BED vs BN Key Distinction — MRCPsych Paper B MCQ

Correct answer: A — Binge eating disorder lacks regular inappropriate compensatory behaviours after binges

The correct answer is A. Both binge eating disorder and bulimia nervosa involve recurrent episodes of binge eating with a subjective loss of control. The key distinction is that bulimia nervosa includes regular inappropriate compensatory behaviours intended to prevent weight gain, such as self-induced vomiting, fasting, laxative misuse or excessive exercise. These behaviours are absent as a regular pattern in binge eating disorder. Neither diagnosis is determined solely by age, sex or body weight: binge eating disorder does not require overweight or obesity, and bulimia nervosa can occur across weight ranges. Differences in binge frequency alone do not provide the defining distinction between the two syndromes.

Reference: NHS England Digital. Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4, Chapter 13: Eating disorders, section 13.2 Definitions and assessments. 2025. https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/survey-of-mental-health-and-wellbeing-england-2023-24/eating-disorders