Therapie der Binge-Eating-Störung

Zusammenfassung

Die Binge-Eating-Störung (BES), als eigenständige Essstörung erstmals im Diagnostischen und Statistischen Manual psychischer Störungen DSM-5 definiert, ist durch wiederkehrende Essanfälle ohne gewichtskompensatorische Verhaltensweisen gekennzeichnet. Die breitere Definition in der avisierten International Classification of Diseases ICD-11 wird zu Veränderungen in Präsentation und Prävalenz dieser Störung führen. Die BES tritt vor dem Hintergrund einer komplexen, multifaktoriellen Ätiologie auf und geht mit einer erhöhten Essstörungs- und allgemeinen Psychopathologie, psychischen und körperlichen Komorbidität einschließlich Adipositas und verringertem Funktionsniveau einher. Trotz dieser Beeinträchtigungen wird die BES häufig weder diagnostiziert noch behandelt. Evidenzbasierte Therapien für die BES umfassen die Psychotherapie, wobei die Kognitive Verhaltenstherapie das etablierteste Verfahren darstellt, und die strukturierte Selbsthilfebehandlung. Andere Therapien wie die Pharmakotherapie, behaviorale Gewichtsreduktionstherapie und Kombinationstherapien erhielten in den aktuellen evidenzbasierten S3-Essstörungsleitlinien einen geringeren Empfehlungsgrad für spezielle Indikationen.

Abstract

Binge-eating disorder (BED), first defined as its own eating disorder in the Diagnostic and Statistical Manual of Mental Disorders 5^th Edition, is characterized by recurrent binge eating in the absence of compensatory behaviors for weight gain prevention. Its broadened definition in the forthcoming International Classification of Diseases 11^th Revision is likely to change the presentation and prevalence of this disorder. BED emerges in the context of a complex multifactorial etiology and co-occurs with increased eating disorder and general psychopathology, mental and physical comorbidity including obesity, and impairment in life functioning. Despite this associated burden, BED remains to be underdiagnosed and undertreated. Evidence-based treatments for BED include psychotherapy, with cognitive-behavioral therapy representing the most well-established approach, and structured self-help treatment. Other treatments, including pharmacotherapy, behavioral weight loss treatment, or combination treatment received a lower level of recommendation in the current evidence-based S3 eating disorder guidelines.

Schlüsselwörter

Binge-Eating-Störung - Essstörungen - Klassifikation - Therapie - Leitlinien

Key words

Binge-eating disorder - eating disorders - classification - therapy - guidelines

Publication History

Article published online:
24 September 2021

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