Binge-Eating Disorder May Linger for Years

Binge-eating disorder (BED) often improves with time, but full remission can take many years and relapse is common, new research suggests.

Key Findings from the Study

🕰️ Long-Term Struggle

The study revealed that 61% of individuals still suffered from BED 2.5 years after their initial diagnosis, and 45% continued to struggle with the disorder at 5 years.

“The big takeaway is that binge-eating disorder does improve with time, but for many people, it lasts years,” said first author Kristin N. Javaras, DPhil, PhD, with the Division of Women’s Mental Health at McLean Hospital, Belmont, Massachusetts.

📅 Study Details

The study was published online on May 28, 2024, in Psychological Medicine.

Clinic Experience vs Literature

📊 Prevalence and Onset

BED is the most common eating disorder in the United States, affecting an estimated 1%-3% of US adults, typically beginning around age 25.

🩺 Clinical Observations

“As a clinician, clients often report many years of binge-eating disorder, which contrasts with studies suggesting it is transient. It’s crucial to understand how long BED lasts and the likelihood of relapse to provide better care,” Javaras noted.

Research Methodology

🧪 Study Design

Javaras and colleagues followed a community-based sample of 137 adults (78% women) with BED for 5 years, using Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The mean age at baseline was 47 years, and the mean BMI was 36 kg/m².

🗓️ Follow-Up Results

Nearly two-thirds (61%) of participants assessed at 2.5 years and nearly half (46%) assessed at 5 years still met DSM-IV criteria for BED. These percentages were even higher using the broader DSM-5 criteria — 68% and 59%, respectively.

Remission and Relapse

🔄 Remission Rates

Only a minority experienced remission at 2.5 years (15%) and 5 years (22%). At 2.5 years, 23% had clinically significant symptoms but below the DSM-IV threshold for BED, increasing to 33% at 5 years.

🕒 Time to Remission and Relapse

The median time to remission exceeded 60 months, and the median time to relapse after remission was 30 months.

Implications and Future Directions

📈 Improvement Trends

“These results suggest that, under natural circumstances, the majority of individuals with BED will experience some improvement in binge eating within a 5-year period, but achieving full remission within this timeframe is uncommon,” the authors wrote.

🔍 Predictive Factors

There was variation among participants in the likelihood of remission and time to remission, but no strong clinical or demographic predictors were identified.

🧩 Understanding BED

The factors contributing to the natural course of BED or cessation of binge-eating in treatment contexts “remain to be fully elucidated,” the investigators wrote.

Support and Conflicts of Interest

💰 Funding

The study was supported by grants from Ortho-McNeil Janssen Scientific Affairs, the National Institute of Diabetes and Digestive and Kidney Diseases, the Brain & Behavior Research Foundation, the National Institute of Mental Health, and the Swedish Research Council.

💼 Conflicts of Interest

Javaras owned equity shares in Sanofi and Centene Corporation and served on the clinical advisory board for Beanbag Health.