The relationship between binge eating disorder and suicidality

Although anorexia and bulimia (BN) have high rates of suicidal ideation and behavior, the link has not been studied extensively in individuals struggling with binge eating disorder (BED). 

Some experts believe the lack of research in this area may be due to a perception that BED is a less severe eating disorder (ED), although BED is linked with similar impairments and psychopathologies when compared with other EDs. The few previous studies on the topic indicate that BED has similar levels of suicidality as BN. However, because both eating disorders are often accompanied by other psychiatric conditions, such as mood, anxiety, and substance use disorders, it can be difficult to parse out whether suicidality is truly associated with the eating disorder or its comorbidity.

A recent study looked further into the relationship between suicidality (i.e. ideation, plan, and/or attempt) and BED in adults and adolescents. Among adolescents (ages 13-18) and adults (ages 18-29) with BED, there were elevated odds of suicidality. When assessing as a whole group (i.e. not dividing into age cohorts) BED was not significantly associated with higher rates of suicidality after adjusting for comorbidities. 

Interestingly, when the relationship was present, adolescents with BED reported higher frequencies of suicidality onset following the onset of BED, whereas adults with BED reported suicidality onset prior to the onset of BED. 

This study showed that BED was associated with an elevated risk for suicidality. What is unclear is whether it is the BED itself, or BED combined with co-occurring disorders; BED was associated with the risk of suicidality when it was the only variable assessed, but comorbidities likely moderate the relationship between BED and suicidality.

This study shines a light on important clinical implications related to BED and suicidality, namely that suicidality should be a serious concern among those with BED; there appear to be complex relationships among BED, psychopathology, and suicidality; and the relationship between BED and suicidality may be bidirectional. The researchers state that the findings also provide further support for the notion that BED is a severe ED.