Binge Eating Disorder and Mood Disorders Comorbidity: Clinical Implications

Abstract

Background: Binge eating disorder (BED) is the most common eating disorder, though it is often unrecognized and undertreated. It has a high rate of psychiatric comorbidity, with mood disorders (MDs) being among the most frequent co-occurring diagnoses. This narrative review explores the link between these two mental disorders, highlighting BED and depressive or bipolar disorders comorbidity, as well as its association with obesity, and implication for severity levels and treatments. BED frequently co-occurs with either depressive or bipolar disorders. This comorbidity is even more frequent within obese populations and appears to lead to more severe eating behaviours and mood symptoms. Emotional instability is a potential mediator of the relationship between BED, MDs and obesity. Moreover, MDs implicate higher severity levels for BED, with more frequent binge eating episodes and a significantly lower probability of remission after treatment, compared to BED patients without MDs. When unadjusted, the pharmacotherapy used in MDs management also can exacerbate BED symptoms and induce weight gain. On the other hand, binge eating behaviour predicts greater severity of bipolar disorders, along with more psychiatric and medical burden and worse long-term outcomes. Thus, a multidisciplinary management of these patients is greatly needed. Conclusion: The marked BED-MDs comorbidity, along with its implication for clinical course and treatments, justifies systematic screening for the other condition, whenever either disorder is present.