Is Binge Eating Disorder really low-risk?

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Jun 6, 2008
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Diagnostic criteria:

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
* Eating, in a discrete period of time (eg, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances;
* A sense of lack of control over eating during the episode (eg, a feeling that one cannot stop eating or control what or how much one is eating).
2. The binge eating episodes are associated with at least three 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 being embarrassed by how much one is eating
* Feeling disgusted with oneself, depressed, or feeling very guilty after overeating
3. Marked distress regarding binge eating.
4. The binge eating occurs, on average, at least 2 days a week for 6 months.
5. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (eg, purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.


I have always been curious about whether BED has the lowest risk among the established eating disorders. I am, however, not that familiar with BED so please feel free to correct me if I am wrong.

I was anorexic in my early teens and spent some time in a ward specializing in the treatment of eating disorders. Almost every girl in there is clinically emaciated (BMI <15) with the exception of one bulimic who is of normal weight. (For those who don't know, if you otherwise meet the diagnostic criteria for bulimia nervosa but have a BMI lower than 17, you are classed as a purging-type anorexic.) She had an extreme case of bulimia, something in the region of >10000Cal binges and purging up to 20 times a day, terrible electrolyte levels (worse than most anorexics actually), minor heart problems and severe depression, which was why she got warded. Not once have I seen anyone who is actually overweight, even in the outpatient centre and when I asked my doctors, I was told that BED "isn't anywhere near as dangerous".

I tried reading up on the health risks of Binge Eating Disorder but the sites I have checked out pretty much listed the health problems most medical professionals associate with obesity (type 2 diabetes, high blood pressure, high blood cholesterol levels, gallbladder disease, heart disease), which we know are flawed anyway. I suppose the unhealthy foods consumed during a binge adds to the risk too.

Anyway, the additional physical risks that binge eating might pose include weakening of the stomach lining, Mallory-Weiss tears, ulcers and possible rupture which is most likely fatal. From what I know, stomach rupture is an extremely rare occurence and far more common in bulimics who compensate by starving (weakens the stomach) and inducing vomiting (retching puts far more stress on the stomach than bingeing alone). I imagine that nutritional deficiency might also be a possibility if the sufferer only consumes junk food, but again, I imagine that this is worse in anorexics and bulimics. Does anyone have more to add?

I understand that BED can be as stressful and isolating as anorexia nervosa, but is it accurate that there are less serious health risks? Is that the reason why medical professionals seem to take it even less seriously than bulimia nervosa?

Thank you for your input.

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