What is this thing called BED? Current status of binge eating disorder nosology

Objective: Although binge eating has been recognized as a clinically relevant behavior among the obese for more than four decades, the concept of binge eating disorder (BED) as a distinct psychiatric diagnosis is of much more recent origin. This article presents four ways of conceptualizing BED: a distinct disorder in its own right, as a variant of bulimia nervosa, as a useful behavioral subtype of obesity, and as a behavior that reflects psychopathology among the obese. It also summarizes the evidence supporting and disconfirming each model. Method: The literature subsequent to the development of DSM-IV regarding the reliability and validity of BED and related conditions was reviewed selectively. Results: The preponderance of the evidence suggests that BED differs importantly from purging bulimia nervosa and that BED is not a strikingly useful behavioral subtype of obesity. Discussion: Further study is needed to definitively determine the validity of BED as a distinct eating disorder. (C) 2003 by Wiley Periodicals, Inc.