Diagnosis and management of binge eating disorder.
Diagnosis and management of binge eating disorder.
复制标题
暴食症的诊断和治疗。
作者：
C. Bulik;K. Brownley;J. Shapiro
本文讨论了当前关于暴食症（BED）的诊断和管理问题。在诊断方面的争议包括缺乏经验验证的标准，缺乏一个普遍公认的操作定义的“暴饮暴食发作”，并缺乏年龄适当的评估工具，鉴于越来越多的儿童和青少年中的床。对于患有BED的成年人，几种药物和行为治疗已经显示出减少暴食频率和饮食失调相关心理症状的希望（即，抑制解除、饥饿、抑郁情绪）。第二代抗抑郁药和认知行为疗法是研究最广泛的治疗方法。然而，没有行为干预措施在减肥方面表现出有效性（这是许多超重的卧床患者的一个关键问题）。此外，BED的随机对照试验一直受到高脱落率和安慰剂应答率的困扰，以及在积极治疗结束后随访不足以确定长期结局。因此，迄今所研究的各种干预战略的长期效用仍不清楚。需要对创新药物和行为治疗进行更多的研究，以探索新的方式来减少暴饮暴食的主观强化特性。此外，扩大使用信息技术可能特别有助于治疗那些经历明显羞耻，否认和人际交往缺陷的患者，或那些面临专业护理有限的患者。最终，在当前肥胖流行的更广泛背景下检查BED将是一个重要的研究领域。
This paper addresses current issues regarding the diagnosis and management of binge eating disorder (BED). Controversies in diagnosis include the lack of empirically validated criteria, the lack of a universally recognized operational definition of a "binge episode", and the lack of age-appropriate assessment instruments in light of growing reports of BED among children and adolescents. For adults with BED, several pharmacological and behavioral treatments have shown promise in reducing binge frequency and related psychological symptoms of disordered eating (i.e., disinhibition, hunger, depressed mood). Second-generation antidepressants and cognitive behavioral therapy are among the most widely studied treatments. However, no behavioral interventions have demonstrated efficacy with respect to weight loss (which is a critical concern for many BED sufferers who are overweight). Furthermore, randomized controlled trials for BED have been plagued by high drop out and placebo response rates, as well as by insufficient follow-up after active treatment ends to determine long-term outcomes. Therefore, the long-term utility of the various intervention strategies studied thus far remains unclear. More research is needed on innovative medications and behavioral treatments that explore novel modalities to reduce the subjectively reinforcing properties of binge eating. In addition, expanded use of information technologies may be particularly instrumental in the treatment of patients who experience marked shame, denial, and interpersonal deficits, or who face limited access to specialty care. Ultimately, examining BED within the broader context of the current obesity epidemic will be an important area of study.
影响因子：
4.7
作者：
STUNKARD, AJ;MESSICK, S
通讯作者：
MESSICK, S