What is Binge Eating Disorder?
Updated: Oct 6, 2020
Binge eating disorder (BED) is when an individual consumes a large amount of food in a short time accompanied by feelings of shame, guilt, and loss of control.
I like the phrase “loss of control” because that’s what I identified with the most. When I binged, I felt so out of control. I couldn’t stop myself from eating. It ruled my life. I couldn’t figure out how to not eat all the time.
The DSM-5 includes emotional and stress eating in binge eating disorder. The definitions above can be used to describe those eating disorders as well. If you would like more information on those disorders specifically, check out “How to Stop Stress Eating” and "How to Stop Binge Eating.”
Diagnosis criteria.
Recurrent episodes of binge eating characterized by both of the following:
Eating a significant amount of food than the average person would eat in a similar time under similar circumstances in discrete time (e.g., within 2 hours).
A sense of lack of control over eating (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
The binge-eating episodes are associated with three (or more) of the following:
Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of feeling embarrassed by how much one is eating.
Feeling disgusted with oneself, depressed, or very guilty afterward.
Marked distress regarding binge eating is present.
Binge eating occurs, on average, at least once a week for three months.
Symptoms.
Evidence of binge eating, including disappearance of large amounts of food in short periods of time or lots of empty wrappers and containers indicating consumption of large amounts of food.
Appears uncomfortable eating around others
Any new practice with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
Fear of eating in public or with others
Steals or hoards food in strange places
Creates lifestyle schedules or rituals to make time for binge sessions
Withdraws from usual friends and activities
Frequently diets
Shows extreme concern with body weight and shape
Frequent checking in the mirror for perceived flaws in appearance
Has secret recurring episodes of binge eating (eating in a discrete period of time an amount of food that is much larger than most individuals would eat under similar circumstances); feels lack of control over ability to stop eating
Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting
Developing food rituals (e.g., eating only a particular food or food group [e.g., condiments], excessive chewing, and not allowing foods to touch).
Eating alone out of embarrassment at the quantity of food being eaten
Feelings of disgust, depression, or guilt after overeating
Fluctuations in weight
Feelings of low self-esteem
Noticeable fluctuations in weight, both up and down
Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
Difficulties concentrating
Causes.
For the most part, the cause of BED is unknown. Research has shown that there isn’t one cause connected to every case of BED, but a multitude of interchangeable reasons. Not every case is the same. Causes are physiological, biological, and environmental.
Mental Health Disorders. Other mental health disorders can lead to BED. Studies show that half of binge eating disorder patients have a history of depression or other mental illness. Many people report negative emotions associated with BED such as anxiety, boredom, anger, and sadness.
Run in Families. Families share not only genetics but also eating habits. BED can be passed down from generation to generation through genetic factors like metabolism and dopamine release. Parents also pass down their eating habits to their children, so if the parents have a pattern of binge eating, the children will more likely too.
Body Image. People with a negative body image are more likely to develop BED. Negative body image can lead to frequent dieting and overeating.
Weight Problems. A majority of binge eating disorder patients are overweight or obese. It’s hard to determine if weight issues cause binge eating or if binge eating causes weight issues, but there is no dispute that they go hand in hand.
Emotional Trauma. Stress can cause BED, more specifically, stressful life events like divorce, abuse, or death. It can be used as a coping mechanism for traumatic experiences.
Statistics
In the study “The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication,” researchers found that 3.5% of women and 2.0% of men had binge eating disorder during their life. This statistic makes BED three times more common than anorexia and bulimia combined. It also makes BED more common than breast cancer, HIV, and schizophrenia.
Hudson JI, Hiripi E, Pope HG Jr, and Kessler RC. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3):348-58. doi:10.1016/j.biopsych.2006.03.040.
In the study “An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents,” researchers found that 5.2% of girls met criteria for anorexia, bulimia, or BED.
Stice E, Marti CN, Shaw H, and Jaconis M. (2010). An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. Journal of Abnormal Psychology, 118(3):587-97. doi: 10.1037/a0016481.
In the study “Eating Disorders,” researchers found that between 0.2% and 3.5% of females and 0.9% and 2.0% of males will develop BED.
Stice E & Bohon C. (2012). Eating Disorders. In Child and Adolescent Psychopathology, 2nd Edition, Theodore Beauchaine & Stephen Linshaw, eds. New York: Wiley.
Research estimates that 28.4% of people with BED are receiving treatment, and 43.6% of people with BED will receive treatment at some point in their lives. BED often begins in the late teens or early 20s. Approximately 40% of those with binge eating disorder are male. Three out of ten individuals looking for weight loss treatments show signs of BED.
For further reading:
Westerberg, D. P., & Waitz, M. (2013). Binge-eating disorder. Osteopathic Family Physician, 5(6), 230-233.
Health Consequences
Gastrointestinal
Binge eating can cause the stomach to rupture, creating a life-threatening emergency.
Neurological
Although the brain weighs only three pounds, it consumes up to one-fifth of the body’s calories. Dieting, fasting, self-starvation, and/or erratic eating means the brain isn’t getting the energy it needs, which can lead to obsessing about food and difficulties concentrating.
Extreme hunger or fullness at bedtime can create difficulties falling or staying asleep.
Individuals of higher body weights are at increased risk of sleep apnea, a disorder in which a person regularly stops breathing while asleep.
Endocrine
Over time, binge eating can potentially increase the chances that a person’s body will become resistant to insulin, a hormone that lets the body get energy from carbohydrates. This can lead to Type 2 Diabetes.
Treatment Options
Cognitive-behavioral therapy
Interpersonal psychotherapy
Dialectical behavior therapy
Weight loss therapy
Medication
These treatment options can be done by one’s self, in a one-on-one setting, or in a group. Individuals might require more than one therapy option.
Author: Anderson, L.K.; Murray, S.B.; Kaye, W.H.
Publish Date: September 26, 2017
Price: $69 (Paperback)
Description: "Clinical Handbook of Complex and Atypical Eating Disorders brings together into one comprehensive resource what is known about an array of complicating factors for patients with ED, serving as an accessible introduction to each of the comorbidities and symptom presentations highlighted in the volume. The first section of the book focuses on the treatment of ED in the presence of various comorbidities, and the second section explores the treatment of ED with atypical symptom presentations. The third section focuses on how to adapt ED treatments for diverse populations typically neglected in controlled treatment trials: LGBT, pediatric, male, ethnically diverse, and older adult populations. Each chapter includes a review of clinical presentation, prevalence, treatment approaches, resources, conclusions, and future directions. Cutting edge and practical, Clinical Handbook of Complex and Atypical Eating Disorders will appeal to researchers and health professionals involved in treating ED."
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