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Tests and diagnosis
By Mayo Clinic staffBinge-eating disorder is not yet officially classified as a mental disorder, and not all experts think it should be. Mental health experts hope that ongoing research will determine if binge eating is a distinct medical condition, a nonspecific type of eating disorder, or simply a cluster of symptoms.
Binge eating is similar to bulimia nervosa, another eating disorder, and some experts think it may be a form of bulimia. But unlike people with bulimia, who purge after eating, people with binge-eating disorder don't try to rid themselves of the extra calories they consume by self-induced vomiting, overexercising or other unhealthy methods. That's why most people with binge-eating disorder are overweight. In fact, some experts say that binge eating may be a type of obesity disorder.
In any case, when doctors suspect someone has an eating disorder, they typically run a battery of tests and exams. These can help pinpoint a diagnosis and also assess any related complications.
These exams and tests generally include:
- Physical exam. This may include such things as measuring height and weight; assessing body mass index; checking vital signs, such as heart rate, blood pressure and temperature; checking the skin; listening to the heart and lungs; and examining the abdomen.
- Laboratory tests. These may include a complete blood count (CBC), as well as more specialized blood tests to check such things as cholesterol levels, thyroid functioning, electrolytes and blood sugar, which may determine if you have metabolic syndrome.
- Psychological evaluation. A doctor or mental health professional will discuss your thoughts, feelings and eating habits with you. You may be asked about binge-eating symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar issues in the past. You may also be asked to complete psychological self-assessments and questionnaires.
- Other studies. Other studies may be done to check for health consequences of binge-eating disorder, such as heart problems, gallbladder disease or sleep apnea.
Criteria for diagnosis
All these evaluations help doctors determine if you meet the criteria for binge-eating disorder or if you may have another eating disorder, such as bulimia. The criteria to diagnose mental health conditions are set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
The DSM says more research is needed before determining whether binge-eating disorder is truly a unique medical condition. However, it offers some criteria for diagnosing binge-eating disorder.
DSM diagnostic criteria for binge-eating disorder include:
- Recurrent episodes of binge eating, including eating an abnormally large amount of food and feeling a lack of control over eating
- Binge eating that's associated with at least three of these factors: eating rapidly; eating until you're uncomfortably full; eating large amounts when you're not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating
- Distress about your binge eating
- Binge eating occurs at least twice a week for at least six months
- Binge eating isn't associated with inappropriate methods to compensate for overeating, such as self-induced vomiting
Some people may not meet all of these criteria but still have an eating disorder. As researchers learn more about eating disorders, the diagnostic criteria may evolve and change. Don't try to diagnose yourself — get professional help if you have any eating disorder symptoms.
