What is Binge Eating Disorder?
Binge eating disorder is one where you frequently eat large amounts of food while feeling compelled and feeling extremely anguished during or after eating. You may end up eating beyond your comfort level and be overcome by feelings of guilt, distress, or shame afterward. You could then end up beating yourself up for your lack of self-control or worry about what such eating will do to your body.
During a binge, you could eat even if you are not hungry and continue to eat even after you are full. You may binge so fast that you hardly register what you are tasting or eating. Unlike in bulimia, however, you do not “make up” for the binging by over-exercising, vomiting, or fasting.
Binge eating disorder affects almost 2% of people worldwide. It is the most common eating disorder in the United States. It usually begins in late adolescence or early adulthood, often following a major diet.
People use binging on food as a way of coping with unwanted stress or emotions. Certainly, binge eating can help ease unpleasant feelings or emotions of stress, anxiety, or depression. But, this feeling of comfort lasts only temporarily. And then once reality sets back in, you will feel self-loathing and regret. Often, you end up gaining weight and become obese. And, this only reinforces compulsive eating. The more dissatisfied you are about yourself generally and, indeed, about your appearance, the more you will resort to binge eating. This leads to a vicious cycle.
But, remember that binge eating disorder is very much treatable. Treatments for binge eating disorder include therapy and medication. You can break the vicious cycle of binge eating, get control your emotions, relate to food healthily, and regulate your eating and thereby your health.
Symptoms of Binge Eating Disorder
People with binge eating disorder try to hide their symptoms by eating in secret. The symptoms can be behavioral or emotional.
Behavioral symptoms of binge eating disorder include:
- Lack of control over what you are eating or inability to stop eating
- Eating large amounts of food much more quickly than normal
- Eating despite feeling full
- Hoarding food to eat it later secretly
- Create lifestyle schedules or rituals to make time for binge sessions
- Eating normally if others are around, but gorging on food when you find yourself alone
- Eating pretty much continuously throughout the day, with no planned mealtimes
Emotional symptoms of binge eating disorder include:
- Feeling stressed or tense, which is relieved only by eating
- Feeling embarrassed over the quantity of food you eat
- Display extreme concern over body weight and shape
- Fear of eating in public or with others
- Feeling numb during bingeing
- Always feeling dissatisfied, irrespective of how much you ate
- Feeling guilty, distressed, or disgusted, after overeating
- Feeling desperate to control eating habits and thereby weight
The causes of binge eating disorder are not well understood. The risk factors include:
- Genetic. There is strong evidence that the disorder is inherited.
- Gender. It is more common in women.
- Altered brain structure. People with this disorder may have altered brain structure, which results in a heightened response to food and a lack of self-control.
- Nearly 50% of people with this disorder have obesity. Obesity may be at once a cause as well as a result of the disorder.
- Body image. People with binge eating disorder usually have a negative body image.
- Stressful life events, such as childhood abuse or bullying, separation from family, death, or an accident, are risk factors.
- Other mental illnesses. Almost 80% of people with binge eating disorder have some psychological disorder, such as depression, phobias, PTSD, anxiety, bipolar disorder, or substance abuse.
DSM-5 considers these as the diagnostic criteria for binge eating disorder:
- Repeated episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a limited period of time (e.g., within a 2-hour period), an amount of food that is more than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode.
- The binge-eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal.
- Continuing to eat even after feeling full.
- Eating large amounts of food even though not hungry.
- Preferring to eat alone due to embarrassment over how much one is eating.
- Feeling disgusted with oneself, very guilty, or depressed afterward.
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for 3 months.
- The binge eating is not associated with compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.
Treatment of Binge Eating Disorder
Treatment options include cognitive-behavioral therapy, interpersonal psychotherapy, dialectical behavior therapy, weight loss therapy, family therapy, and medication.
- Cognitive-behavioral therapy. Here the focus is on changing your negative thought patterns about your body or a depressed mood. Specific interventions are self-monitoring, setting goals, sticking to regular meal patterns, altering thoughts about weight and self, and encouragement of healthy weight-control habits.
- Interpersonal psychotherapy. This type of therapy improves your interpersonal skills—how you relate to others. Thereby, it reduces binge eating triggered by problematic relationships and unhealthy communication skills.
- Dialectical behavior therapy. This therapy helps you learn behavioral skills to tolerate stress, control your emotions and have healthy relationships with others, all of which can decrease the need to binge eat.
- Weight loss therapy. Weight loss therapy aims to improve binge eating symptoms by reducing weight so that that this will improve body image. Weight-loss programs that tackle binge triggers can be helpful when you are also undergoing cognitive-behavioral therapy.
- Family therapy. Here you teach the family members about the disorder so that they can spot the sources of stress at home, and get to know how to support you.
- Stress management. You can manage stress through exercise, yoga, meditation, and massage therapy.
- Medication. FDA approved lisdexamfetamine (Vyvanse) to treat moderate to severe binge eating disorder in adults. The anti-seizure drug topiramate (Topamax) could allay the urge to binge. If depression or anxiety is present, you will need an antidepressant or anti-anxiety medication. Naltrexone/bupropion (Contrave) can help with losing weight.