TORONTO — Although official estimates indicate that 1.6% of females and 0.8% of males suffered from binge-eating disorder (BED) in the prior year, the disorder is thought to be greatly underdiagnosed due to lack of awareness in the medical community. However, a recently developed patient-reported screening tool, that is more concise than other currently available measurements, may help identify more people with the condition.
The Binge Eating Disorder Screener-7 (BEDS-7), was developed by a team led by Barry K. Herman, MD, of Shire Development. In late January, Shire’s attention-deficit/hyperactivity drug lisdexamfetamine dimesylate (Vyvanse) won FDA approval for binge-eating disorder.
The screener contains seven questions, the first of which asks whether a patient has had any episodes of overeating (defined as eating significantly more than a normal person would) in the last three months. If a respondent answers yes, they move on to the other questions, which ask more specific questions about episodes of overeating. For example, one of them asks how often (never/rarely, sometimes, often, always) they continued eating if they were not hungry or how often they were embarrassed by how often they ate.
If a respondent answers sometimes, often or always (shaded areas) to most of those questions, it is recommend that the patient be referred to a doctor or eating-disorders specialist, Herman told Psychiatry Advisor at the American Psychiatric Association Annual Meeting during a poster presentation on BEDS-7.
Herman said that the screener is based on the DSM-5 criteria for BED and is designed to be simple to use by individuals.
“We reduced the number of items to maintain optimal sensitivity, and established it to be a valid patient-reported screening tool. It can be used as an important addition to help identify adults for whom further evaluation by a physician or referral to an eating disorder specialist may be warranted,” he said.
In an analysis Herman’s team conducted among 97 participants, 47 (48.5%) endorsed all the screening items consistent with the DSM-5 criteria for the BED. However, based on a structural interview, only 16 (16.5%) of the study participants were diagnosed by clinicians with BED.
Because the study aimed to maximize sensitivity (proportion of true positives) of the scanner while obtaining an acceptable level of of specificity (proportion of true negatives), to help identify patients who may have BED, a high level false positive rate was found, which may pose a limitation of the screener, according to the poster.
Also, while a large number of individuals said they were overeating regularly and had a lack of control over eating, they did not meet diagnostic criteria for BED based on a structured interview. Therefore, the screener should always be followed by a full medical evaluation using the diagnostic criteria presented in the DSM-5.
Despite this, a field test is underway with clinicians to test the real-world feasibility and value of the BEDS-7.
Disclosure: The development of BEDS-7 and related studies was funded by Shire.
Herman BK, et al. Development of the Binge Eating Disorder Screener. Poster P6-069. Presented at: APA 2015. May 16-20, 2015; Toronto, Canada.