A new five-year study from McLean Hospital, part of the Mass General Brigham healthcare system, reveals that binge-eating disorder (BED) persists longer than previously believed. The research shows that 61% of individuals still experienced BED 2.5 years after their initial diagnosis, with 45% continuing to meet the criteria for the disorder five years later. These findings challenge earlier studies that suggested a quicker remission timeline for those affected.
Dr. Kristin Javaras, the study’s first author and an assistant psychologist in the Division of Women’s Mental Health at McLean, emphasized the significance of these results. “The big takeaway is that binge-eating disorder does improve over time, but for many, it lasts for years. Many clients I work with report experiencing BED for a long time, which contrasts with earlier studies suggesting it is a transient condition. Understanding the duration and relapse likelihood of BED is crucial for providing effective care.”
The research findings were published in the journal Psychological Medicine by Cambridge University Press.
Binge-eating disorder, which affects an estimated 1% to 3% of U.S. adults, is characterized by episodes of consuming large amounts of food while feeling a loss of control. The average age of onset for BED is around 25 years. Previous retrospective studies have indicated that the disorder can last anywhere from seven to sixteen years, while some prospective studies suggested that many individuals enter remission within one to two years. However, the authors noted that earlier prospective studies often had limitations, such as small sample sizes (fewer than 50 participants) and a lack of diversity, focusing primarily on adolescent or young adult females with lower BMIs.
To gain a clearer understanding of the duration of binge-eating disorder, the researchers followed 137 adults diagnosed with BED over a five-year period. Participants, aged 19 to 74 with an average BMI of 36, were assessed for binge-eating episodes at the study’s outset and again at 2.5 and 5 years.
After five years, while many participants reported improvements, a significant number continued to experience binge-eating episodes. At the 2.5-year mark, 61% still met the full criteria for BED, and an additional 23% exhibited clinically significant symptoms below the threshold for a diagnosis. By the five-year follow-up, 46% met the full criteria for BED, with 33% showing clinically significant but sub-threshold symptoms. Notably, 35% of those who were in remission at 2.5 years relapsed into either full or sub-threshold BED by the five-year mark. Dr. Javaras pointed out that changes in diagnostic criteria since the study was conducted would likely result in an even higher percentage of participants being diagnosed with BED at the follow-ups.
The study’s design, which included community members who may or may not have been receiving treatment, provided a more representative picture of BED’s natural progression compared to previous studies focused on treatment populations. The findings suggest that while treatment can lead to faster remission, significant disparities exist in access to care for individuals with eating disorders.
Despite variations in the likelihood of remission among participants, the researchers found no strong clinical or demographic predictors for the duration of the disorder. “This suggests that no one is significantly less or more likely to recover than anyone else,” Dr. Javaras noted.
Following the study, researchers at McLean Hospital are exploring new treatment options for binge-eating disorder and developing improved screening methods to identify individuals who would benefit from intervention. “We are using neuroimaging to better understand the neurobiology of binge-eating disorder, which could inform the development of new treatments,” said Dr. Javaras. “Additionally, we are examining ways to identify individuals earlier, as many people are unaware they have BED. There is a pressing need for increased awareness and screening to facilitate earlier intervention.”
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