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consumption of a large amount of food in a discrete period of time followed by a sense of lack of control over eating. Stunkard first described this clinical phenomenon in 1959 in obese individuals.1 More recently, the DSM-IV included the episode of binge eating as a defining component of bulimia nervosa (BN) and of the new proposed diagnostic category of binge eating disorder (BED). BED is an example of an eating disorder not otherwise specified and its provisional diagnostic criteria were included in the Appendix B of the DSM-IV. In short, the diagnosis of BED describes people who engage in recurrent, uncontrollable and distressing binge eating without any compensatory behaviors as those seen in BN. Although BED is not limited to obese individuals, it is a common diagnosis in this group, especially in those seeking weight loss treatment. While the estimated prevalence of BED in the general population ranges from 1.5 to 5%, in obese clinical samples it varies from 7.5% to 30%. Moreover, BED patients usually exhibit higher-thanexpected rates of eating-related (body image distress) and general psychopathology (depression, anxiety and impulsivity). Of note, since it was included in DSM-IV, the validity of BED diagnosis has been the subject of an intense debate among clinicians and researchers. The discrete boundaries between BED and BN nonpurging type and the high recovery rates observed in community samples are some of the arguments against the validity of BED as an independent diagnosis. On the other hand, BED’s distinctive association with core eating-related psychopathology, the cooccurrence of physical and psychiatric conditions and impaired psychosocial functioning reinforced the idea of BED as a distinctive eating disorder of clinical severity. Devlin et al.2 have addressed the current status of BED’s nosology reviewing exhaustively the evidence supporting and disconfirming four models to conceptualize this condition. In the first model, BED is considered as a distinct subtype of an eating disorder; in the second one, BED is defined as a variant of BN; in the third one, it is viewed as a behavioral subtype of obesity, and in the last model, BED occurs as an associated feature that appears when two primary disorders co-exist (obesity and depression or obesity and impulsivity). At the end of their discussion, the authors conclude that according to the current evidence none of these models should be entirely discarded. It is also important to recognize that, to date, most contemporary psychiatric disorders have not been described as valid disease categories per se. However, it does not mean that they are not valuable constructs with high clinical utility. Kendell3 proposed that ‘a diagnostic rubric possesses utility if it provides nontrivial information about prognosis and treatment outcomes’. In line with this assumption, BED may be considered as a valuable diagnostic concept. The acceptance of BED as a valid diagnostic category still Editorial

Transtorno da compulsão alimentar periódica: uma entidade clínica emergente que responde ao tratamento farmacológico