________________________________________________________________________ Behavioral Addictions
DSM-5-TR DIAGNOSTIC CRITERIA FOR BINGE EATING DISORDER
Criteria Set Criterion 1
Specific Definitions for Each Criterion
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 two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances • 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)
Criterion 2
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 being embarrassed by how much one is eating • Feeling disgusted with oneself, depressed, or very guilty after overeating
Criterion 3 Criterion 4 Criterion 5
Marked distress regarding binge eating is present
The binge eating occurs, on average, at least one day per 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
Severity grading
Mild: 1 to 3 episodes per week Moderate: 4 to 7 episodes per week Severe: 8 to 13 episodes per week Extreme: 14 or more episodes per week
Source: [11]
Table 4
Psychological Interventions Cognitive-Behavioral Therapy
criterion and to describe eating behavior that is contraindicated based on meal size and meal content. Children may not meet the binge eating disorder criterion for a larger-than-normal amount of food because their parents or others limit the quantity of food they consume or because they are unable to accurately quantify the amount they eat [81]. Nevertheless, loss-of-control eating is one of the most commonly reported disordered eating behaviors in children and adolescents and is particularly common in youth who have overweight or obesity [257; 258]. TREATMENT Binge eating disorder treatment addresses the core behavioral (binge eating) and psychological (distress and eating, weight, and shape concerns) features of the condition. Other impor- tant targets include metabolic health (in patients with obesity, diabetes, or both) and mood regulation (in patients with comorbid depression or anxiety) [81; 259; 260]. Although binge eating disorder is found across all weight categories and overweight/obesity is not a criterion of binge eating disorder, weight loss has been considered an important treatment outcome, due to its strong association with the disorder and the heightened risk for obesity and associated medical comorbidities [261].
Therapy variants in binge eating disorder include CBT com- bined with body image exposure or cognitive restructuring components, and ecologic momentary assessment to increase self-monitoring adherence [81; 259; 262]. A meta-analysis of studies that randomized patients to CBT or non-treatment (control) found improved binge frequency and abstinence outcomes with therapist-led, partially therapist-led, structured self-help, and guided self-help CBT. Therapist-led CBT out- comes were compelling, with a higher rate of abstinence (59% CBT vs. 11% control), reduction of binge episodes, reduced patient hunger and eating concerns, and improved sense of control over eating. Guided self-help CBT reduced global eating-related psychopathology. When all study results were pooled, CBT and control groups were similar in weight lost and depressive symptom reductions. Therapist-led CBT was much more effective in improving key behavioral and eating- specific psychological domains [81]. In a separate study, patients with clinical or subclinical binge eating disorder were randomized to individual or group CBT. Significant reductions in binge eating frequency and mild weight reduction were shown in both CBT formats at three- year follow-up. Predictors of full, long-term recovery were absence of treatment history with amphetamine derivatives,
55
EliteLearning.com/Social-Work
Powered by FlippingBook