Quick reference
- When to use
- Use F50.81 when the client meets full criteria for Binge Eating Disorder. Specify severity level per DSM-5 guidelines. For anorexia, base severity on BMI. For bulimia/BED, base on frequency of compensatory behaviors or binge episodes.
- Duration
- Anorexia: ongoing until remission criteria met. Bulimia/BED: behaviors must occur at least weekly for 3 months. Partial remission: previously met full criteria, some symptoms persist. Full remission: no criteria met for sustained period.
- Session codes
- Pair with CPT 90837 (60-min, often needed for meal planning + therapy). 90834 for maintenance. 96127 for EDE-Q screening. Medical monitoring may require coordination with primary care. FBT: 90847.
- Key indicators
- Restriction, bingeing, or purging behaviors • Body image disturbance • Weight/shape overvaluation • Medical complications • Functional impairment • Specific BMI or behavior frequency thresholds
What F50.81 represents
BED is the most common eating disorder. It involves recurrent binge eating episodes without the compensatory behaviors seen in bulimia nervosa. It's associated with marked distress and often with obesity.
Key diagnostic criteria
- Recurrent binge eating episodes with 3+ of:
- Eating much more rapidly than normal - Eating until uncomfortably full - Eating large amounts when not hungry - Eating alone due to embarrassment - Feeling disgusted, depressed, or guilty afterward
- Marked distress regarding binge eating
- Once a week for 3 months
- No regular compensatory behaviors
Specify severity based on binge frequency
Documentation essentials
Document binge frequency, triggers, emotional context, and distress level. Track with Binge Eating Scale.
Differential diagnosis
Distinguish from bulimia nervosa (no compensatory behaviors), overeating without loss of control, and mood-related appetite changes.
Treatment planning
CBT-E, IPT, DBT adapted for BED. Lisdexamfetamine (Vyvanse) FDA-approved. Address emotional eating patterns.
Insurance & billing
Accepted diagnosis (new in DSM-5). Document distress and functional impact.
Updates & changes
Newly recognized as formal diagnosis in DSM-5.
Documentation pitfalls
Don't diagnose based on overeating alone – must have loss of control and marked distress.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).