F50.81·ICD-10-CM

Binge Eating Disorder

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 screener
Binge 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
  • 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
    • 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+.

    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.

    Frequently asked questions

    What is ICD-11 code F50.81?

    F50.81 is the ICD-11-CM code for Binge Eating Disorder. It was added to ICD-11-CM in 2014 following BED's recognition as a distinct diagnosis in DSM-5-TR (2013). 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.

    How is BED severity classified?

    DSM-5-TR severity for BED is based on average frequency of binge eating episodes per week: Mild (1–3 episodes/week), Moderate (4–7), Severe (8–13), Extreme (14+). Severity can be increased to reflect functional disability or other clinical features. Severity classification informs treatment intensity and modality selection.

    Is F50.81 a billable ICD-11-CM code?

    Yes, F50.81 is a billable ICD-11-CM code as of the 2025 official tabular list. It is the standard reimbursed code for Binge Eating Disorder, added to ICD-11-CM in 2014 after BED's recognition as a distinct DSM-5-TR diagnosis. F50.81 stands at maximum specificity in its hierarchy with no further subdivisions.

    What are the symptoms of binge eating disorder?

    Binge eating disorder produces recurrent episodes of eating unusually large amounts of food with a sense of loss of control, without the compensatory behaviors that distinguish bulimia. Core features include eating much more rapidly than normal, eating until uncomfortably full, eating large amounts when not physically hungry, eating alone due to embarrassment, and feeling disgusted, depressed, or guilty afterward. At least three of these features must occur, with binges happening at least once weekly for three months.

    How is binge eating disorder diagnosed?

    Binge eating disorder is diagnosed by a clinician using DSM-5-TR criteria, which require recurrent binge episodes with at least three of five associated features, marked distress about binge eating, and frequency of at least once weekly for three months. Diagnosis typically follows a positive BES, EDE-Q, or SCOFF screen, structured clinical interview, ruling out bulimia nervosa (compensatory behaviors absent), and assessment for comorbid metabolic and mood conditions.

    What causes binge eating disorder?

    Binge eating disorder arises from a combination of genetic, neurobiological, and psychosocial factors. Heritability estimates from twin studies range from 40% to 60%. Neurobiological contributors include altered dopamine reward signaling, blunted satiety responses, and elevated impulsivity in food-related contexts. Psychosocial triggers include early-life adversity, dieting history, weight-related stigma, emotional dysregulation, and comorbid depression or anxiety.

    Can binge eating disorder be cured?

    Binge eating disorder is highly treatable and many patients achieve full or substantial remission. Cognitive behavioral therapy adapted for eating disorders (CBT-E) and interpersonal therapy are first-line treatments, with roughly 40% to 60% of patients achieving binge abstinence. Lisdexamfetamine (Vyvanse) is the only FDA-approved medication for moderate-to-severe BED and reduces binge frequency by about 50%. SSRIs may help when comorbid depression is present.

    How is BED severity classified · Is F50.81 a billable ICD-11-CM… · What are the symptoms of… · How is binge eating disorder…
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