Identification of binge eating can be a starting point for evaluating a patient, especially if the patient is obese. Determining the underlying basis can help determine the optimal management strategy for the affected patient.


Features of binge eating:

(1) eating during a discrete period of time (usually a few hours) an amount of food that is larger than most people would eat in a similar period and under similar circumstances

(2) a sense of being out of control during the episode (unable to stop eating, what is being eaten and/or how much is being eaten)



• The criteria are somewhat subjective and open to interpretation.

• Some understandable circumstances for overeating would include unintentional fasting/starvation or excessive physical exertion (once bulimia nervosa excluded).

• Many people may have an episode of binge eating once in a while. To be problematic it should be frequent, present for a prolonged period and/or moderate to severe in degree.


Once binge eating has been identified, the patient needs to be further classified:

(1) binge eating disorder

(2) bulimia nervosa

(3) night-eating syndrome

(4) Kleine-Levin syndrome

(5) Prader-Willi syndrome

(6) part of an obsessive-compulsive reaction

(7) lesion in the ventromedial nucleus of the hypothalamus

(8) acute encephalitis affecting the hypothalamus

(9) other causes


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