Description

An eating disorder which includes binge eating and inappropriate compensatory behaviors; symptoms include:

• Episodes of binge eating, lack of self-control for eating
• Inappropriate compensations
  • For example, excessive exercise, self-induced vomiting, inappropriate diuretics use
• Alternating binge eating and compensations for prolonged time
• Distorted self-body image
• System(s) affected: oropharyngeal, endocrine/metabolic, gastrointestinal, dermatologic, cardiovascular, pulmonary, psychiatric

Epidemiology

• Mean age of onset: 18 to 21 years
• Predominant sex: female > male (13:1)

Prevalence
Up to 3% of females and ~1% of males in their lifetime

Etiology and Pathophysiology

Combination of biologic, psychological, environmental, and social factors

Genetics
Heritability estimated to be up to 41%

Risk Factors

• Female gender
• History of obesity and dieting
• Body dissatisfaction: critical comments about weight, body shape, or eating: low self-esteem
• Depression, social anxiety, severe life stressor
• Poor impulse control, substance abuse
• Family history of substance abuse, affective disorders, eating disorder, or obesity
• Diabetes
• Childhood trauma (sexual or physical abuse, neglect)

General Prevention

• Realistic and healthy weight management strategies and attitudes
• Decrease body dissatisfaction and promote self-esteem.
• Reduce focus on thin as ideal.

Commonly Associated Conditions

• Major depression, dysthymia, anxiety, obsessive-compulsive, bipolar disorders
• Substance use disorder
• Personality disorders: borderline, schizotypal, antisocial (1)