F50.81ICD-10-CMBinge Eating Disorder
Official ICD-10-CM descriptor: Binge eating disorder · Category header, not billable: use a more specific code
Recurrent episodes of binge eating with marked distress, occurring at least once per week for three months or longer, without the regular compensatory behaviors that distinguish bulimia nervosa.
Recommended screener
- Validated screenerBinge Eating Scale (BES)
DSM-5-TR diagnostic criteria summary
Binge Eating Disorder requires:
- Recurrent episodes of binge eating, characterized by:
- Eating, in a discrete period (e.g., within 2 hours), an amount of food larger than what most people would eat in a similar period under similar circumstances
- A sense of lack of control over eating during the episode
- Binge eating episodes are associated with ≥3 of:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts when not feeling physically hungry
- Eating alone because of embarrassment about how much one is eating
- Feeling disgusted, depressed, or very guilty afterward
- Marked distress regarding binge eating.
- Frequency: at least once per week for 3 months.
- Not associated with regular compensatory behaviors (vomiting, laxatives, excessive exercise, fasting) and does not occur exclusively during anorexia or bulimia.
Severity (based on average binge episodes/week): Mild 1–3, Moderate 4–7, Severe 8–13, Extreme 14+.
Billing (FY2027 ICD-10-CM): F50.81 is a category header. Bill the severity code: F50.810 mild, F50.811 moderate, F50.812 severe, F50.813 extreme, F50.814 in remission, F50.819 unspecified.
Source: American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), p. 381–387.
Differential diagnosis
- F50.2 Bulimia Nervosa, binge eating WITH compensatory behaviors (the key distinguisher).
- F50.0 Anorexia Nervosa, restrictive eating with significantly low body weight; binge-purge subtype includes compensation.
- F50.89 Other Specified Feeding or Eating Disorder, binge eating below threshold (e.g., once monthly), atypical anorexia, purging disorder, night eating syndrome.
- F33, F32 Major Depressive Disorder with Atypical Features, increased appetite/weight gain in atypical depression; differential rests on whether eating is "out of control" (BED) vs simply increased (atypical MDD).
- Medical conditions, Prader-Willi syndrome, Kleine-Levin syndrome, hypothalamic lesions; rare but characterized by hyperphagia of distinct etiology.
Common comorbidities
Binge Eating Disorder has very high lifetime psychiatric comorbidity. Common co-occurring conditions: Major Depressive Disorder (F33, F32, up to 32% lifetime), Generalized Anxiety Disorder (F41.1), Substance Use Disorders (F10–F19), Bipolar Disorders (F31.x), and metabolic conditions (Type 2 diabetes, cardiovascular disease, obesity-related comorbidities). Routinely co-administer PHQ-9, GAD-7, and AUDIT alongside eating disorder screening.
Sources
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), F50.81, p. 381–387.
- Gormally, J., Black, S., Daston, S., & Rardin, D. (1982). The assessment of binge eating severity among obese persons. Addictive Behaviors, 7(1), 47–55.
- Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines.
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Frequently asked questions
What is ICD-10 code F50.81?
F50.81 is the ICD-10-CM category for Binge Eating Disorder. Since FY2025 it is billed with a 6-character severity code (F50.810 to F50.814, or F50.819 unspecified). BED is characterized by recurrent episodes of binge eating without the compensatory behaviors that distinguish bulimia nervosa.
What are the diagnostic criteria for F50.81?
DSM-5-TR Binge Eating Disorder requires: (A) recurrent binge eating episodes (eating an unusually large amount with sense of loss of control); (B) episodes associated with ≥3 of 5 features (eating rapidly, eating until uncomfortably full, eating when not hungry, eating alone due to embarrassment, feeling disgusted/depressed/guilty afterward); (C) marked distress about binge eating; (D) occurs ≥1×/week for ≥3 months; (E) NOT associated with regular compensatory behaviors (distinguishes from bulimia).
What scale is used to screen for F50.81?
The Binge Eating Scale (BES) is a 16-item self-report screener; scores 18–26 indicate moderate binge eating, 27+ indicate severe binge eating. The Eating Disorder Examination Questionnaire (EDE-Q) is a more comprehensive 28-item assessment covering eating, weight, and shape concerns. The SCOFF Questionnaire is a brief 5-item screener used in primary care.
What is the difference between F50.81 and F50.2 (Bulimia Nervosa)?
F50.81 BED requires recurrent binge eating WITHOUT compensatory behaviors (vomiting, laxatives, excessive exercise, fasting). F50.2 Bulimia Nervosa requires binge eating WITH compensatory behaviors. Both share loss-of-control eating; presence/absence of compensation is the key distinguisher. Many patients move between presentations over time.