  • eating large amounts of food even when not feeling physically hungry;
  • eating alone because of being embarrassed by how much one is eating;
  • feeling disgusted with oneself, depressed or guilty after overeating.
• The binges occur at least twice a week for 6 months.
• The binges are NOT associated with regular purging (vomiting, fasting or excessive exercise).

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