This paper investigates the significance of overvaluation of body shape and weight in binge eating disorder (BED), arguing that this cognitive feature should be formally incorporated into diagnostic criteria. While bulimia nervosa and anorexia nervosa require documented overvaluation as a diagnostic criterion, BED currently makes no such provision despite clinical evidence suggesting its presence. The paper distinguishes between body dissatisfaction and overvaluation, examining how the latter serves as a primary basis for self-worth evaluation. Recent research indicates that overvaluation is clinically significant in BED, associated with greater psychological problems and poorer treatment outcomes. The author argues that incorporating overvaluation into DSM-5-based BED diagnosis would improve clinical understanding and treatment effectiveness.
This research concentrates on the role of body weight and shape in self-evaluation among individuals. A healthy individual will use self-evaluation correctly to manage their weight. However, some individuals over-evaluate their weight or body shape in relation to their self-image, a phenomenon referred to as "overvaluation" (Grilo, 2013). Overvaluation of body shape or weight is a common characteristic among most eating disorders. However, there has been debate about whether this characteristic is present in binge eating disorder (BED).
Binge eating disorder is defined by recurrent binge eating—eating unusually large quantities of food in a discrete period accompanied by feelings of loss of control. Binge-eating episodes are associated with at least three of five behavioral indicators (such as eating much more rapidly than usual) and marked distress about the binge eating. Additionally, BED is characterized by the absence of inappropriate weight-compensatory behaviors that are characteristic of bulimia nervosa (Grilo, 2013).
The frequency of binge-eating episodes is defined as binge eating once or more per week for at least three months. A formal diagnosis also requires evidence of some kind of "marked distress" in the individual before it can be officially recognized.
Other eating disorders such as bulimia nervosa (BN) and anorexia nervosa (AN) require that an individual has an overvaluation of their body type, weight, or body image. However, BED makes no formal provision for overvaluation, and this research directly challenges this definition by addressing the importance of overvaluation of shape and weight in BED (Grilo, 2013). It is argued that overvaluation is, in fact, present in BED.
The presence of overvaluation is the key consideration that separates BED from behavioral overeating. Other eating disorders are characterized by both eating behaviors and the manner in which the body is evaluated. A critical distinction exists between dissatisfaction with body type and overvaluation. Many individuals in our society experience varying degrees of body dissatisfaction, but relatively few individuals place such importance on shape and weight that it serves as the primary way in which they judge themselves or define their self-worth (Grilo, 2013). This distinction is the connection that can work to define binge eating as a disorder as opposed to simple behavioral overeating.
"Incorporating overvaluation into DSM-5 criteria"
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