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The natural course of binge-eating disorder: findings from a prospective, community-based study of adults

Published online by Cambridge University Press:  28 May 2024

Kristin N. Javaras Open the ORCID record for Kristin N. Javaras [Opens in a new window] ,
Victoria F. Franco ,
Boyu Ren ,
Cynthia M. Bulik ,
Scott J. Crow ,
Susan L. McElroy ,
Harrison G. Pope Jr  and
James I. Hudson
Kristin N. Javaras*
Affiliation:
McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Victoria F. Franco
Affiliation:
McLean Hospital, Belmont, MA, USA
Boyu Ren
Affiliation:
McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Cynthia M. Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Scott J. Crow
Affiliation:
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA Accanto Health, Saint Paul, MN, USA
Susan L. McElroy
Affiliation:
Lindner Center of HOPE, Mason, OH, USA Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Harrison G. Pope Jr
Affiliation:
McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
James I. Hudson
Affiliation:
McLean Hospital, Belmont, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
*
Corresponding author: Kristin N. Javaras; Email: [email protected]
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Abstract

Background

Epidemiological data offer conflicting views of the natural course of binge-eating disorder (BED), with large retrospective studies suggesting a protracted course and small prospective studies suggesting a briefer duration. We thus examined changes in BED diagnostic status in a prospective, community-based study that was larger and more representative with respect to sex, age of onset, and body mass index (BMI) than prior multi-year prospective studies.

Methods

Probands and relatives with current DSM-IV BED (n = 156) from a family study of BED (‘baseline’) were selected for follow-up at 2.5 and 5 years. Probands were required to have BMI > 25 (women) or >27 (men). Diagnostic interviews and questionnaires were administered at all timepoints.

Results

Of participants with follow-up data (n = 137), 78.1% were female, and 11.7% and 88.3% reported identifying as Black and White, respectively. At baseline, their mean age was 47.2 years, and mean BMI was 36.1. At 2.5 (and 5) years, 61.3% (45.7%), 23.4% (32.6%), and 15.3% (21.7%) of assessed participants exhibited full, sub-threshold, and no BED, respectively. No participants displayed anorexia or bulimia nervosa at follow-up timepoints. Median time to remission (i.e. no BED) exceeded 60 months, and median time to relapse (i.e. sub-threshold or full BED) after remission was 30 months. Two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission from baseline demographic and clinical variables.

Conclusions

Among community-based adults with higher BMI, BED improves with time, but full remission often takes many years, and relapse is common.

Keywords

binge-eating disordereating disordersepidemiologymachine learningnatural courseoutcomespredictorsrelapseremission
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 11
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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