Feeding and Eating Disorders
Binge-Eating Disorder
ICD-10-CM: F50.81
1. Criteria
DSM Criteria
Criterion A
- Recurrent binge eating episodes occur.
- A binge episode involves eating, in a discrete period, an amount that is definitely larger than most people would eat in similar circumstances.
- There is also a sense of lack of control over eating during the episode.
DSM Criteria
Criterion B
- The binge episodes are associated with at least 3 of the following: eating much more rapidly than normal, eating until uncomfortably full, eating large amounts when not physically hungry, eating alone because of embarrassment, or feeling disgusted, depressed, or very guilty afterward.
DSM Criteria
Criterion C
- There is marked distress regarding binge eating.
DSM Criteria
Criterion D
- The pattern occurs at least once a week for 3 months.
DSM Criteria
Criterion E
- The binge eating is not associated with regular compensatory behaviors and does not occur exclusively during bulimia nervosa or anorexia nervosa.
2. Context
- Binge-eating disorder centers on recurrent loss-of-control eating that feels distressing and hard to stop, but without the regular purging or compensatory behaviors seen in bulimia nervosa. Patients often describe shame, secrecy, and feeling disconnected from hunger or fullness cues.
- No regular compensatory behaviors: That is the major dividing line from bulimia nervosa and helps keep the diagnosis conceptually clean.
- Distress required: The person has to be meaningfully distressed by the binge eating, not just overeating from time to time.
- Frequency threshold: The episodes need to recur often enough to form a syndrome, with DSM threshold set at least weekly for 3 months.
- Clinical focus: Brief self-report tool for binge-eating severity.
3. Validated scales
BES
Brief self-report tool for binge-eating severity.
EDE-Q
Useful when broader eating-disorder symptom tracking is needed.
4. FDA approved treatments
FDA-indicated medication for binge-eating disorder
Lisdexamfetamine has diagnosis-specific FDA labeling for moderate to severe binge-eating disorder in adults.
Common off-label medications
Interventional psychiatry modalities
- TMS is under study in binge-eating disorder.
- Ketamine is investigational rather than standard care.
- ECT is not a standard BED intervention.
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5. Top management articles
- Management review for Binge-Eating Disorder PubMed search
- Binge-Eating Disorder treatment guideline PubMed search
- Binge-Eating Disorder pharmacotherapy or psychotherapy review PubMed search