Comorbidity Burden May Increase After Binge Eating Disorder Diagnosis

After a diagnosis of binge eating disorder (BED), patients may be at risk for increased comorbidity burden over time, according to study results presented at Psych Congress 2019, held October 3 to 6 in San Diego, California.

William M. Spalding, MS, principal investigator of the study, spoke with Psychiatry Advisor about his findings.

“In this particular study, we looked at patients with BED who already had a high history of metabolic and psychological disorders, primarily anxiety and depression,” said Mr Spalding. The team of researchers aimed to answer the following: “Once we had identified them as having BED, did we see these factors as getting better or worse?”

“What we found was that in a population that was already at high risk for these types of comorbidities, we continued to see increases in the same comorbidities,” he explained.

As BED falls under the general International Classification of Diseases, Ninth Revision code for Eating Disorder, Not Otherwise Specified, patients with BED were identified using a natural language processing algorithm developed from free-text clinical notes sourced from the Optum electronic health record database. A total of 1042 adults with BED or probable BED were identified (mean age, 45.6 years; 80.8% women, 87.1% white; 83.4% with obesity), and comorbidities related to metabolic and psychiatric health were assessed after the index date of first BED recognition.

In the first year after index date, new-onset comorbidities reported by >5% of patients included hyperlipidemia (6.2%); overweight/obesity (5.4%); anxiety, dissociative, or somatoform disorder (9.3%); major depressive disorder (7.0%); and gastroesophageal reflux disease (9.0%). Rates for these comorbidities were higher when assessed across the entire post-index follow-up period.

The researchers noted that the algorithms used in the study had imperfect positive predictive values and may have incorrectly classified some individuals with BED. Further, the cohort comprised more individuals with moderate or severe BED vs mild BED, and therefore may not be representative of all patients with the disorder.

“My takeaway from [these findings] is that if I was a practicing clinician, [it would be important] to focus on checking in to see what is happening with these patients in terms of metabolic and mental health,” Mr Spaulding concluded.

Disclosure: Mr Spalding is an employee of Shire. Please see the original reference for a full list of authors’ disclosures.

Reference

Spalding WM, Bertoia ML, Lu M, Akinwonmi A, Seeger JD. New onset comorbidities following the diagnosis of binge eating disorder in adults: findings from a retrospective cohort study. Presented at: Psych Congress 2019; October 3-6, 2019; San Diego, CA. Poster 254.