無茶喰い障害(Binge-eating disorder)

無茶喰い障害(Binge-eating disorder)DSM-IIIからDSM-IVの改訂に当たって導入された概念。加えられたのは、307. 50「特定不能の摂食障害」(Eating Disorder Not Otherwise Specified)の項目である。

無茶喰い障害:無茶喰いのエピソードが繰り返すが,神経性大食症に特徴的な不適切な代償行動の定期的な使用はない(研究用基準案は728頁参照). (DSM-IV)

Binge-eating disorder: recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa (see p. 729 for suggested research criteria). (DSM-IV-TR)


Binge Eating Disorder, like other eating disorders in the "N.O.S." category, can be a gateway to or from other eating disorders. I have heard many stories of people who used to binge eat who then turn to anorexic or bulimictype behaviors when they panic at the weight gain caused by their excessive eating.



Diagnostic criteria for BINGE EATING DISORDER (sometimes referred to as "compulsive overeating")
A. Recurrent episodes of binge eating. An episode of binge eating is characterizedby both of the following:

  1. eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.
  2. a sense of lack of control over eating during the episode (i.e., feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:

  1. eating much more rapidly than normal
  2. eating until feeling uncomfortably full
  3. eating large amounts of food when not feeling physically hungry
  4. eating alone because of being embarrassed by how much one is eating
  5. feeling disgusted with oneself, depressed, or very guilty after overeating

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least 2 days a week for 6 months.

E. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of Anorexia Nervosa or Bulimia Nervosa.


Emotional Eatingというのがキーワードか。ストレスがたまってドカ喰いするに近い。診断基準によると、それが少なくとも1週間に2度、6ヶ月の持続した場合とのこと。

Early binge eating field trials suggest that as many as 30% of people who participate in weight control programs actually have binge eating disorder (BED). This same study suggests that binge eating disorder affects 3% of female college students and 5% of obese people in the general community (*Spitzer et al.1992.1993).


Spitzer, RL, Devlin, MJ; Walsh, BT: Hasin, D; Wing,RR; Marcus,MD;
 Stunkard, A;Wadden, TA;Agras, WS;Mitchell,J and, Nonas,C. (1992). 
Binge eating disorder: A multisite field trial for the diagnostic criteria. 
Int.J.Eat.Disord. 11, 191-203.
Spitzer, RL; Yanovski, S; Wadden,T; Wing,R; Marcus,MD; Stunkard,A;
Devlin,M; Mitchell,J; and, Hasin, D. (1993). 
Binge eating disorder: Its further validation in a multisite study.
Int.J.Eat.Disord. 13, 137-154.


Even though binge eating is the primary diagnosis, many clients typically have co-morbid conditions, such as depression, which may warrant pharmacological treatment. Anti-depressants that influence Serotonin levels (SSRIs) are often an important component of treatment.




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