Binge Eating Disorder
Binge Eating Disorder (BED) is a serious and growing problem in the United States. It’s a psychiatric diagnosis that describes frequent binge-eating episodes that result in feelings of guilt, shame, and disgust.
Binge eaters often report feeling out of control during these episodes, which involve eating large amounts of food in a short period (typically within two hours).
The disorder can lead to obesity and other health problems, including cardiovascular disease, diabetes, and high blood pressure. However, people with BED can get their lives back on track with proper treatment and support.
What is an Eating Disorder?
An eating disorder is a serious and complex mental illness that can cause a person to develop extreme attitudes about food, weight, and body image—leading to an unhealthy relationship with food.
Some common symptoms of an eating disorder include:
- Excessive dieting or binging and purging
- A distorted body image
- Obsessive thoughts about weight and body size
- Intense fear of gaining weight or feeling fat, despite being underweight or average weight
- A distorted perception of hunger cues, such as feeling hungry when not hungry
Eating disorders can have serious health effects on both physical and psychological health. They often begin in adolescence and young adulthood, but they can start at any age, affecting both males and females.
Binge Eating Disorder (BED) is the most common type of eating disorder. It involves recurrent binge eating without the regular compensatory behaviors that characterize bulimia nervosa or anorexia nervosa.
People with BED will eat large amounts of food in a short period—often in secret—and feel out of control. They often feel guilty or ashamed after binge eating but continue to engage in the behavior despite this feeling.
Binge Eating Disorder VS Bulimia Nervosa
Binge Eating Disorder (BED) and bulimia nervosa are eating disorders that are often confused because they can look similar on the surface. Both disorders involve episodes of overeating—that result in feelings of discomfort, guilt, and shame.
However, there are some critical differences between each disorder:
- A person who has bulimia nervosa will engage in inappropriate compensatory behaviors after a binge episode—such as self-induced vomiting or laxative abuse—to rid themselves of calories consumed during a binge episode. However, this is not the case with binge eating disorder. Instead, people with binge eating disorders are often at risk of being obese or overweight.
- The cycle of binging and purging for bulimics can occur several times a week or even daily for some people. However, the binges can be less frequent for people with BED, depending on their severity.
- Those with bulimia also tend to obsess over their weight and body image, even though they are often of average weight. However, binge eaters’ weight or body shape is not their primary concern.
- While people suffering from both disorders often binge eat in response to negative emotions, such as stress, anxiety, or depression—bulimics are more likely to binge due to extreme dieting and overexercising.
Symptoms of Binge Eating Disorder
The symptoms of BED can be both physical and mental, and they vary from person to person. Some people experience only one or two symptoms, while others experience all of them.
It’s important to know that these symptoms are not signs of weakness or a character flaw—they’re signals that you or a loved one needs help so that you can get better.
Physical Symptoms of Binge Eating Disorder
The following are some of the physical symptoms of binge eating disorder:
Bloating is a common symptom of a binge eating disorder. It occurs because binge eaters often consume large amounts of food at one time—leading to gas production and increased pressure in the digestive tract.
This feeling of fullness in the abdomen can cause discomfort, pain, and even difficulty breathing and may last for several hours or even days.
Eating a large amount of food can cause abdominal pain because of the pressure it places on internal organs such as the stomach, intestines, and colon.
This pain usually goes away once the food has been digested; however, in some cases, it can be severe enough to require medical attention.
Fluctuations in Weight
It is not uncommon for people with BED to have a weight gain and loss pattern. It can be due to periods of excessive eating combined with periods of strict dieting—or it may result from the person intentionally starving themselves during periods when they are not binging.
Heartburn is a symptom that often accompanies binge eating disorder. It occurs when acid from food travels back up into your esophagus, causing pain in the chest area. Consuming large amounts of fatty or spicy foods can cause heartburn.
Because of high levels of fatty foods and weight gain, a binge eater may risk lacking enough oxygen due to a blocked airway. They, therefore, often develop sleep apnea—a condition where you have trouble breathing when you’re asleep.
Constipation is another physical symptom of binge eating disorder resulting from poor nutritional intake and dietary habits.
For binge eaters, it can occur because of overeating food at once and being unable to digest it properly due to a lack of fiber.
People with BED often experience intense cravings for specific types of food—such as salty snacks or fatty or sugary foods. Their cravings are also driven by other factors like stress and boredom, which can lead them to overeat even when they are not hungry.
Binge eaters often experience nausea after they have finished eating. It can be due to the physical discomfort of overeating or feelings of guilt and self-loathing that follow a binge episode.
People who binge eat may also experience diarrhea as their bodies struggle to digest large amounts of food. In some cases, it can be severe enough to cause dehydration, leading to other health problems if left untreated for too long.
Mental and Emotional Symptoms of Binge Eating Disorder
In addition to the physical symptoms of binge eating, BED can also cause mental and emotional symptoms.
Here’s an overview of some common mental and emotional symptoms of binge eating disorder:
Guilt and Shame
Many binge eaters feel ashamed and guilty after overeating or binging on unhealthy foods. They may think that they’ve let themselves down by succumbing to their cravings despite their best efforts not to.
People struggling with a binge-eating cycle often suffer from depression. They might feel like they’ve lost control over their body and eating habits, which could lead to hopelessness and despair.
Binge eaters often avoid social situations because they fear judgment from others for their behavior. They might also feel like their eating habits are too embarrassing to talk about with friends or family members—which means they don’t reach out for support when needed.
This social isolation prevents them from getting help and opens them up to a never-ending binge-eating cycle.
People with binge eating disorder often have difficulty perceiving themselves as capable. They may feel hopeless, helpless, and like they’re not in control of their lives.
Obsessive Thoughts About Food and Eating
Obsessive thoughts about food and eating are another common symptom of binge eating disorder. People with BED often think about food constantly throughout the day, leading to unhealthy behaviors like overeating or binging on unhealthy foods such as junk food or candy bars.
Loss of Control
Binge eaters may feel like they are not in control of themselves during a binge episode. During these episodes, they will often describe being “out of it” or trance-like.
Sensitivity to Comments About Food and Dieting
Binge eaters may feel like other people’s comments about their food choices or eating habits are personal and offensive. They are especially sensitive to any criticism of their weight or shape.
Using Binge Eating as a Coping Mechanism
People with BED often turn to food when feeling sad, angry, or anxious. They use binges to deal with these feelings instead of processing them in healthy ways (like talking about them with friends or family).
Obsessing Over the Next Bingeing Episode
People with Binge Eating Disorder often spend a lot of time thinking about when they can have their next binging episode. It could also include planning what food they will eat during the binge and where they’ll consume it.
Behavioral Symptoms of Binge Eating Disorder
Common behavioral symptoms of binge eating disorder include:
Disruption in Eating Patterns
The person with BED will have a disrupted pattern of eating. They may skip meals, overeat at one time or too little during other times, or eat too often.
It can lead to weight fluctuations and a feeling of hunger or fullness that may be out of proportion to their food intake.
Secret Recurring Episodes of Binge Eating
Binge eating disorder is marked by episodes where individuals consume large amounts of food quickly and often in private. The lack of control over these episodes can result in severe weight gain or obesity if left untreated.
Stealing or Hoarding Food
People with BED may find themselves stealing or hiding food so that no one else can find it—even if they’re not hungry.
Eating When Not Hungry
Binge eaters often eat when they aren’t hungry or don’t need to, which can lead to weight gain and poor health. Some people with BED eat because of boredom, anxiety, stress, or depression. Others eat because it gives them pleasure and helps them escape reality for a short time.
Eating More Rapidly Than Normal
Eating too quickly may be a sign of binge eating disorder. Some people eat so fast that they don’t realize how much food they’ve consumed until after the fact. This rapid eating can lead to overeating and eventually excessive weight gain if left unchecked over time.
Eating Too Much in a Short Period
Binge eaters may experience periods of uncontrolled and impulsive eating periods—consuming significantly more calories than what they would normally eat at one meal. It is, however, important to note that not everyone who eats a large amount of food will have BED.
Eating Until Uncomfortably Full
People with BED often feel compelled to continue eating even after they are full or may eat until they become sick from overeating.
Evidence of Binge Eating
Evidence of binge eating can mean many things: leftovers in strange places (like under the bed), wrappers found behind cushions, or a large amount of food missing from the refrigerator/pantry.
If you’ve noticed these signs in yourself or someone else, it’s important to talk to a doctor or other healthcare professional about what they mean and how they can be treated.
Causes of Binge Eating Disorder
BED is not linked to any particular cause—however, a combination of factors can contribute to its development.
It’s important to understand these factors so you can start to take steps to address them.
Risk Factors for Binge Eating Disorder
Regarding binge eating disorder, several risk factors can contribute to an individual’s likelihood of developing the condition.
Although binge eating disorder can occur at any age, it is most common in young people—beginning in the late teens or early 20s. One reason may be that they are still developing their personalities and coping skills.
People who have faced traumatic events or abuse are more likely to develop binge eating disorder later in life. Trauma/abuse can lead to feelings of powerlessness and depression, both of which can trigger unhealthy behaviors like binge eating.
Family History of Eating Disorders
Having a family member who has suffered from an eating disorder increases your risk of developing one yourself. It can be due to genetics or exposure to unhealthy attitudes about weight and body image in their home environment.
While eating disorders can affect both men and women, studies have shown that women report more cases of binge eating disorder.
Women are also more likely to turn to food when dealing with negative emotions than men, who often turn to substance abuse.
Being Overweight or Obese
Being overweight or obese can lead to low self-esteem—which may make you more prone to developing an eating disorder than someone who is at an average weight for their height and build.
Individuals who suffer from depression or anxiety may be at higher risk for binge eating disorder as it could lead them towards unhealthy coping mechanisms—like bingeing on food instead of seeking help.
Causes and Influences of Binge Eating Disorder
Several factors can cause binge eating disorders, including:
A person with low self-esteem may be more likely to develop a binge eating disorder than someone with high self-esteem. They tend to have a negative self-image, which can lead them to seek comfort in food or other substances when they feel down.
Conflicts with family members can also lead to binge eating disorder. If you’re going through a divorce or have strained relationships with your parents or siblings, it could cause your binge eating.
Poor Coping Skills
People who don’t have good coping skills may lack the ability to manage their emotions effectively when faced with stressful situations or events.
They may therefore turn to binge eating because it gives them temporary relief from these issues without having to face them head-on (e.g., talking things through with others).
If you live in a home where food is often used as a reward or comfort, you may be more likely to develop binge eating disorder later on in life. This environment can teach you that food is the best way to deal with bad feelings or stressors in life.
People who live in an environment where unhealthy foods surround them may be more likely to develop BED than those who do not.
Complications of Binge Eating Disorder
Binge eating disorder is a serious mental health condition that can devastate your physical health.
In addition to the emotional distress that comes with binge eating, several short- and long-term complications can develop due to this illness.
Short-Term Effects of Binge Eating Disorder
Binge eaters often use food to cope with emotions or stressors in their lives, which can lead them to overeat more frequently than they normally would.
The excess calories consumed during these episodes of overeating add up over time and lead to weight gain and other health problems associated with obesity—such as high blood pressure and type 2 diabetes mellitus.
Sleep apnea is a condition where a person stops breathing for certain periods while sleeping—causing them to wake up numerous times throughout the night.
This interruption can lead to excessive daytime fatigue and headaches. Because it is typically caused by high-fat foods, obesity, or other weight issues, it can be a common occurrence among binge eaters.
Lethargy and Fatigue
If you have binge eating disorder, you may experience lethargy and fatigue. One reason may be that binge eating disorder causes your body to be under chronic stress.
In addition, the high amount of sugar and fat in food items like pizza, hamburgers, and cookies can result in insulin resistance and diabetes.
Because binge eaters tend to eat foods high in sugar and sodium, they risk becoming dehydrated—which can cause headaches, muscle cramps, and dizziness. Most of the time, people confuse thirst with hunger, so staying well-hydrated can help alleviate that.
Nausea and Vomiting
Nausea and vomiting are common symptoms of binge eating disorder—because they signal the body’s attempt to eliminate excess food or unhealthy foods consumed in large quantities.
Diarrhea or Constipation
Eating large meals or overeating puts more strain on the digestive tract than it can handle—leading to digestive problems such as constipation or diarrhea.
Long-Term Effects of Binge Eating Disorder
Obesity is a common long-term complication of binge eating disorder. It’s not always the case, but many people who struggle with binge eating disorder gain a lot of weight. It can lead to serious health problems, like heart disease and diabetes.
People who binge eat are more likely to have insulin resistance—the inability of cells in the body to use insulin efficiently—it can be brought on by a diet high in fats and sugars.
The increased levels of insulin that occur during a binge episode can cause binge eaters to develop type 2 diabetes over time if left untreated.
Women who struggle with binge eating disorder may have difficulty getting pregnant. They are at a higher risk of developing hormonal imbalances, which can result in irregular menstrual cycles and blocked ovulations—resulting in infertility.
The elevated fat and sodium levels that result from binge eating increase the risk of high blood pressure and high cholesterol—which raises the risk of a stroke or a heart attack.
Osteoarthritis is a degenerative joint disease that causes pain, stiffness, and limited mobility of the joints. It most often affects the weight-bearing joints such as hips, knees, and ankles.
People with binge eating disorder are at a higher risk for developing osteoarthritis because they are more likely to be overweight or obese than people without BED. It can lead to extra strain on joints during daily activities and make them more susceptible to injury.
The gallbladder is a small organ that stores bile, a fluid made by the liver that helps break down and absorb fats from food.
Gallstones are solid pieces of cholesterol and calcium that form in the gallbladder. People with binge eating disorder may develop gallstones because they eat so much fat and cholesterol.
Binge Eating Disorder Statistics
- Based on a national survey, an estimated 2.8 million U.S. adults suffer from binge eating disorder—more than the combined number of people with anorexia or bulimia nervosa.
- DSM-IV estimates of the lifetime prevalence of anorexia nervosa, bulimia nervosa, and binge eating disorder among women are 0.9%, 1.5%, and 3.5%. These numbers are 0.3%, 0.5%, and 2% among men.
- Research by National Eating Disorders Association reveals that:
- BED is often first noticed in the late teens or early 20s, although people of all ages can suffer from it.
- About 30% of people who seek weight-loss treatments have symptoms that meet the criteria for binge eating disorder.
- Of the people diagnosed with binge eating disorder, 28.4% are receiving treatment for it.
- Binge eating disorder affects women from different races and ethnicities. However, it’s particularly common among Hispanic, Asian-American, and African-American women—according to the Office on Women’s Health.
- According to Statista, binge eating disorder was responsible for more than 30% of deaths due to eating disorders in the U.S. in 2018 and 2019.
Binge Eating Disorder Diagnosis
If you think you may be suffering from binge eating disorder, getting help as soon as possible is important. The first step in receiving treatment for binge eating disorder is to visit a doctor who can diagnose the condition and prescribe an effective treatment plan.
DSM-5 Binge Eating Disorder Criteria
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists several criteria for a BED diagnosis:
- Recurrent binge-eating episodes featuring both of the following:
- Eating more food in a short period (during any 2-hour period) than most people would eat given the same amount of time and similar circumstances.
- The feeling that one has no control over what or how much one eats during the episode.
- Binge-eating episodes should be associated with at least three of the following:
- Eating food at a much faster rate than usual.
- Eating until uncomfortably full.
- Eating when not feeling physically hungry, often in large amounts.
- Eating alone because of embarrassment over how much food one is consuming.
- A feeling of guilt, disgust, and depression after the act
- Clear signs of distress when binge eating.
- Binge eating occurs, on average, once every week for at least three months.
- Binge eating occurs without the regular use of compensatory behaviors such as purging seen in bulimia nervosa. It should also not occur exclusively during episodes of anorexia nervosa and bulimia nervosa.
According to the DSM-5, the severity grading for binge eating disorder includes:
- Mild: 1 to 3 episodes per week
- Moderate: 4 to 7 episodes per week
- Severe: 8 to 13 episodes per week
- Extreme: 14 or more episodes per week
Physical Examination for Diagnosing BED
A physical examination is usually the first step in diagnosing binge eating disorder. The test will include an assessment of your weight and height, plus any other medical conditions that might be contributing to your symptoms. The doctor will also ask about your medical history and family history.
During the physical examination, the doctor will check your vital signs, including:
- Pulse rate
- Blood pressure
- Breathing rate
- Blood glucose levels
The test results will help your doctor determine the next steps in treating your condition.
Psychiatric Interview to Diagnose BED
A healthcare professional, such as a psychologist or psychiatrist, will conduct a psychiatric interview.
During the interview, your doctor will ask questions about your symptoms, your family history of mental health problems, and any traumatic experiences you’ve had in the past.
The psychologist or psychiatrist will also ask questions about the following:
- Age of onset of the eating disorder
- Frequency and duration of binge eating
- Substance use
- Sleep patterns
- Mood changes
- Mental health conditions like depression or anxiety
This type of interview aims to gather as much information as possible so they can make an accurate diagnosis.
The interviewer may also ask you to complete standardized tests designed to measure the severity of your BED symptoms and determine whether or not you meet the diagnostic criteria for BED.
If the psychiatric interview suggests that you may have BED, the interviewer will likely recommend further evaluation using specific assessment tools for eating disorders.
Here are some common tools used to evaluate binge eating disorder:
- Binge eating scale
- Three-factor eating questionnaire
- Body shape questionnaire
- Eating disorders examination (EDE)
Blood Tests and Other Assessments
Blood tests can screen for conditions that may have developed due to binge eating, such as diabetes and hypothyroidism. These tests also help to rule out other causes of your symptoms.
A doctor may perform blood tests to check for the following:
- High blood sugar levels (hyperglycemia)
- Low levels of thyroid hormones (hypothyroidism)
- High levels of triglycerides, a type of fat found in the blood
Treatment for Binge Eating Disorder
Treatment for binge eating disorder may include:
Psychotherapy can help you learn how to deal with the stress and emotions that lead to binges—as well as any underlying issues that may cause or contribute to the problem.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a form of psychotherapy used to treat BED. This therapy focuses on the relationship between thoughts, feelings, and behaviors—helping people understand their eating behaviors and put them into perspective.
CBT teaches patients to recognize their unhealthy habits and change them to manage their emotions more effectively.
Interpersonal Psychotherapy (IPT)
IPT focuses on relationships between people. It helps patients identify interpersonal problems contributing to their eating disorder symptoms—so they can address these issues directly through communication.
Dialectical Behavioral Therapy (DBT)
DBT teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills help individuals cope with difficult emotions, stressors, and problematic behaviors.
Binge eating disorder can cause serious health problems if left untreated for too long. Medical care is, therefore, essential when treating patients suffering from this disorder. The staff will closely monitor your health during this time and provide treatment if necessary.
Patients with BED may need nutritional counseling to help them learn about portion sizes and healthy eating habits to prevent future episodes of binge eating. A nutritionist can help you create an individualized plan based on your needs and goals—so you can stick with it.
Your doctor may prescribe medications—including antidepressants and mood stabilizers—to help control symptoms of depression or anxiety accompanying BED. However, medication is only used in conjunction with other treatments, such as psychotherapy, for effective recovery.
Obesity or Weight Loss Treatment
Treatment for obesity is often necessary for people with BED to lose weight and improve their health. Weight loss can help avoid complications associated with obesity, such as hypertension and diabetes mellitus.
You can improve your self-confidence and self-esteem by getting the right nutrition, exercising regularly, and monitoring your weight.
How Friends and Family Members Can Help
Friends and family members are a great source of support for people with binge eating disorder. You can help your loved one stay motivated to make healthy changes and encourage them to keep going when things get tough.
But it’s not always easy to understand what someone with binge eating disorder is going through. So here are some tips for how best to help:
What to Do to Help:
- Understand what binge eating disorder is and how it affects your loved one.
- Encourage your loved one to seek professional help. If they are not ready, you may need to be patient with them while gently advising them on the benefits of treatment.
- Listen without judgment and ensure you get the right kind of help—so they can succeed with the treatment plan.
- Be supportive of their efforts to seek treatment for their BED, even if you don’t understand why they have this illness.
- Encourage your loved one to maintain a healthy lifestyle so that they can get the most out of their recovery process.
- Focus on being there for them as they work through their feelings and learn healthier ways of coping with stress.
What NOT to do:
- Don’t try to fix your loved one’s problem—instead, encourage them to get help from a professional.
- Don’t criticize or judge your loved one with binge eating disorder—they are already dealing with a lot.
- Don’t ask your loved one to change their eating habits. People with binge eating disorder may want to change their eating habits but can’t do it on their own—they need professional help.
- Don’t give up on them or walk away if they don’t change their behavior immediately.
- Don’t make comments about weight gain or weight loss.
- Don’t restrict what your loved one eats; instead, try to focus on making healthy food choices available and accessible for them.
Get Help for Binge Eating Disorder
Binge eating disorder is a serious condition that, if left untreated, could lead to health problems and behavioral difficulties. Fortunately, treatment options are available that can help you or your loved one reclaim your life.
Talk to your doctor or mental healthcare provider if you suspect you or a loved one may have a binge eating disorder.
Frequently Asked Questions About Binge Eating Disorder
What is the difference between binge eating disorder and bulimia?
Binge eating disorder and bulimia are two different types of eating disorders. Both conditions involve frequent episodes of overeating—but with binge eating disorder, these episodes don’t occur as frequently as in bulimia and don’t involve purging or other compensatory behaviors.
With bulimia, on the other hand, an individual will regularly eat large amounts of food and engage in inappropriate compensatory behavior (such as purging) afterward.
How common is binge eating disorder?
Binge eating disorder affects up to 2.8 million adults in the United States. It can affect people of any age or gender, though it’s more common in women than men.
Why do people develop binge eating disorder?
The exact cause of binge eating disorder is unknown, but several factors may contribute to the development of binge eating disorder, including:
- Genetics (family history of eating disorders)
- History of trauma or abuse
- Mental disorders such as anxiety or depression
- Poor coping mechanisms
- Being overweight or obese
- Family conflicts
How does binge eating disorder affect the brain?
Generally, overeating is attributed to either heightened reward sensitivity, diminished self-control, or a combination of the two—according to a study by the National Library of Medicine.
Most studies of the brain pathways determining eating behavior in BED patients compare the latter to weight-matched controls and lean participants. Overall, people with binge eating disorder display decreased inhibitory control and increased sensitivity to reward.
What are some common warning signs that someone has binge eating disorder?
Some common warning signs that someone has binge eating disorder include:
- Feeling out of control while eating
- Eating food at a much faster rate than usual
- Eating until uncomfortably full
- Eating when not feeling hungry, often in large amounts.
- Eating alone because of embarrassment over how much food one is consuming
- Feeling guilty, disgusted, and depressed after the act