Comorbidity

Binge eating is strongly associated with both obesity and psychiatric disorder. It is well documented that obesity is linked to adverse medical and psychosocial outcomes. Preliminary findings also suggest that BED may be associated with poor health, independent of the effects of comorbid psychopathology or comorbid obesity.

Severity of binge eating is positively associated with degree of overweight. Additionally, there are important differences between overweight individuals with and without BED. BED patients report earlier onset of obesity, along with a history of more severe obesity, dieting, and weight fluctuations. When compared with equally overweight individuals without binge eating problems, BED patients report considerably less 'restraint' or control overeating, lower self-esteem, more fear of weight gain, more preoccupation with food, and higher body dissatisfaction.

Individuals with BED endorse high rates of psychiatric symptoms and disorders. For example, when compared to equally overweight individuals without binge eating problems, individuals with BED report significantly higher lifetime rates of major depressive disorder, substance abuse or dependence, and anxiety disorders. Some studies have shown that patients with BED report levels of eating disorder symptomatology, such as eating, shape, and weight concerns, that are comparable to those of normal weight patients with BN. Individuals with BED also have considerably higher rates of personality disorders than overweight individuals without an eating disorder. Thus, among individuals with BED, psychiatric symptomatology appears to be related to the binge eating rather than to the degree of obesity.

Treatment

Among those who seek treatment, BED tends to be a chronic and fluctuating disorder. The clinical picture in BED often involves onset in late adolescence or the early 20s, with numerous periods of relative control over eating, and weight loss during periods of successful calorie restriction, alternating with periods characterized by binge eating and weight gain. Individuals with BED often seek obesity treatment rather than treatment of disordered eating per se.

A variety of psychosocial and pharmacological interventions, as well as behavioral weight loss programs, can help individuals gain control over binge eating. Figure 1 provides an overview of non-pharmacologic treatments and their postulated mechanisms of action; it should be noted that this list of treatments is not exhaustive. Furthermore, although the postulated treatment mechanisms reflect respective theoretical models of binge eating, the effects of psychosocial treatment usually lack specificity and the treatments often share common elements (e.g., self-monitoring is a central component of cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and behavioral weight control). Also, effects of psychosocial treatments often extend to areas that are not a focus of treatment (e.g., behavioral weight management programs that target changing eating and exercise also have been shown to improve mood). Thus, some of the treatments do overlap. Finally, it is important to note that a substantial number of patients are not abstinent from binge eating after treatment, suggesting

Figure 1 Overview of nonpharmacologic treatments for binge eating.

the need for clinical trials of novel therapeutic approaches as well as combinations and sequencing of treatments.

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5 Ways To Get Rid Of The Baby Fat

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