Loading…

Potential psychological & neural mechanisms in binge eating disorder: Implications for treatment

Binge Eating Disorder (BED) is a newly-established eating disorder diagnosis in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although systematic research on BED is in its infancy and many studies feature small samples, several observations emerge. First, we r...

Full description

Saved in:
Bibliographic Details
Published in:Clinical psychology review 2018-03, Vol.60, p.32-44
Main Authors: Kober, Hedy, Boswell, Rebecca G.
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Binge Eating Disorder (BED) is a newly-established eating disorder diagnosis in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although systematic research on BED is in its infancy and many studies feature small samples, several observations emerge. First, we review diagnostic, developmental, and socio-demographic features of BED. Next, although BED and obesity are linked and frequently co-occur, we review data suggesting that BED is a distinct phenotype. Importantly, we take a mechanism-focused approach and propose four psychological processes with neurobiological bases that may uniquely differentiate BED from obesity: emotion reactivity, food-cue reactivity, food craving, and cognitive control. Further, we propose that interactions between impairments in cognitive control and increased emotional reactivity, food-cue reactivity, and craving may underlie emotion dysregulation and promote binge eating. Consistently, neuroimaging studies point towards neural alterations in the response to rewards and to food specifically, and suggest preliminary links between impaired cognitive-control-related neural activity and binge eating. However, additional systematic work is required in this area. We conclude with a detailed review of treatment approaches to BED; specifically, we suggest that psychological and pharmacological treatments that target core mechanisms – including cognitive control and emotion/craving dysregulation – may be particularly effective. •Psychological and neural mechanisms in Binge Eating Disorder (BED) are unknown.•Distinguishing BED from co-morbid obesity is key to examining this psychopathology.•Emotion reactivity, food cue reactivity, and craving are candidate processes in BED.•Deficits in cognitive control may further exacerbate emotion/craving dysregulation.•Targeting these processes may improve treatments for BED.
ISSN:0272-7358
1873-7811
DOI:10.1016/j.cpr.2017.12.004