Binge Eating Disorder

Binge Eating Disorder is characterized by the urgency to consume substantial amounts of food frequently, being unable to stop eating despite feeling uncomfortably full without any recurrent episodes of compensatory behaviors.

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What Is Binge Eating Disorder (BED)?

Binge eating disorder (BED) is a new proposed ¹ eating disorder where a person engages in brief yet recurrent binge-eating episodes that lead to psychological distress. During an episode, the sufferer experiences a lack of control and eats larger amounts of food than other normal people. On average, it can occur for at least one day per week for a period of 3 months and each episode can last for around 2 hours. According to a 2016 study ², approximately 3% of U.S. adults experience this common eating disorder at least once in their lifetime. Moreover, it is more common in women than men and is widely observed in obese individuals. The condition starts to develop during adolescence and gains prominence during early adulthood and persists well into adulthood.

Recurrent episodes of binge eating is typically characterized by the following –

Eating a large amount of food within any 2 hour period.
The amount of food consumed is larger than what a healthy person would eat under similar circumstances.
Feelings of a lack of control over food consumption during episodes.
Eating food much faster than usual.
Eating large quantities of food even when not actually hungry.
Eating until they feel uncomfortably full.
Preference to eat alone due to embarrassment for binge eating habits.
Feeling distressed, disgusted, guilty and depressed after overeating.

The 2016 study explains “BED is associated with poorer psychological and physical well-being, including major depressive and other psychiatric disorders, relationship distress and impaired social role functioning, chronic pain, obesity and diabetes.” Treatment options such as psychological and behavioral interventions, medications, or a combination of the two can assist someone suffering from this eating disorder.

Having a lot of stress and anxiety makes it more likely to binge eat, in order to deal with it. So, it is essential to adopt mindful habits such as meditation or yoga to manage stress and anxiety. Some people also require emotional support from their friends and family. So it is of utmost importance, to pay attention to the symptoms in order to detect the disorder early and devise a treatment plan.

Understanding Binge Eating Disorder

This condition is an intense and life-threatening, yet treatable disorder that involves recurrent episodes of rapid binge eating even when it is uncomfortable. Although shame, guilt and distress are experienced by the sufferer, unhealthy compensatory measures such as purging, are typically not observed. For many individuals, binges are often planned in advance and they tend to buy special foods for binging. This disorder is a type of “feeding” and “eating disorder”. People suffering from this condition often feel a lack of control over eating impulses during their binge episodes. Some of the other features of this condition also include having significant psychological distress such as shame or guilt after binge eating and the absence of recurrent unwanted compensatory behaviors. Binge eating disorder is often termed ³ as an “expressive disorder” since it is an expression of deeper psychological problems through excess consumption of food.

A person with binge eating disorder (BED) usually feels like they can’t stop even if they are uncomfortably full. Some people also tend to eat a lot or quickly even if they are not hungry. People with obesity are at a higher risk of developing this disorder. If someone is suffering from this disorder they may also experience difficulty in handling their emotions or feel out of control. They often tend to use food as a means of rewarding themselves or processing uncomfortable feelings. People with this condition suffer from depression as well and it is also found to run in families. Binge eating often becomes a side effect of depression since people often turn to comfort foods when they are feeling down or sad. People with this condition have a lower quality of life and commonly experience social difficulties.

Read More About Eating Disorders Here

Signs And Symptoms Of Binge Eating Disorder

There are several signs that can indicate this disorder. They are as follows:

1. Emotional And Behavioral Symptoms

The disappearance of large amounts of food in a short span of time
Being uncomfortable eating around other people
Planning binges in advance, that involves purchasing special binge foods
Anxiety over eating in front of people or in public
Stealing or hoarding food in strange places
Creating lifestyle schedules or rituals to make time for binge sessions
Withdrawing from the social circle
Frequent diets
Excessive concern about body weight and shape
Frequently checking the mirror for perceived flaws in appearance
Having secret recurring episodes of binge eating
Inability to stop eating due to a lack of control
Eating alone out of embarrassment at the quantity of food consumed
Feelings of disgust, depression, or guilt after overeating
Fluctuations in weight
Feelings of low self-esteem
Developing food rituals such as excessive chewing or not allowing anyone to touch their food

2. Physical Symptoms

Weight changes that go both up and down are noticeable
Stomach cramps, other non-specific gastrointestinal complaints
Difficulties concentrating

Causes Of Binge Eating Disorder

Experts are still working on the exact causes of BED. But it is likely due to the following risk factors that a person may develop this condition:

1. Genetic Factors

Evidence suggests that this disorder is inherited. Genetic factors play a significant role in developing this condition. It is found that people with this condition have an increased sensitivity to a brain chemical called dopamine. Dopamine is responsible for feelings of reward and pleasure. The heightened sense of reward that comes from binge eating enables a person to engage in these behaviors. Studies ⁴ have shown that binge eating tends to run in families and a twin study has shown a, “moderate heritability for binge eating” at 41 percent.

Read More About Genetics Here

2. Gender

A scientific review ⁵ suggests that this condition is found to be more common in women than in men. Around 3.6 percent of women ⁶ experience BED at some point in their lives as compared with 2 percent of men. This may also occur due to underlying biological conditions.

Read More About Gender Here

3. Changes In The Brain

Studies show that this disorder occurs due to changes in the brain structure that causes a heightened response to food and less self-control

4. Obesity

Research ⁷ found that almost 50 percent of people with binge eating disorder have obesity. Almost 25 to 50 percent ⁸ of patients seeking weight loss surgery meet the diagnostic criteria for this disorder. Gaining weight ⁹ is found to be both a cause and the result of binge eating disorder.

5. Body Image

People suffering from this condition often have a negative body image ¹⁰. This can cause body dissatisfaction which ultimately results in dieting or overeating.

Read More About Body Image Here

6. Emotional Trauma Or Stress

Sometimes this condition can occur due to stressful life events or emotional trauma such as death, abuse, car accident, or others. Being bullied during childhood may also be a contributing factor to developing this disorder.

Read More About Stress Here

7. Other Psychological Factors

People suffering from this condition have at least one comorbid condition associated with this disorder such as phobias, depression, post-traumatic stress disorder (PTSD), bipolar disorder, anxiety, or substance abuse. Studies suggest that almost 80% of people with BED have other comorbid conditions.

Health Risks Associated With BED

There may be certain physical, emotional, and social health risks associated with this condition. They are as follows:

Obesity
Heart disease
Stroke
Type 2 diabetes
Cancer
Sleeping problems or insomnia
Chronic pain conditions
Asthma
Irritable bowel syndrome
Fertility problems
Pregnancy complications
Polycystic ovary syndrome (PCOS)
Challenges with social interactions

Read More About Insomnia Here

Comorbid Conditions Associated With Binge Eating Disorder

There are several comorbid conditions that may be associated with BED. individuals may have other comorbidities and can include:

Major depressive disorder
Personality disorder
Bipolar disorder
Substance abuse
Body dysmorphic disorder
Kleptomania
Fibromyalgia
Anxiety disorders

Read More About Major Depressive Disorder (Depression) Here

Diagnosis Of Binge Eating Disorder

When an individual starts to notice the symptoms, it is advisable to seek professional help. The doctor will physically evaluate the patient to ensure that the symptoms are not triggered by any underlying physical conditions. Next, the doctor will recommend an experienced psychiatrist in order to diagnose the patient and devise a treatment plan that is suitable for the patient.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ¹¹, the following are the diagnostic criteria for binge eating disorder:

1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

Eating an amount of food in a discrete period of time (e.g., within any 2 hour period) that is clearly greater than what most people would eat in a similar period of time under similar circumstances.
During the episode, a sense of loss of control over eating

2. Binge eating episodes are associated with two of the following:

Eating rapidly than normal
Eating until feeling uncomfortably full
Consuming substantial amounts of food even when not hungry
Eating alone due to embarrassment
Feeling disgusted, depressed, or guilty afterward

3. Feeling distressed when binge eating
4. The urgency occurs at least once a week for three months
5. It is not associated with other compensatory behaviors such as purging in bulimia nervosa
6. It doesn’t occur exclusively during the course of bulimia nervosa or anorexia nervosa

The doctor may ask the patient several questions regarding their eating habits and mental health in order to give a correct diagnosis. Some of the questions that can be expected are as follows:

What does your daily food intake look like?
Do you eat a substantial amount of food or until you are uncomfortably full?
Do you think your eating is out of control?
Have you tried to lose weight?
If yes, what were the methods you adopted?
Do you eat even when you are not hungry?
Do you ever eat secretly?
Do you feel depressed, ashamed, or guilty about your eating?
Do you ever try to vomit to get rid of calories?
Are you often concerned about your weight?
How often do you exercise?

Treatment For Binge Eating Disorder

The treatment for this condition depends on the severity and causes of the disorder. The main agenda may be treating binge eating, excess weight, body image, mental health issues, or a combination of these. The treatment methods that are generally used in treating patients with this condition are as follows –

1. Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is responsible for analyzing and evaluating the relationship between negative thoughts, feelings, and behaviors related to eating, body shape, and weight. After the negative thought patterns are identified, the doctor will help the patient to develop different coping strategies that will help them with their issue. Some of the strategies may be setting goals, self-monitoring, having a set regular meal pattern, changing thoughts about self and weight, and having healthy weight control habits.

Reviews on treatment methods found that CBT led by therapists are most effective for people suffering from this condition. One study ¹² found that after 20 sessions of this therapy, 79% of the participants were no longer binge eating and 59% continued to be successful without any relapse even after one year.

Read More About Cognitive Behavioral Therapy (CBT) Here

2. Interpersonal Psychotherapy

This therapy suggests that binge eating disorder is a coping mechanism for unresolved issues such as grief, conflicts in relationships, drastic life changes, and social issues. It aims to identify the specific issues that are directly linked with the binge eating behavior, acknowledging it, and making necessary adjustments to curb the issue over the next 12 to 16 weeks. Interpersonal psychotherapy may involve a group format or a one to one session with a trained psychiatrist and it may be combined with Cognitive Behavioral Therapy.

Evidence suggests that this therapy has both short and long-term effects on reducing binge-eating behavior and it is the only alternative therapy that has good long-term outcomes like cognitive behavioral therapy. It is found to be particularly effective in severe forms of binge eating and in people with lower self-esteem.

3. Dialectical Behavior Therapy (DBT)

This therapy views this disorder as a negative emotional reaction to unfavorable experiences. The person cannot find any other way of coping with this issue. Dialectical Behavior therapy teaches the patient how to regulate their emotional responses so that they can learn how to cope with negative situations in their daily life without the need to binge. The four key areas of this therapy involve mindfulness, distress tolerance, regulation of emotions, and interpersonal effectiveness.

A 2011 study ¹³ that included 44 women with this disorder who underwent this therapy showed that 89% of them stopped binging by the end of the therapy. However, this dropped to 56% when a six-month follow up was conducted. Research is still ongoing on the effectiveness of this therapy in treating patients with binge eating disorder.

4. Weight Loss Therapy

Weight loss therapy’s key focus is to help people reduce weight and reach their desired goal. It involves reducing binge eating behavior by improving self-esteem and body image. The aim is to inculcate healthy lifestyle changes gradually that include diet and exercise as well as keeping a track of daily food intake throughout the day. The individual is expected to reduce 1 pound (0.5 kg) per week with these lifestyle changes. Studies ¹⁴ found that this therapy may help to improve body image, self-esteem, and the health risks associated with obesity.

It is a successful option for people whose primary aim is to reduce weight. This therapy may be successful in reducing weight but may not prove effective in cases of binge eating.

5. Medications

Several medications have proven effective in treating patients with Binge Eating Disorder. It is often found to be cheaper and faster than traditional therapy treatments. However, in the long run there are no medications that work as good as behavioral therapies. Some medications that are useful can include antidepressants, antiepileptic drugs such as topiramate, and the drugs that are usually used for hyperactive disorders such as lisdexamfetamine.

Research ¹⁵ has found that medications have proven effective in the short term reduction of binge eating than the placebo medication. Medication showed 48.7 percent to be effective while placebos showed 28.5 percent effectiveness. Medications may also help to reduce appetite, obsessions, compulsions, and symptoms of depression associated with this condition. However, there may be side effects such as headache, nausea, stomach problems, sleep disturbances or insomnia, increased blood pressure, and anxiety.

6. Surgery

Bariatric surgery is often adopted by people suffering from this disorder. This surgery is usually performed on obese patients that involves alteration of gut hormone levels that are responsible for hunger and satiety. A recent meta-analysis ¹⁶ showed that people who seek this surgery for weight loss often have BED. It was also found that they are more likely to continue their binge eating habits even after receiving the surgery.

Prevention Of Binge Eating Disorder

It is important to encourage healthy eating habits and exercising regularly. This may act as a preventive measure when the symptoms first start to appear. It may not be possible to prevent all cases of this disorder but it is important to seek professional assistance in any case.

Recovering From Binge Eating Disorder

When symptoms appear, the first step toward recovery is to seek medical attention. This disorder is a common problem but if left untreated, it can cause serious health problems. It can have dire negative effects related to overall health, body weight, self-esteem, and mental health. The most effective treatment methods are cognitive behavioral therapy and interpersonal psychotherapy. So opting for healthy lifestyle changes and therapy can help the patient to ease the symptoms of this condition.

How To Manage Over Binging?

The most important step towards healing is to seek professional help. After evaluation, the doctor will devise an effective treatment plan suited to the needs of the patient. Cognitive-behavioral therapy is the most effective treatment for this condition. However, there are other treatment options that may prove fruitful.

It is of utmost importance to understand that no matter what treatment options are available, leading a healthy lifestyle and having a healthy diet is crucial. Here are some ways that you can manage you binge eating urgency:

Keep a food and mood tracking diary where you can identify personal triggers in order to control your binging impulses.
Practicing mindfulness can increase your awareness of binge eating triggers
Talking to someone about your symptoms may help you to understand why you are binge eating. You can also join support groups to help you work through together on your issue
Eating healthy foods is an important step toward healing. Choosing foods rich in high protein and nutrients can help satisfy the constant hunger.
Exercising can help enhance weight loss, improve body image, reduce anxiety symptoms, and boost your mood.
Getting enough sleep is an important part of your regular routine.

Binge Eating Disorder At A Glance

Binge eating disorder is where a person consumes substantial amounts of food frequently.
A person with BED usually feels like they can’t stop even if they are uncomfortably full leading to psychological distress.
People typically gravitate to comfort foods when they are down or unhappy, therefore it often becomes a side effect of depression.
The treatment for this condition is determined on the severity and cause of the condition. The primary goal might be to address binge eating, excess weight, body image issues, mental health difficulties, etc.

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