What is this thing called BED? Current status of binge eating disorder nosology

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Abstract
ObjectiveAlthough binge eating has been recognized as a clinically relevant behavior among the obese for more than four decades, the concept of binge eating disorder (BED) as a distinct psychiatric diagnosis is of much more recent origin. This article presents four ways of conceptualizing BED: a distinct disorder in its own right, as a variant of bulimia nervosa, as a useful behavioral subtype of obesity, and as a behavior that reflects psychopathology among the obese. It also summarizes the evidence supporting and disconfirming each model.MethodThe literature subsequent to the development of DSM-IV regarding the reliability and validity of BED and related conditions was reviewed selectively.ResultsThe preponderance of the evidence suggests that BED differs importantly from purging bulimia nervosa and that BED is not a strikingly useful behavioral subtype of obesity.DiscussionFurther study is needed to definitively determine the validity of BED as a distinct eating disorder. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: S2–S18, 2003.