Characteristics and use of treatment modalities of patients with binge-eating disorder in the Department of Veterans Affairs

• Natural language processing identified patients with BED from health records.
• Only 68 of 593 patients with BED were also diagnosed with EDNOS.
• More patients with BED were obese (vs. EDNOS), but fewer used treatment modalities.
• More patients with BED used treatment modalities than those with no eating disorder.

ObjectiveIn 2013 binge-eating disorder (BED) was recognized as a formal diagnosis, but was historically included under the diagnosis code for eating disorder not otherwise specified (EDNOS). This study compared the characteristics and use of treatment modalities in BED patients to those with EDNOS without BED (EDNOS-only) and to matched-patients with no eating disorders (NED).MethodsPatients were identified for this study from electronic health records in the Department of Veterans Affairs from 2000 to 2011. Patients with BED were identified using natural language processing and patients with EDNOS-only were identified by ICD-9 code (307.50). First diagnosis defined index date for these groups. NED patients were frequency matched to BED patients up to 4:1, as available, on age, sex, BMI, depression, and index month encounter. Baseline characteristics and use of treatment modalities during the post-index year were compared using t-tests or chi-square tests.ResultsThere were 593 BED, 1354 EDNOS-only, and 1895 matched-NED patients identified. Only 68 patients with BED had an EDNOS diagnosis. BED patients were younger (48.7 vs. 49.8 years, p = 0.04), more were male (72.2% vs. 62.8%, p < 0.001) and obese (BMI 40.2 vs. 37.0, p < 0.001) than EDNOS-only patients. In the follow-up period fewer BED (68.0%) than EDNOS-only patients (87.6%, p < 0.001), but more BED than NED patients (51.9%, p < 0.001) used at least one treatment modality.DiscussionThe characteristics of BED patients were different from those with EDNOS-only and NED as was their use of treatment modalities. These differences highlight the need for a separate identifier of BED.