Prevalence and Risk Factors

Available research suggests that the prevalence of BED among the general population is approximately 1 or 2% and thus more common than BN. In addition, preliminary findings suggest that the demographic profile of individuals with BED may be more diverse, affecting relatively more men and minority groups than BN or anorexia nervosa. Furthermore, binge eating is more prevalent among obese individuals in both clinical and community samples. It is estimated that up to one-third of individuals who present for treatment in university-based weight control clinics report significant binge eating.

The most comprehensive risk factor study to date suggests that the risk factors for BED may be weaker and more circumscribed than for BN. Fairburn and colleagues interviewed four groups of subjects matched for age and social class: individuals with BED, BN, another psychiatric disorder, and healthy controls. In comparing the BED group to the controls, negative self-evaluation, parental depression, adverse childhood experience, and exposure to repeated negative comments about shape, weight, or eating emerged as risk factors for BED. Further comparing BED patients to other groups with psychiatric diagnoses, childhood obesity and negative comments from family about eating, shape, and weight emerged as risk factors specific to BED. Thus, BED appears to be associated with two classes of risk factor—those that increase the risk of psychiatric disorder in general and factors that increase risk of obesity.

In order to improve our understanding of how multiple factors interact to determine the onset and maintenance of binge eating, prospective risk factor studies including males and females of different racial groups are needed. As suggested previously, biological (e.g., obesity), psychological (e.g., negative self-evaluation), and social (e.g., exposure to repeated negative comments about shape, weight, or eating) factors have been implicated in the patho-genesis of binge eating. Emergent research also has linked binge eating in a small proportion of individuals to a mutation in MC4R, a candidate gene for the control of eating behavior. Thus, future research may further elucidate the genetic influences on aberrant eating patterns.

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