An international study by the World Health Organization (WHO) suggests binge eating disorders inflict more hardship on individuals over the course of a lifetime than bulimia.
The American Psychiatric Association classified binge-eating disorder as a diagnosis only a few months ago in its Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. However, researchers have been studying binge eating for over a decade.
Researchers from the WHO conducted community epidemiological surveys in 12 nations worldwide, capturing a total of 22,635 adult respondents.
Both binge-eating disorder and bulimia involve recurrent episodes of excessive food consumption with experienced loss of control.
A defining symptom of bulimia, lacking in binge-eating disorder, is inappropriate compensatory behavior such as purging or laxative use to offset the weight gain associated with bingeing.
However, compared to matched populations of people with no history of eating disorders, a lifetime history of binge-eating disorder or bulimia each predicted between two- and nearly four-fold increases in current days unable to work or carry out usual activities.
Despite the significant challenges that people with these disorders face, both are generally undetected by medical professionals and therefore left untreated.
“Binge-eating disorder has been largely ignored by health care providers, but it has a tremendous cost to the physical and psychological well-being of people with the disorder,” said Ronald Kessler, Ph.D., McNeil Family Professor of Health Care Policy at Harvard Medical School and senior author of the paper.
“When all of the cases of the disorder are taken together, the elevated levels of depression, suicide and lost days at work represent substantial costs to society.”
The study found that binge-eating disorder and bulimia nervosa both typically arose during adolescence and were associated with a range of later-onset mental disorders (including depression and anxiety disorders) and physical disorders (such as musculoskeletal disorders and diabetes).
Early-onset binge-eating disorder was associated with subsequent low rates of employment among men, low rates of marriage among women and high rates of work disability among both men and women.
The researchers concluded that the adverse effects of binge-eating disorder and bulimia on subsequent functioning were largely the result of these later-onset comorbidities.
Learning that the detrimental effects of eating disorders typically arise after the illness has been established, raises the possibility that expanded efforts at early detection and treatment of eating disorders (during the vulnerable school years) might significantly improve mental and physical outcomes.
Janet Treasure, Ph.D. and Cynthia Bulik, Ph.D. commented that the evidence in the report argues strongly for proceeding with clinical effectiveness trials to evaluate the long-term effects on adult health and well-being of early detection and treatment of binge-eating disorder and bulimia among students.
Binge-eating disorder was roughly twice as common as bulimia across the countries studied, which included the U.S., several countries in Latin America (Brazil, Colombia, Mexico), a number in Europe (Belgium, Italy, Netherlands, Northern Ireland, Portugal, Romania, Spain) and New Zealand.
The publication of the results appear online in the journal Epidemiology and Psychiatric Sciences.
Source: Harvard Medical School