Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5

BMC Psychiatry

Secondo Fassino¹  Giovanni Abbate Daga¹  Luisa Ottone¹  Federico Amianto¹ 

[1] Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, Turin, 10126, Italy

关键词: Treatment;    Eating disorders;    Obesity;    Overeating;    Binge eating disorder;   

Others  :  1171034
DOI  :  10.1186/s12888-015-0445-6

 received in 2014-07-18, accepted in 2015-03-18,  发布年份 2015

【 摘 要 】

Introduction

Binge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies.

Methods

We identified studies published in the last 6 years searching the MeSH Term “binge eating disorder”, with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct.

Results

A total of 233 studies were found and, among them, 71 were selected and included in the review.

Review

Although Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy.

Conclusions

Despite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.

【 授权许可】

   
2015 Amianto et al.; licensee BioMed Central.

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