Assessment and treatment of binge-eating disorder

Binge-eating disorder is a newly recognized eating disorder characterized by uncontrolled binge eating in the absence of compensatory behavior such as vomiting. The overweight patient with binge-eating disorder requires assessment and treatment that takes into account all aspects of the disorder: somatic (obesity), behavioral (binge eating), and psychological (body image distress and comorbid psychopathology). Given the recent identification of binge-eating disorder and paucity of treatment studies to date, clinical judgment is, in large part, based on information concerning the treatment of obesity and of bulimia nervosa. Antidepressant medications and cognitive behavioral therapy appear to be effective in the short-term reduction of binge eating. Appetite suppressant medications and behavioral weight control promote weight reduction and do not seem to stimulate breakthrough binge eating. Further study is needed to clarify the long-term efficacy of treatments for binge-eating disorder and factors that predict the individual patient's response to particular treatment approaches.