Understanding vulnerabilities and resilience in binge eating disorder among female population and transgender individuals across the lifespan: a narrative review.

Nagaia Madini, Chiara Breda, Dana El Masri, Cecilia Ricciardi Rizzo, Simone Lanati, Fatima Cody Stanford, Alessandra Vincenti, Hellas Cena, Rachele De Giuseppe

Journal: Eating and weight disorders : EWD 2026;31(1):

PMID: 42700205

Abstract

Binge eating disorder (BED) represents a significant public health concern due to its multifaceted physical, psychological, and economic consequences, all of which substantially impair the quality of life of affected individuals. Individuals with BED often experience persistent body dissatisfaction, emotional distress, anxiety, depression, chronic stress, and social prejudice. Fear of judgment, stigmatisation, and discrimination frequently leads to delays in, or complete avoidance of, seeking medical or psychological support. Although BED remains largely underdiagnosed, existing literature indicates a higher prevalence among females. Nevertheless, the factors contributing to its onset remain insufficiently explored, despite the well-documented vulnerability of women throughout various life stages. Specifically, gendered social roles and ongoing hormonal fluctuations are known to influence emotional regulation, potentially triggering and sustaining binge eating behaviours. This narrative review explores the prevalence and associated factors of BED in the female population across the lifespan, including childhood, adolescence, pregnancy, and menopause. It also considers the transgender population, acknowledging how gender identity, stigma, discrimination, and hormonal treatments can influence BED risk and presentation. Moreover, studies highlighted that the risk and maintenance of BED are exacerbated at various life stages by biological changes associated with sex, as well as by sociocultural influences related to gender roles and socially constructed ideals of femininity. Understanding these diverse factors is essential for developing targeted prevention and treatment strategies that address the specific psychological and biological, as well as social challenges faced by women and individuals assigned female at birth. Importantly, further research is warranted to reduce disparities in healthcare access and to dismantle structural barriers and stigma. Both clinical practice and research must embrace inclusive frameworks that acknowledge the unique vulnerabilities of marginalised populations, while also enhancing healthcare professionals' training to ensure equitable, culturally competent, and effective care.

© 2026. The Author(s).

Address: Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100, Pavia, Italy.; Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100, Pavia, Italy. [email protected].; Clinical Nutrition Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.; MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Department of Pediatrics-Division of Endocrinology, Boston Area Nutrition Obesity Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100, Pavia, Italy.; Clinical Nutrition Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.

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