What Is Binge Eating Disorder?
Binge eating disorder, or BED, is perhaps one of the most misunderstood eating disorders. Eating disorders often come with the stereotype of someone who significantly restricts their food intake and is of a very low body weight. However, binge eating disorder is the most common eating disorder in the US and has the potential to be just as serious, distressing, and life-threatening as anorexia or bulimia. In fact, a 2007 study of nearly 10,000 individuals found that binge eating disorder was three times more common than anorexia and bulimia. Despite this, BED is one of the newest eating disorder diagnoses to be added to the DSM-5, having been added in 2013.
What is binge eating disorder?
According to the National Eating Disorders Association (NEDA): “Binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress, or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.” You can find the full diagnostic criteria for BED here.
How is binge eating disorder different from bulimia nervosa?
Binge eating disorder is different from bulimia nervosa because those struggling with bulimia also engage in compensatory behaviors after binging (ex. self-induced vomiting, misuse of laxatives or diuretics, and/or overexercise). Those struggling with BED do not engage in these compensatory activities, though they often experience similar feelings of guilt, shame, and poor self-esteem after binging. There may still be a strong desire to “make up” for the binge by engaging in restrictive eating, dieting, or “eating only healthy foods”. This contributes to the binge-restrict cycle and keeps the individual feeling stuck between being “good” or “bad” with eating.
How is binge eating different from overeating?
Everyone overeats past the point of comfortable fullness sometimes. That’s a part of normal eating and being human. We can overeat naturally in social settings, such as at a buffet, at a wedding or party, Thanksgiving dinner, or out to eat with friends. Some reasons we might overeat are distraction, boredom, comfort, because the food is so pleasurable, or simply because food is present. Binge eating is different because it involves an intense drive to overeat frequently, and is accompanied by intense feelings of guilt, shame, and feeling out of control. Binge eating causes significant distress to the person and interferes with their ability to fully engage in relationships, work, school, and other areas of life.
Warning signs and symptoms of binge eating disorder:
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; fear of eating in public
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 body checking
Feels a lack of control over ability to stop eating
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
Chaotic, unpredictable eating patterns
Eating when not physically hungry
Eating excessive amounts of “off limits” foods
Concern about weight gain following a binge eating episode
Feeling high, numb, or dissociated during a binge eating episode
Eating “normal” quantities in social settings, and bingeing when alone
Depression and/or anxiety
Physical risks of binge eating disorder:
Significant weight fluctuations
Indigestion, heartburn, and/or acid reflux
High blood pressure
High cholesterol
Heart disease
Type II diabetes mellitus
Stomach rupture, bowel problems, constipation, and/or gastrointestinal upset
Emotional and mental distress: preoccupation with food and weight, low self-esteem, anxiety, depression, disrupted sleep
As with all eating disorders, there is no one specific cause of binge eating disorder. Many psychological, social, and biological influences can contribute to BED. Some risk factors which may contribute to the development of BED include dieting, food insecurity, or unmet needs (emotional, social, professional, pleasure, etc.). Those who struggle with BED also often have co-occurring mental health diagnoses, such as anxiety, depression, and mood disorders.
Treatment for binge eating disorder
Treatment for binge eating disorder is centered around addressing the underlying reasons for binge eating. As with other eating disorders, treatment usually involves a treatment team, including a medical doctor, psychiatrist, therapist, and eating disorder-specialized registered dietitian. This supports the individual in both mental and physical recovery. A dietitian will help you uncover food-related factors that contribute to binging and will provide guidance around eating and making peace with food. A therapist may use cognitive behavioral therapy (CBT) and/or dialectical behavioral therapy (DBT) strategies, among others.
While it may feel embarrassing or shameful to share about your struggles binge eating disorder, experiencing an eating disorder is not your fault, and you deserve support. Binge eating disorder has nothing to do with a lack of “willpower”; it is a mental illness deserving of help, treatment, and recovery. If you or someone you know is struggling with binge eating, compulsive overeating, or has been diagnosed with BED and needs support, we at SD Nutrition Group can help. Please find our contact info here. We would love to discuss how we can support you in your recovery.
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