Diagnostic Criteria for Binge Eating Disorder

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Updated on November 30, 2020

Binge eating disorder (BED) is an eating disorder introduced in 2013 in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although newly recognized as a distinct disorder, it is the most common eating disorder and is more common than anorexia nervosa and bulimia nervosa.

A nationally representative face-to-face household survey (U.S.) of nearly ten thousand respondents determined that 2.3% of females and 0.8% of males will develop binge eating disorder.

Approximately 40% of those with binge eating disorder are male. BED often begins in the late teens or early 20s, although it has been reported in young children as well as older adults.

Binge eating disorder is sometimes mischaracterized as food addiction, which is not a recognized psychiatric disorder. While a large number of people with binge eating disorder are overweight, BED can also occur in people who are normal weight.

As most people who are overweight or have obesity do not have BED, it is important not to conflate obesity with binge eating disorder.

While many people may think of binge eating disorder as a less serious disorder than anorexia nervosa or bulimia nervosa, it can be severe, debilitating, and even life-threatening.

Criteria for Binge Eating Disorder Diagnosis

To be diagnosed with binge eating disorder, a person must have episodes of binge eating at least once a week for three months. During these episodes, the person will feel a lack of control over their eating (they can't stop eating or control how much or when they eat).

Binge-eating episodes cannot occur exclusively during the course of anorexia nervosa or bulimia nervosa. Repeated attempts to stop binge eating, or repeated attempts at dieting, do not exclude someone from a binge eating disorder diagnosis.

Binge-eating episodes are associated with three (or more) of the following symptoms:

Eating much more quickly than normal
Eating until uncomfortably full
Eating large amounts of food even when not physically hungry
Eating alone because of embarrassment about how much one is eating
Feeling disgusted with oneself, depressed, or very guilty afterward

A major distinction between binge eating disorder and bulimia nervosa is that there are no recurrent behaviors used to avoid weight gain or compensate for binge eating. Known as “compensatory behaviors,” these behaviors may include purging or extreme restriction of food intake.

Triggers for Binge Eating

Several triggers for binge eating have been reported in people with binge eating disorder, including:

Feeling unhappy, anxious, or other negative emotions about body weight, body shape, or food
Feeling bored
Problems with interpersonal relationships
Weight stigma

Treatment

Treatments for binge eating disorder include medications (SSRIs and Vyvanse) and psychotherapy, such as cognitive behavioral therapy and interpersonal therapy. Guided self-help may also be effective. Discuss your specific treatment options—which may include any of the following or a combination of medication and therapy—with your doctor to find the right treatment for you.

Binge Eating Disorder Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

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Remission

The DSM-V also allows professionals to specify if a person is in partial remission or in full remission (recovery) from binge eating disorder. The severity, based on the average frequency of binge-eating episodes, can also be specified:

Mild: 1 to 3 episodes each week
Moderate: 4 to 7 episodes each week
Severe: 8 to 13 episodes each week
Extreme: 14 or more episodes each week

A Word From Verywell

Regardless of how frequent the individual's troubled eating episodes, if you or someone you know is struggling with binge-eating or compulsive overeating episodes, it is important to see a physician, dietician, or a mental health professional for an assessment. Treatment is available and recovery is possible.