Understanding binge eating disorder in intellectually disabled population

Hancock, Mariah
Intellectual disability (ID) refers to clinically significant adaptive and functional deficits in social, conceptual, and practical situations, with onset of ID occurring within the developmental period and typically requires continued support for daily living. Binge-Eating Disorder (BED) causes distress because of binge-eating episodes, defined as eating a large amount of food in a discrete period of time, accompanied by a lack of control over eating during the episode. Both ID and BED are associated with obesity and decreased quality of life. Individuals with ID show reduced interceptive awareness and demonstrate adverse self-awareness, maladaptive behavior, negative affect, and disinhibition. These psychological constructs are etiological risk factors for BED, which may predispose individuals with ID to developing BED. Existing research consistently identifies individuals with ID who meet criteria for a diagnosis of BED who did not receive this diagnosis from health care professionals. Failing to recognize BED in individuals with ID likely prevents them from receiving appropriate treatment for BED. In addition, issues associated with the assessment of BED in individuals with ID, such as current diagnostic criteria and cognitive functioning, will be discussed. Specifically, diagnostic criteria, like those in the DSM-5, may not capture some eating-related problems in individuals with ID, which may be responsible for under-recognition of problems like BED in this group. For individuals with ID who also have BED, cognitive treatments are unlikely to be appropriate, given ID cognitive function deficits. Finally, challenges posed by existing treatments for BED in individuals with ID will be addressed.
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