Binge-eating disorder is estimated to affect between 1 per cent and 3 per cent of adults in the U.S. and is marked by periods when individuals experience uncontrollable eating. The disorder typically begins at around 25 years of age.
Historically, retrospective studies relying on potentially unreliable memories have suggested that the duration of binge-eating disorder spans seven to sixteen years. However, more recent prospective studies that follow individuals over time indicate that many may enter remission within a significantly shorter period, ranging from one to two years.
Researchers have observed that most prior prospective studies have notable limitations, such as small participant groups (fewer than 50 people) and a lack of representativeness, focusing predominantly on adolescent or young adult females with Body Mass Indexes (BMIs) under 30. This is particularly restrictive as approximately two-thirds of individuals with binge-eating disorder have BMIs exceeding 30.
To gain a deeper understanding of the progression of binge-eating disorder, a team of researchers conducted a five-year study with 137 adults from the community diagnosed with the disorder. These participants, aged 19 to 74 with an average BMI of 36, were evaluated at the outset and reassessed after 2.5 and 5 years.
Results after five years indicated that while many participants showed signs of improvement, a significant number continued to experience binge-eating episodes. Specifically, at the 2.5-year checkpoint, 61 per cent still met the full criteria for binge-eating disorder, with an additional 23 per cent displaying significant symptoms. Still, more was needed to meet the full diagnostic criteria. By the end of the study, these figures changed to 46 per cent meeting the full criteria and 33 per cent showing significant but sub-threshold symptoms. Notably, 35 per cent of those who were in remission at the 2.5-year mark had relapsed by the five-year follow-up. With changes in the diagnostic criteria for binge-eating disorder since the study’s inception, even more participants would likely meet the updated criteria at each follow-up.
Javaras pointed out that the sample consisted of community members who might not be undergoing treatment, making the study findings more reflective of the natural progression of binge-eating disorder. Comparisons with treatment-based studies suggest that intervention could expedite remission, highlighting the benefits of treatment for those with the disorder. Despite this, Javaras noted significant disparities in access to treatment for eating disorders.
The researchers found no clinical solid or demographic indicators that could predict the duration or likelihood of remission, suggesting that recovery chances are broadly similar across different groups.
Since completing the study, the research team has continued to explore and develop treatment options for binge-eating disorder. They are investigating the disorder’s neurobiological underpinnings using neuroimaging techniques, which could lead to improved or new treatments. Additionally, efforts are being made to enhance early detection of the disorder, as many affected individuals remain unaware of their condition, underscoring the urgent need for increased awareness and early screening to facilitate timely interventions.
More information: Kristin N. Javaras et al, The natural course of binge-eating disorder: findings from a prospective, community-based study of adults, Psychological Medicine. DOI: 10.1017/S0033291724000977
Journal information: Psychological Medicine Provided by McLean Hospital
