6
Nutrition
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 distress about eating without
purging. May be associated with attention-deficit
hyperactivity disorder (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 and depression. Consider night eating in
ref ractory obesity.
Weight stigma/
trauma
History of bullying or restrictive dieting may
suggest disordered eating. Empathetic and non-
judgemental communication are key. Weight stigma
can trigger binge eating and avoidance of care.
Other
psychiatric
comorbidities
Common: depression, anxiety, posttraumatic stress
disorder (PTSD), ADHD. Red flags: suicidal ideation
or self-harm require urgent psychiatric referral.
Sleep Related
Eating Disorder
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.
