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Prevalence of DSM-5 binge-eating disorder higher than DSM-IV

Analysis of a community sample indicated higher binge-eating disorder prevalence estimates when using DSM-5 criteria, compared with DSM-IV-TR criteria. Further, the majority of individuals who met DSM-5 criteria were not formally diagnosed with the disorder.

“Binge eating disorder (BED), the general symptomatology of which was recognized as early as 1959, was included in the [DSM-IV] as a diagnosis for further study in the early 1990s. However, it did not receive official recognition as a distinct eating disorder until its inclusion in DSM-5 in 2013,” Nicole Cossrow, MPH, PhD, of Shire Pharmaceuticals, and colleagues wrote. “Although studies have estimated the epidemiologic implications of the updated DSM-5 BED criteria, no large-scale surveys have used these criteria to assess BED prevalence or the demographic and clinical profiles of afflicted individuals.”

To estimate BED prevalence based on DSM-5 and DSM-IV-TR criteria and how many individuals were formally diagnosed, researchers surveyed a representative sample of adults who participated in the National Health and Wellness Survey (n = 22,397).

Overall, 344 participants (242 women, 102 men) reported symptoms consistent with DSM-5 BED criteria.

DSM-5 BED prevalence estimates were 1.19% (95% CI, 1.04-1.37) within the last 3 months, 1.64% (95% CI, 1.45-1.85) within the last 12 months, and 2.03% (95% CI, 1.83-2.26) within lifetime.

Projected DSM-IV-TR prevalence estimates were 1.15% (95% CI, 1-1.32) within the last 12 months and 1.52% (95% CI, 1.35-1.7) within lifetime.

Of the participants who met DSM-5 BED criteria in the last 12 months, 3.2% reported receiving a formal diagnosis.

Participants who met DSM-5 BED criteria in the past 12 months were younger (P < .001), had higher BMI (P < .001) and had lower self-esteem (P < .001), compared with participants who did not meet BED criteria.

“The 12-month BED prevalence estimate based on DSM-5 criteria in the current study was 1.64%. As expected, this estimate was higher than the estimate based on DSM-IV-TR criteria (1.15%), owing to the reduction in the duration and frequency criteria for binge eating episodes. The increase was particularly pronounced in men,” the researchers wrote. “Importantly, approximately 97% of BED respondents had never received a formal diagnosis of BED from a health care provider. However, BED is a new diagnosis in DSM-5, so the opportunity for physicians to make the diagnosis has been limited, which could partially account for the low level of diagnosis in study respondents. This low rate of diagnosis emphasizes the need to improve awareness and recognition of BED among patients and health care providers.” – by Amanda Oldt

Disclosure: Cossrow reports being an employee of Shire at the time the study was conducted and holding stock and/or stock options in Shire. This research was conducted by Kantar Health (Horsham, Pennsylvania), with funding provided by the sponsor, Shire Development LLC (Lexington, Massachusetts). Shire Development LLC provided funding to Complete Healthcare Communications, LLC (Chadds Ford, Pennsylvania) for support in writing and editing this manuscript. Please see the full study for a list of all authors’ relevant financial disclosures.