BED is likely the most prevalent eating disorder (ED). It is underdiagnosed and undertreated due to a lack of clinical familiarity with BED, its only recent recognition as a specific disorder by psychiatrists themselves, and underreporting because of stigmatization. Symptoms usually begin in late adolescence or early adulthood, a little later than for other eating disorders like anorexia nervosa or bulimia nervosa. There is no reported difference in prevalence between racial or ethnic groups, with a slightly higher reported prevalence in assigned females than assigned males at birth.

Disturbances in numerous neurotransmitter systems have been reported in BED, including the serotonergic, dopaminergic, cannabinoid, and opioid transmitter systems. Functional MRI studies have revealed impaired cognitive control and altered reward processing in BED, specifically heightened neural reactivity to food cues.