An eating disorder characterized by recurrent episodes of binge eating followed by inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, laxative misuse, fasting, or excessive exercise. Affects 1-2% of women and 0.1-0.5% of men. Associated with significant medical complications.

• 1DSM-5 criteria assessment
• 2Eating Disorder Examination
• 3Medical evaluation for complications
• 4Electrolyte panel
• 5ECG
• 6Dental examination
• 7Assessment of binge/purge frequency
• 8Psychiatric comorbidity screening

Better than anorexia nervosa. With CBT, 50% achieve abstinence from binge/purge behaviors; 30% have significant reduction. Fluoxetine reduces binge eating by 60-70%. Relapse common; 30-50% relapse within 1 year of treatment cessation. Mortality rate 2-3x general population. With treatment, 70-80% improve significantly. Chronic course possible without treatment. Medical complications often reversible with cessation of behaviors. Comorbid substance abuse worsens outcomes.

• Media literacy and body image programs
• Reducing weight stigma
• Early identification of dieting behaviors
• Mental health screening
• Building healthy coping skills
• Family communication about food and weight
• Promoting size diversity acceptance