Binge eating disorder is a serious eating disorder marked by a compulsive need to consume large quantities of food on a frequent basis. Individuals with this disorder struggle to stop eating, even when they feel uncomfortably full, and they do not engage in any compensatory behaviors such as purging or excessive exercise.
What Is Binge Eating Disorder?
Binge eating disorder (BED) is a type of eating disorder 1 Iqbal, A., & Rehman, A. (2022). Binge Eating Disorder. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551700/ characterized by recurrent episodes of binge eating, where individuals consume a large amount of food in a short period of time while feeling a lack of control over their eating behavior.
Binges are typically accompanied by feelings of shame, guilt, or distress, and occur at least once a week for three months or longer.
Unlike other eating disorders (such as anorexia nervosa and bulimia nervosa), individuals with BED do not engage in compensatory behaviors such as purging or excessive exercise.
Because of this characteristic, binge eating disorder is recognized 2 Kornstein, S. G., Kunovac, J. L., Herman, B. K., & Culpepper, L. (2016). Recognizing Binge-Eating Disorder in the Clinical Setting: A Review of the Literature. The primary care companion for CNS disorders, 18(3), 10.4088/PCC.15r01905. https://doi.org/10.4088/PCC.15r01905 in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a distinct eating disorder that is diagnosed when an individual experiences recurrent episodes of binge eating and overeating without regular compensatory behaviors.
Prevalence of binge eating disorder
Studies show that binge eating disorder affects approximately 1-3% of the global population 3 Kessler, R. C., Berglund, P. A., Chiu, W. T., Deitz, A. C., Hudson, J. I., Shahly, V., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Benjet, C., Bruffaerts, R., de Girolamo, G., de Graaf, R., Maria Haro, J., Kovess-Masfety, V., O’Neill, S., Posada-Villa, J., Sasu, C., Scott, K., Viana, M. C., … Xavier, M. (2013). The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biological psychiatry, 73(9), 904–914. https://doi.org/10.1016/j.biopsych.2012.11.020 . The disorder is more prevalent in women than men, and tends to occur in late adolescence or early adulthood.
BED is also more common in individuals who are overweight or obese, although it can occur in individuals of any weight or body size.
Case Example:
Sophia is a 20-year-old girl who, for the last 5 months has been struggling with her weight most of the time. She has tried numerous diets and weight loss programs, but none have been successful in the long term. Sophia has noticed that she has a strong desire to eat large amounts of food, even when she is not hungry.
She often finds herself eating too many snacks in a very short time, especially late at night when she is alone, and feels guilty and ashamed about her behavior afterward.
These events gradually started leading to significant weight gain and with such uncomfortable feelings, Sophia started avoiding social situations which slowly developed her feelings of worry and distress regarding her behaviors of eating.
Case Analysis:
From the present case, it can be observed that Sophia has recurrent episodes of eating large quantities of food in a short period, with associating feelings of emotional distress, guilt, and embarrassment regarding weight gain and a lack of sense of control over eating during the episode, which consequently turns into signs of anxiety and depression. All of her behavior indicates that Sophia has significant signs of Binge-Eating Disorder (BED).
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Symptoms Of Binge Eating Disorder
The signs of binge eating disorder can vary from person to person, but may typically 4 Berkman, N. D., Brownley, K. A., Peat, C. M., Lohr, K. N., Cullen, K. E., Morgan, L. C., Bann, C. M., Wallace, I. F., & Bulik, C. M. (2015, December 1). Table 1, DSM-IV and DSM-5 diagnostic criteria for binge-eating disorder. Www.ncbi.nlm.nih.gov. Available from: https://www.ncbi.nlm.nih.gov/books/NBK338301/table/introduction.t1/ include:
- Eating large amounts of food in a short period of time
- Eating rapidly and not stopping until feeling uncomfortably full
- Eating when not hungry or experiencing negative emotions
- Hoarding or hiding food
- Consistently eating alone due to shame or embarrassment
- Gastrointestinal problems, such as bloating, constipation, or stomach pain
- Fluctuations in appetite and weight
- Feeling a lack of control over eating behavior during binges
- Preoccupation with weight, body shape, and food
- Negative body image or self-esteem
- Irritability and resentment
- Avoiding social situations or activities due to shame about eating habits
What Causes Binge Eating Disorder?
Several factors 5 Yanovski S. Z. (1993). Binge eating disorder: current knowledge and future directions. Obesity research, 1(4), 306–324. https://doi.org/10.1002/j.1550-8528.1993.tb00626.x contribute to the development of the disorder, including:
- Genetic predisposition or innate inclination toward overeating
- Neurological differences in the brain (like abnormalities in the reward centers of the brain)
- Negative body image issues (triggered by experiences of body shaming)
- Societal pressures to conform to certain body standards
- Dieting or restrictive eating behaviors (like yo-yo dieting)
- Negative life experiences related to bullying, abandonment, death of a loved one, etc.
- Traumatic life events related to childhood or sexual abuse
- Underlying mental health conditions like insomnia, anxiety, depression, eating disorder, obsessive-compulsive disorder, etc.
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Binge Eating And Mental Health
Binge eating and mental health are intricately related. Binge eating disorder can be caused by or result in poor mental health conditions 6 Bohon C. (2019). Binge Eating Disorder in Children and Adolescents. Child and adolescent psychiatric clinics of North America, 28(4), 549–555. https://doi.org/10.1016/j.chc.2019.05.003 characterized by:
- Increased risk of developing anxiety and depression
- Enhanced risk of sleep disorders and body image issues
- Decreased quality of life
- Decreased self-esteem and self-worth
- Social isolation and relationship problems
- Increased risk of substance abuse and addiction
- Suicidal ideation and attempts
The physical health impact of binge eating disorder
Binge eating disorder (BED) can also have a significant impact on physical health. It can enhance physical health conditions like cardiovascular diseases, obesity, type 2 diabetes, gastrointestinal problems, liver diseases, and certain cancers (such as breast, colon, and pancreatic cancer). People with binge eating patterns also experience premature aging and a decreased lifespan.
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Diagnosis Of Binge Eating Disorder
Binge eating disorder diagnosis has been shaped by both extensive research and clinical practice. The DSM-5 diagnostic criteria for BED 7 Iqbal, A., & Rehman, A. (2022). Binge Eating Disorder. In StatPearls. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551700/ include experiencing episodes of binge eating at least once a week for three months or longer, feeling a lack of control over eating during these episodes, and experiencing marked distress regarding binge eating.
Additionally, the manual specifies that individuals with BED must not engage in compensatory behaviors such as purging or excessive exercise, and must not meet the diagnostic criteria for other eating disorders like anorexia nervosa.
The diagnosis of binge eating disorder usually involves a clinical interview with the patient and his/her completion of several self-report standardized questionnaires 8 Reas, D. L., Grilo, C. M., & Masheb, R. M. (2006). Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder. Behaviour research and therapy, 44(1), 43–51. https://doi.org/10.1016/j.brat.2005.01.004 like the Binge Eating Scale (BES) and the Eating Disorder Examination-Questionnaire (EDE-Q).
The affected person also undergoes medical and psychological evaluations. In the process, his/her symptoms of BED, eating behaviors, thoughts and feelings, and psychosocial factors are assessed.
How To Recover From Binge Eating Disorder
Treatment of binge eating disorder encompasses a combination of treatment options 9 Peat, C. M., Brownley, K. A., Berkman, N. D., & Bulik, C. M. (2012). Binge eating disorder: Evidence-based treatments. Current psychiatry, 11(5), 32–39. like:
1. Psychotherapy
Psychotherapy is a widely recognized and effective treatment option for individuals with binge eating disorder. It involves talking to a mental health professional to address the underlying causes of the disorder and develop coping strategies to manage the urges to binge. Most commonly, cognitive-behavioral therapy (CBT) and Interpersonal psychotherapy (IPT) are effective in treating BED.
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2. Family-based therapy
Family-based therapy aims to address the impact of BED on family dynamics and relationships. It can help family members understand the disorder better and develop strategies to support their loved one’s recovery.
Additionally, family-based therapy can help the individual with BED improve their communication skills and develop healthier relationships with their family members.
3. Group therapy
Group therapy is a valuable and effective treatment option for individuals with binge eating disorder (BED). It involves participating in therapy sessions with a group of peers who are also struggling with the disorder.
Groups like Overeaters Anonymous 10 Russell-Mayhew, S., von Ranson, K. M., & Masson, P. C. (2010). How does overeaters anonymous help its members? A qualitative analysis. European eating disorders review : the journal of the Eating Disorders Association, 18(1), 33–42. https://doi.org/10.1002/erv.966 can provide a sense of community and support, as well as reduce feelings of isolation and shame often associated with the disorder.
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4. Pharmacotherapy
While medication 11 Yanovski S. Z. (1993). Binge eating disorder: current knowledge and future directions. Obesity research, 1(4), 306–324. https://doi.org/10.1002/j.1550-8528.1993.tb00626.x is not typically the first line of treatment for binge eating disorder, it may be recommended in combination with other forms of therapy for certain individuals. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have shown effectiveness in reducing the frequency and severity of binge episodes.
Doctors may also monitor individuals with BED for other medical conditions that can arise due to the disorder, such as heart disease, type 2 diabetes, and hypertension.
5. Nutritional counseling
Working with a registered dietitian can help to establish regular eating patterns and balanced meal plans. A balanced diet can reduce the risk of binge episodes and promote overall health and well-being.
6. Hospitalization
For extreme cases of binge eating disorder, doctors recommend hospitalization and other forms of in-patient treatment and programs.
How To Cope With Binge Eating Disorder
Consider the following strategies for coping 12 Bulik, C. M., Brownley, K. A., & Shapiro, J. R. (2007). Diagnosis and management of binge eating disorder. World psychiatry : official journal of the World Psychiatric Association (WPA), 6(3), 142–148. with the symptoms of binge eating disorder:
- Seek professional help from a therapist or a healthcare provider who specializes in eating disorders.
- Identify triggers and keep a food diary to track thoughts, emotions, and behaviors.
- Create a meal plan with a balanced and nutritious diet, and avoid skipping meals.
- Practice mindful eating by savoring every bite, chewing slowly, and paying attention to the body’s signals of hunger and fullness.
- Use distraction techniques such as taking a walk, reading a book, or doing a puzzle when feeling the urge to binge eat.
- Replace negative self-talk with positive affirmations and self-compassion.
- Engage in regular physical activity that feels enjoyable and sustainable.
- Surround yourself with supportive friends and family members.
- Consider joining a support group for people with eating disorders.
- Avoid restrictive diets and focus on building a healthy relationship with food and exercise.
- Work on improving overall mental health care through stress management, self-care, and therapy.
Takeaway
Binge eating disorder involves a pattern of overeating that can lead to significant distress and can have serious physical and psychological consequences. Therefore, it is important to seek professional help if you suspect that you or someone you know may be struggling with binge eating disorder.
At A Glance
- Binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of binge eating without compensatory behaviors.
- It affects 1-3% of the population, with more prevalence in women, overweight or obese individuals, and those experiencing negative life experiences.
- The common signs of binge eating disorder include binge eating, purging, etc.
- BED can cause mental health conditions such as depression, anxiety, and social isolation, as well as physical health issues such as obesity and type 2 diabetes.
- Binge eating disorder diagnosis involves a clinical interview and standardized questionnaires.
- The treatment for binge eating disorder includes psychotherapy, family-based therapy, group therapy, and medication.
Frequently Asked Questions (FAQs)
1. Is binging on food a coping mechanism?
Binge eating is essentially an emotional eating that many people take to cope with negative emotions like stress, anxiety, grief, or boredom.
2. How can dieting affect mood and behavior?
Unhealthy dieting can reduce energy levels and trigger mood swings.
3. Can the timing and pattern of eating affect mental health?
Irregular meal times and disordered eating patterns (like food binging) are largely associated with mental health disorders like depression, anxiety, mood disorders, etc.
4. How do I mentally prepare myself to change my eating habits?
Practice mindful eating and convince yourself that you need to develop healthier food habits for your own well-being. This may prepare you for changes in your food consumption for the better.