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binge eating disorder

Etiology: 1) bulimia nervosa 2) depression 3) impulsive behavior 4) hyperphagia 5) idiopathic Epidemiology: 1) probably the most common eating disorder. 2) 2% of population 3) 10-15% of people who are mildly obese & who try to lose weight have binge eating disorder 4) even more common in people who are severely obese 5) female/male ratio 3/2 6) affects blacks as often as whites (no data onother ethnic groups) Clinical manifestations: most of us overeat from time to time; however people with serious binge eating problems often: - feel their eating is out of control - eat what most people would think is an unusually large amount of food - eat much more quickly than usual during binge episodes - eat until so full they are uncomfortable - eat large amounts of food, even when they are not really hungry - eat alone because they are embarrassed about the amount of food they eat - feel disgusted, depressed, or guilty after overeating. Complications: 1) increased risk of obesity [2] (RR=1.9) 2) obesity & binge eating disorder increase risk of - diabetes mellitus - hypertension - hypercholesterolemia - gallbladder disease - heart disease - certain types of cancer 3) increase risk of depression [2] (RR=2.3) 4) overeating & binge eating in adolescence is a predictor for future use of marijuana & other drugs [3] Maagement 1) cognitive-behavioral therapy teaches people how to a) keep track of their eating b) change their unhealthy eating habits c) change the way they act in tough situations 2) interpersonal psychotherapy helps people a) look at their relationships with friends and family b) make changes in problem areas 3) pharmaceutical therapy [1] a) antidepressants may be helpful - sibutramine - sertraline may be useful for night binging - fluoxetine b) topiramate c) lisdexamfetamine (Vyvanse) [9] (FDA-approved) 4) patient education

Specific

bulimia nervosa

General

eating disorder impulse control disorder

References

  1. Prescriber's Letter 13(8): 2006 Drug Treatment for Eating Disorders Detail-Document#: 220811 (subscription needed) http://www.prescribersletter.com
  2. Field AE et al Prospective Association of Common Eating Disorders and Adverse Outcomes Pediatrics, Juoy 16 2012 http://pediatrics.aappublications.org/content/early/2012/07/11/peds.2011-3663.abstract
  3. Longitudinal Associations Between Binge Eating and Overeating and Adverse Outcomes Among Adolescents and Young Adults. Does Loss of Control Matter? Arch Pediatr Adolesc Med. 2012, Dec PMID: 23229786 http://archpedi.jamanetwork.com/article.aspx?articleid=1476811
  4. Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2015
  5. Agency for Healthcare Research and Quality Comparative Effectiveness Review. Number 160. Dec 2015 Management and Outcomes of Binge-Eating Disorder http://www.effectivehealthcare.ahrq.gov/ehc/products/563/2157/binge-eating-report-151207.pdf
  6. Binge Eating Disorders http://www.niddk.nih.gov/health/nutrit/pubs/binge.htm
  7. Eating Disorders: Facts About Eating Disorders and the Search for Solutions (NIMH) http://www.nimh.nih.gov/publicat/eatingdisorders.cfm
  8. Berkman ND, Brownley KA, Peat CM et al Management and Outcomes of Binge-Eating Disorder Agency for Healthcare Research and Quality (AHQR). Dec 9, 2015 PMID: 26764442 Free Books & Documents http://www.effectivehealthcare.ahrq.gov/ehc/products/563/2157/binge-eating-report-151207.pdf
  9. Brownley KA, Berkman ND, Peat CM et al Binge-Eating Disorder in Adults: A Systematic Review and Meta- analysis. Ann Intern Med. Published online 28 June 2016 PMID: 27367316 http://annals.org/article.aspx?articleid=2531704 - Devlin MJ Binge-Eating Disorder Comes of Age. Ann Intern Med. Published online 28 June 2016 PMID: 27366876 http://annals.org/article.aspx?articleid=2530858 - FDA News Release. January 30, 2015 FDA expands uses of Vyvanse to treat binge-eating disorder. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm432543.htm - Windle ML Rapid Rx Quiz: Stimulants Medscape.Oct 23, 2022 https://reference.medscape.com/viewarticle/981392