350 Feeding and Eating Disorders
ing effective treatment of the bulimia nervosa. The lifetime prevalence of substance use,
particularly alcohol or stimulant use, is at least 30% among individuals with bulimia ner-
vosa. Stimulant use often begins in an attempt to control appetite and weight. A substan-
tial percentage of individuals with bulimia nervosa also have personality features that
meet criteria for one or more personality diso rders, most frequently  borderline personality
disorder.
Binge-Eating Disorder
Diagnostic Criteria 307.51 (F50.8)
A. Recurrent episodes of binge eating. An episode of binge eating is characterized
by 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 what 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 (e.g., a 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 feeling embarrassed by how much one is eating.
5. Feeling disgusted with oneself, depressed, or very guilty afterward.
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensa-
tory behavior as in bulimia nervosa and does not occur exclusively during the course