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Elevated Status for Binge Eating Disorder in the DSM-5

Contributed Article by Dr. Kimberly DennisFormer CEO/Medical Director Emeritus at Timberline Knolls

For those working in the field of behavioral health, the “go-to” book for definitions of the various mental illnesses is The Diagnostic and Statistical Manual of Mental Disorders (DSM). The current version, DSM-IV, was released in 1994 and the updated manual is slated for release in May of next year.  Several changes will affect the eating disorder community. The term NOS or not otherwise specified will be eliminated from the DSM-5; therefore, the diagnosis of ED-NOS will no longer be utilized. Conversely, binge eating disorder (BED) will be elevated to a distinct category of eating disorder. In the previous manual BED appeared in the appendix.  By placing it in that location, the formulators of the DSM-IV were sending a message to the behavioral health community indicating the need for more research in this particular area. Evidently, that message was received and in the 20 years since publication of DSM-IV, there have been more than 1,000 papers published on BED, which provided a strong basis for the argument that it was appropriate for inclusion in the updated manual.

For a diagnosis of BED, the food and eating-related behavior occurs on average at least once a week for three months and is not associated with the recurrent use of inappropriate compensatory behavior (such as purging).  The behavior is marked by “a sense of lack of control over eating during the episode” and is associated with three or more of the following:

  •   Eating much more rapidly than normal
  •  Eating until feeling uncomfortably full
  •  Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating, and/or feeling disgusted with oneself, depressed, or very guilty afterward.

This DSM-5 alteration has two distinct benefits for those suffering from BED. First, this status change, in effect, provides greater legitimacy to the disorder.  It will hopefully result in greater awareness and improved diagnosis.  Second, those with BED will have the opportunity to receive the treatment they need with the benefit of insurance coverage. Currently, insurance is only extended if specific criteria are met, which definitely creates a roadblock to treatment for many men and women.


Articles published by guest authors do not necessarily express the opinion of Eating Disorder Hope. We strive to provide a wide array of articles, from different perspectives, and offer respect and consideration of various views of issues related to eating disorders.

Published Date: August 6, 2012
Last reviewed: By Jacquelyn Ekern, MS, LPC on August 12, 2012

Page last updated: August 12, 2012

Article Contributed by our Sponsor ~ Timberline Knolls Residential Treatment Center

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