title: Recognizing Binge-Eating Disorder in the Clinical Setting: A Review of the Literature.
abstract: OBJECTIVE
  Review the clinical skills needed to recognize, diagnose, and manage binge-eating disorder (BED) in a primary care setting.
  
  
  METHODS
  A PubMed search of English-language publications (January 1, 2008-December 11, 2014) was conducted using the termbinge-eating disorder. Relevant articles known to the authors were also included.
  
  
  METHODS
  Publications focusing on preclinical topics (eg, characterization of receptors and neurotransmitter systems) without discussing clinical relevance were excluded. A total of 101 publications were included in this review.
  
  
  RESULTS
  Although BED is the most prevalent eating disorder, it is underdiagnosed and undertreated. BED can be associated with medical (eg, type 2 diabetes and metabolic syndrome) and psychiatric (eg, depression and anxiety) comorbidities that, if left untreated, can impair quality of life and functionality. Primary care physicians may find diagnosing and treating BED challenging because of insufficient knowledge of its new diagnostic criteria and available treatment options. Furthermore, individuals with BED may be reluctant to seek treatment because of shame, embarrassment, and a lack of awareness of the disorder. Several short assessment tools are available to screen for BED in primary care settings. Pharmacotherapy and psychotherapy should focus on reducing binge-eating behavior, thereby reducing medical and psychiatric complications.
  
  
  CONCLUSIONS
  Overcoming primary care physician- and patient-related barriers is critical to accurately diagnose and appropriately treat BED. Primary care physicians should take an active role in the initial recognition and assessment of suspected BED based on case-finding indicators (eg, eating habits and being overweight), the initial treatment selection, and the long-term follow-up of patients who meetDSM-5BED diagnostic criteria.
authors.affiliation: Department of Psychiatry and Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Kornstein
authors.affiliation: Altea Research, Las Vegas, Nevada.
authors.forename: Jelena L
authors.initials: JL
authors.lastname: Kunovac
authors.affiliation: Shire, Global Medical Affairs, Wayne, Pennsylvania.
authors.forename: Barry K
authors.initials: BK
authors.lastname: Herman
authors.affiliation: Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Larry
authors.initials: L
authors.lastname: Culpepper
mesh_terms: D056912:Binge-Eating Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006801:Humans