title: Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5.
abstract: BACKGROUND
  Binge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies.
  
  
  METHODS
  We identified studies published in the last 6 years searching the MeSH Term "binge eating disorder", with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct.
  
  
  RESULTS
  A total of 233 studies were found and, among them, 71 were selected and included in the review.
  
  
  METHODS
  Although Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy.
  
  
  CONCLUSIONS
  Despite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.
authors.affiliation: Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy. federico.amianto@unito.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Amianto
authors.affiliation: Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy. luisaottone@libero.it.
authors.forename: Luisa
authors.initials: L
authors.lastname: Ottone
authors.affiliation: Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy. giovanni.abbatedaga@unito.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbate Daga
authors.affiliation: Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy. secondo.fassino@unito.it.
authors.forename: Secondo
authors.initials: S
authors.lastname: Fassino
mesh_terms: D000328:Adult; D019167:Appetite Stimulants / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000379:methods; D056912:Binge-Eating Disorder / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D013315:Stress, Psychological / Q000209:etiology; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology
chemical_list: D019167:Appetite Stimulants