Description

• Restriction of intake, leading to markedly low body weight for age, height, and/or developmental trajectory
• Intense fear of gaining weight or becoming fat, or behavior that prevents weight gain
• Severe body image disturbance, undue influence of body weight and shape on self-evaluation, or denial of seriousness of low body weight
• Lifetime prevalence: 0.9% of females, 0.3% of males in the U.S.
• Onset adolescence to young adult

• Recurrent episodes of binge eating characterized by:
  • Eating an unusually large amount of food in a discrete period of time
  • A sense of loss of control over eating during the episode
• Recurrent inappropriate compensatory behaviors used to prevent weight gain:
  • Self-induced vomiting
  • Misuse of laxatives or enemas
  • Diuretics
  • Diet pills
  • Fasting
  • Excessive exercise
• Bingeing and compensation occur on average at least once a week for 3 mo
• Self-evaluation that is excessively influenced by weight or body shape
• Lifetime prevalence: 1.5% of females, 0.5% of males in the U.S.
• Commonly onset in late adolescence or early adulthood

• Recurrent episodes of binge eating characterized by:
  • Eating a larger than usual amount of food in a discrete period of time
  • A sense of loss of control over eating during the episode
• Binge eating episodes associated with 3 or more 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 embarrassment about how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty after overeating
• Marked distress over binge eating
• Occurs on average at least once a week for 3 mo
• No compensatory behavior
• Lifetime prevalence: 3.5% of females and 2% males in the U.S.
• Onset in late adolescence or early adulthood

Etiology

• Twin studies have supported a strong genetic component
• Cultural emphasis on thinness as a valued attribute has been implicated
• Temperament or personality attributes of perfectionism, anxiety, and behavioral rigidity have been described
• Family conflict or stress is a frequent element
• Neurochemical (serotonin) and neuroendocrinologic (leptin, HPA axis) abnormalities have been reported
• Dieting is a frequent immediate precipitant