Dingemans A E, Bruna M J, van Furth E F
Robert-Fleury Stichting, National Centre for Eating Disorders, Leidschendam, The Netherlands.
Int J Obes Relat Metab Disord. 2002 Mar;26(3):299-307. doi: 10.1038/sj.ijo.0801949.
Binge eating disorder (BED) is a new proposed eating disorder in the DSM-IV. BED is not a formal diagnosis within the DSM-IV, but in day-to-day clinical practice the diagnosis seems to be generally accepted. People with the BED-syndrome have binge eating episodes as do subjects with bulimia nervosa, but unlike the latter they do not engage in compensatory behaviours. Although the diagnosis BED was created with the obese in mind, obesity is not a criterion. This paper gives an overview of its epidemiology, characteristics, aetiology, criteria, course and treatment. BED seems to be highly prevalent among subjects seeking weight loss treatment (1.3-30.1%). Studies with compared BED, BN and obesity indicated that individuals with BED exhibit levels of psychopathology that fall somewhere between the high levels reported by individuals with BN and the low levels reported by obese individuals. Characteristics of BED seemed to bear a closer resemblance to those of BN than of those of obesity.A review of RCT's showed that presently cognitive behavioural treatment is the treatment of choice but interpersonal psychotherapy, self-help and SSRI's seem effective. The first aim of treatment should be the cessation of binge eating. Treatment of weight loss may be offered to those who are able to abstain from binge eating.
暴饮暴食症(BED)是《精神疾病诊断与统计手册》第四版(DSM-IV)中新增的一种进食障碍。在DSM-IV中,BED并非正式诊断,但在日常临床实践中,该诊断似乎已被普遍接受。患有BED综合征的人与神经性贪食症患者一样会出现暴饮暴食发作,但与后者不同的是,他们不会采取代偿行为。尽管设立BED这一诊断时考虑到了肥胖因素,但肥胖并非诊断标准。本文概述了其流行病学、特征、病因、诊断标准、病程及治疗方法。在寻求减肥治疗的人群中,BED似乎极为普遍(1.3%-30.1%)。对比BED、BN和肥胖症的研究表明,BED患者的精神病理学水平介于BN患者报告的高水平和肥胖个体报告的低水平之间。BED的特征似乎肥胖症相比,其特征似乎与BN更为相似。对随机对照试验的综述表明,目前认知行为疗法是首选治疗方法,但人际心理治疗、自助疗法和选择性5-羟色胺再摄取抑制剂似乎也有效。治疗的首要目标应是停止暴饮暴食。对于能够戒除暴饮暴食的患者,可提供减肥治疗。