352 Feeding and Eating Disorders
Development and Course
Little is known about the deve lopment of binge-eating disorder. Both binge eating and
loss-of-control eating without objectively ex cessive consumption occur in children and are
associated with increased body fat, weight gain, and increases in psychological symptoms.
Binge eating is common in adolescent and college-age samples. Loss -of-control eating or
episodic binge eating may represent a prodroma l phase of eating disorders for some indi-
viduals. 
Dieting follows the development of binge eating in many indi viduals with binge-
eating disorder. (This is in contrast to bu limia nervosa, in which dysfunctional dieting
usually precedes the onset of binge eating.) Binge-eating disorder typically begins in ad-
olescence or young adulthood but can begin in later adulthood. In dividuals with binge-
eating disorder who seek treatment usually ar e older than individuals with either bulimia
nervosa or anorexia nerv osa who seek treatment.
Remission rates in both natural course an d treatment outcome studies are higher for
binge-eating disorder than fo r bulimia nervosa or anorexia nervosa. Binge-eating disorder
appears to be relatively persistent, and the cour se is comparable to that of bulimia nervosa
in terms of severity and duration. Crossover from binge-eating diso rder to other eating
disorders is uncommon.
Risk and Prognostic Factors 
Genetic and physiological. Binge-eating disorder appears to run in families, which may
reflect additive genetic influences. 
Culture-Related Diagnostic Issues
Binge-eating disorder occurs with roughly similar frequencies in most industrialized
countries, including the United States, Cana da, many European countries, Australia, and