What are the key diagnostic criteria for binge eating disorder according to the DSM-5?

The key diagnostic criteria for binge eating disorder (BED) according to the DSM-5 include:

• Recurrent episodes of binge eating, defined as eating an amount of food that is definitely larger than what most people would eat in a similar period under similar circumstances, accompanied by a sense of lack of control over eating during the episode.
• Binge episodes are associated with at least three of the following: eating much more rapidly than normal; eating until feeling uncomfortably full; eating large amounts of food when not physically hungry; eating alone because of embarrassment over the amount eaten; feeling disgusted with oneself, depressed, or very guilty afterward.
• Marked distress regarding binge eating is present.
• The binge eating occurs, on average, at least once a week for three months.
• The binge eating is not associated with recurrent use of inappropriate compensatory behaviours (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

These criteria are consistent with the UK NICE guideline NG69 on eating disorders, which aligns with DSM-5 definitions emphasizing the behavioural and psychological features of binge episodes and the absence of compensatory behaviours ¹. Recent literature further supports these criteria, highlighting the importance of the sense of loss of control and associated distress as central to diagnosis (Amianto et al., 2015; Wilfley et al., 2016). Additionally, studies have compared BED with other eating-related conditions, reinforcing the specificity of these DSM-5 criteria in distinguishing BED from food addiction and other disorders (Ratković et al., 2023).