Characteristics of Disordered Eating Patterns
Topic Summary
Binge eating
disorder
Occurs in up to 1 in 2 patients with severe obesity.
Consider the presence of BED if patients report loss of
control or marked distress about eating without purging.
May be associated with ADHD.
Bulimia nervosa Look for Russell sign and parotid swelling. Red flags:
unexplained hypokalemia, metabolic alkalosis, or high
serum amylase.
Night eating
syndrome
Characterized by morning anorexia, evening hyperphagia,
and insomnia. Associated with obesity, depression and
daytime fatigue. Consider night eating in ref ractory
obesity. Individuals are aware of their nighttime eating
events.
Weight stigma/
trauma
History of bullying or restrictive dieting may suggest
disordered eating. Empathetic and nonjudgemental
communication are key. Weight stigma can trigger binge
eating and avoidance of care.
Other psychiatric
comorbidities
Common: depression, anxiety, PTSD, ADHD. Red flags:
suicidal ideation or self-harm require urgent psychiatric
referral.
Sleep Related
Eating Disorder
(SRED)
SRED is non-REM parasomnia characterized by recurrent
episodes of involuntary eating during partial arousals
f rom sleep, typically with reduced awareness and amnesia
for the episodes.
➤ Diagnostic Criteria
• The diagnosis of OSA is established through objective sleep testing,
with polysomnography serving as the gold standard for measuring
the apnea-hypopnea index. Home sleep apnea testing is suitable for
certain uncomplicated cases. The apnea-hypopnea index def ines
OSA severity as mild (5–14.9 events/h), moderate (15–29.9 events/h),
and severe (≥30 events/h). Clinical symptoms, such as excessive
sleepiness and hypertension, are integrated with apnea-hypopnea
index values to inform treatment decisions. Although emerging
biomarkers, such as adipokine prof iles, are being studied, they are
not yet part of standard diagnostic practice.
