Clinical significance and distinctiveness of purging disorder and binge eating disorder.

OBJECTIVE

In the DSM-IV, individuals with binge eating disorder (BED) and those with purging disorder (PD) receive a diagnosis of eating disorder not otherwise specified (EDNOS), suggesting no meaningful differences between clinical presentations. This article compares PD and BED on eating disorder severity and comorbid disorders.

METHOD

Individuals with PD (n = 33), DSM-IV BED (n = 23 with BMI >30 kg/m(2) , and n = 18 with BMI between 18.5 and 26.5 kg/m(2) ), and noneating disorder controls (n = 35) completed SCID-I interviews and questionnaires.

RESULTS

Eating disorder groups reported significantly greater depression, body dissatisfaction, and dietary restraint and more Axis I disorders compared with controls. Compared with both the obese and normal weight BED groups, PD reported significantly greater dietary restraint and body dissatisfaction. Compared with obese BED, PD reported lower prevalence of impulse control disorders.

DISCUSSION

Findings support differentiating among EDNOS based on behavioral presentation in both research and future nosological schemes such as the DSM-V.