DSM-5 criteria for binge eating disorder

Recurrent episodes of eating an unusually large amount of food in a discrete period, with a sense of loss of control over eating

Eating much more rapidly than usual

One of five associated features; at least 3 are required.

Eating until uncomfortably full

Eating large amounts when not physically hungry

Eating alone because of embarrassment about the amount eaten

Feeling disgusted, depressed, or guilty afterward

Marked distress about the binge eating

Binge eating occurs, on average, at least once a week for 3 months

No regular use of compensatory behaviours (e.g., purging) and episodes do not occur exclusively during bulimia nervosa or anorexia nervosa

Average binge episodes per week (optional, for severity)

/week

ResultCriteria not met

Does not fulfil all DSM-5 diagnostic criteria for binge eating disorder as entered.

Associated features present: 0 of 5 (need >=3)

When to use

Structuring a DSM-5 diagnostic assessment for suspected binge eating disorder.

Formula

Diagnosis requires: Criterion A (binge episodes with loss of control) AND >=3 of 5 associated features AND marked distress AND episodes >=weekly for 3 months AND absence of compensatory behaviours / not exclusively during bulimia or anorexia nervosa.

Pearls and pitfalls

Severity specifiers are based on average weekly binge frequency: mild 1-3, moderate 4-7, severe 8-13, extreme >=14.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: APA; 2013.