Bulimia Nervosa and Binge Eating Disorder

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Bulimia Nervosa and Binge Eating Disorder are serious eating disorders that are very similar. Here are the official criteria for diagnosing them according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

 

Bulimia Nervosa

Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors, such as self-induced vomiting, designed to undo or compensate for the effects of binge eating.

An episode of binge eating is characterized by at least two of the following:
  • Eating, in a short period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than what most people would eat during a similar period of time and under similar circumstances.
  • A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
  • Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise.
  • The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for three months.
  • Self-evaluation is unduly influenced by body shape and weight.
  • The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Binge Eating Disorder

Binge Eating Disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort). A feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards. And not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. It is the most common eating disorder in the United States.

An episode of binge eating is characterized by at least two of the following: 
  • Eating, in a short period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge eating episodes are associated with three (or more) of the following: 
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for 3 months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in Bulimia Nervosa. And does not occur exclusively during the course of Bulimia Nervosa or Anorexia Nervosa.

According to the National Eating Disorders Association of America – NEDA, between 1.1% and 4.6% of females and 0.1% and 0.5% of males will develop Bulimia. BED is more than three times more common than Anorexia and Bulimia combined. According to NEDA, BED is also more common than breast cancer, HIV and schizophrenia.