- Dialectic Behavior Therapy
- Mindfulness-Based Eating Awareness Training

Mindfulness-Based Interventions for Binge Eating Disorder

- Hunger
- Fullness
- Pleasure in small quantities of food
- Quality preference over quantity
- Non-nutrition eating triggers
- Mindful food choices

Aspects of Binge Eating Addressed when Cultivating Mindful Eating

- control of responses to varying emotional states
- ability to make conscious food choices
- awareness of hunger and satiety cues
- difficulty with self-acceptance


Core Issues of Binge Eating Disorder Addressed by Mindfulness-Based Eating Awareness Training

Complications resulting from binge eating disorder can be divided into two main types, based on acuteness:

- Chronic binge eating disorder complications
- Acute binge eating disorder complications

Binge Eating Disorder Complications

An estimated 94% of BED patients also have at least one other comorbid psychiatric condition, and nearly 23% of BED patients have attempted suicide. Some mental illnesses seem to be most common among patients:

- Mood disorders
- Substance use disorders
- Anxiety disorders
- Personality/conduct disorders

Binge Eating Disorder Comorbid Psychiatric Conditions

Several risk factors have been found to be associated with an increased likelihood of developing binge eating disorder:

- Minority status(es)
- Low socioeconomic status
- Trauma/violence
- Body dissatisfaction
- Comorbid psychiatric conditions

Binge Eating Disorder Risk Factors

The primary factor that differentiates binge eating disorder from simple overeating is the significant psychological distress experienced after a binge. Individuals with the disorder often feel guilt and embarrassment following their eating episodes, which is not a defining characteristic of overeating.

Distinguishing Binge Eating Disorder from Overeating

Analyze the following clinical scenario. Based on the information provided, what is the most likely diagnosis? Justify your reasoning by referencing specific details from the case and explaining why other potential diagnoses are less probable.

Clinical Scenario: Eating Patterns

A client reports that at least twice a week, they secretly and rapidly consume an unusually large amount of food until they are uncomfortably full. They do not engage in any behaviors like vomiting or excessive exercise afterward. The client expresses profound feelings of guilt, shame, and disgust with themselves following these episodes. Based on this information, which statement best analyzes the client's condition?

Binge eating disorder (BED), officially recognized by the American Psychiatric Association in the DSM-5 since 2013, is characterized by recurrent episodes of consuming large amounts of food. Unlike bulimia nervosa, these binges are not followed by compensatory behaviors such as purging. A key diagnostic feature is the significant psychological distress, including feelings of guilt and embarrassment, that occurs after a binge, which distinguishes the disorder from simple overeating.

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In contrast to the widespread issue of being overweight, a significant minority of the population suffers from eating disorders, which commonly lead to being underweight. These conditions, such as bulimia nervosa and anorexia nervosa, are often characterized by an intense fear of gaining weight and can result in numerous negative health effects.

Eating Disorders 

The DSM-5-TR separates Feeding and Eating disorders into the following specific disorders:
-	Pica
-	Rumination Disorder
-	Avoidant / Restrictive Food Intake Disorder
-	Anorexia Nervosa
-	Bulimia Nervosa
-	Binge-Eating Disorder
-	Other Specified Feeding or Eating Disorder
-	Unspecified Feeding or Eating Disorder


[DSM-5-TR] List of Feeding and Eating Disorders

Petre, A. (2019, October 30). Learn about 6 common types of eating disorders and their symptoms. Healthline. https://www.healthline.com/nutrition/common-eating-disorders#what-they-are. 

Eating disorders general summary

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

Bulimia nervosa is an eating disorder characterized by a cycle of binge eating—consuming a large amount of food—followed by attempts to compensate for it. These compensatory behaviors are intended to prevent weight gain.

Bulimia Nervosa

Binge Eating Disorder (BED)

References for Bulimia Nervosa 

Pica is an eating disorder in which an individual compulsively consumes inedible items. The inedible items consumed vary by those with the disorder.

Pica

Rumination disorder is an eating disorder where an individual unconsciously regurgitates food immediately after eating. This eating disorder is rare and is most common in children.

Rumination Disorder

A disorder commonly found in children, ARFID can be described as extremely picky eating, though fear foods differ significantly from those with anorexia nervosa and bulimia nervosa. Although ARFID involves food restriction and thus shares some features with anorexia nervosa, the fear and restriction surrounding food is not due to concerns about weight or body image. 

Avoidant/Restrictive Food Intake Disorder (ARFID)

Bulimia nervosa. Johns Hopkins Medicine. (2023, January 31). https://www.hopkinsmedicine.org/health/conditions-and-diseases/eating-disorders/bulimia-nervosa 

Cleveland Clinic. (2022). Pica. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22944-pica 

Mayo Foundation for Medical Education and Research. (2018, May 5). Binge-eating disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627 

Mayo Foundation for Medical Education and Research. (2020a, October 14). Rumination syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/rumination-syndrome/symptoms-causes/syc-20377330 

Meczekalski, B., Podfigurna-Stopa, A., & Katulski, K. (2013). Long-term consequences of anorexia nervosa. Maturitas, 75(3), 215–220. https://doi.org/10.1016/j.maturitas.2013.04.014

References for Eating Disorders: Consequences

Other Specified Feeding and Eating Disorder (OSFED) is a category of eating disorders in which individuals do not meet full criteria for other eating disorders. Around 30% of individuals diagnosed with an eating disorder fall into this classification.

Other Specified Feeding and Eating Disorder

Eating disorders, particularly conditions like bulimia nervosa and anorexia nervosa, are associated with a wide range of severe and adverse health consequences.

Adverse Health Consequences of Eating Disorders

Anorexia nervosa is an eating disorder defined by maintaining a body weight significantly below average, which is achieved through methods like starvation or excessive exercise. A central characteristic of this disorder is a distorted body image, a form of body dysmorphia, where individuals perceive themselves as overweight despite being underweight.

Anorexia Nervosa

A person begins a new diet and exercise regimen with the goal of losing 10 pounds. They start counting calories and increase their physical activity. Which of the following additional observations would be the strongest indicator that this behavior is evolving into a clinical eating disorder?

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