What's to know about binge eating disorder?
It can affect both men and women, it often affects people in their teens and early adulthood, and there is a strong link with low self-esteem.
For a person with a binge eating disorder, eating and the cycle of guilt and binge eating can be a way of dealing with emotional problems. It is a symptom of an underlying condition.
Treatment can help the person find a new way to approach these issues as well as ways of controlling their eating.
According to the Office on Women's Health, binge eating is the most common type of eating disorder in the United States.
What is binge eating disorder?
Both males and females can have binge eating disorder.
Most people occasionally overeat, especially on holidays or at festive celebrations. This is not a sign of binge eating disorder.
Binge eating becomes a disorder when it occurs regularly, and the person starts to feel shame and a desire for secrecy about their eating habits.
Unlike eating for pleasure, it tends to stem from an unresolved emotional or mental health issue or sometimes a medical condition.
One study suggests that binge eating disorder affects up to 3.5 percent of females in the U.S. and 2 percent of males.
One source suggests that 40 percent or more of people with binge eating disorder are male.
A person who has binge eating disorder regularly consumes large and unhealthful amounts of food.
The American Psychological Association's (APA) Diagnostic and Statistical Manual, fifth edition (DSM–5), added binge eating disorder to its list of mental health diagnoses in 2013.
The main criteria are as follows:
The individual recurrently and persistently engaging in binge eating.
Episodes of binge eating involve:
- eating much more quickly than usual
- eating until the person feels too full
- eating a lot when not hungry
- eating alone, due to embarrassment about the quantity
- feeling disgusted, depressed, or guilty after eating
For a diagnosis of binge eating disorder, the person must binge eat at least once a week for 3 months or more, according to the DSM–5.
A person with binge eating disorder may also:
- feel that the eating behavior is uncontrollable
- diet frequently but find it difficult to keep to the diet or to lose weight
- plan a binge and buy special food in advance
- hoard food
- hide empty food containers
- have feelings of panic, a lack of focus, anxiety, and despair
The U.S. National Eating Disorder Association (NEDA), mention a study that found that 36.8 percent of women who were in the hospital during treatment for an eating disorder engaged in self-harm.
Eating disorders and mental health
Stress and anxiety can be triggers for a binge eating disorder.
Binge eating disorder often stems from an underlying mental health problem.
Conditions that commonly occur with binge eating include:
- mood and anxiety disorders
- major depressive disorder
- obsessive-compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD)
- alcohol or substance use disorder
- borderline personality disorder
It can also lead to further emotional challenges. The individual may experience a cycle of guilt in which they:
- feel despair at being trapped in a binge
- feel guilt
- attempt self-discipline
- engage in another binge
Low self-esteem is a common underlying factor with eating disorders, including binge eating. A binge can lead to self-blame and further damage to self-esteem.
When to see a doctor
Binge eating can seriously impact a person's mental and physical health.
Anyone who notices that they have a compulsion to eat large amounts of food should see a doctor, even if their weight is healthy.
A doctor may also do some tests to check for additional medical conditions, such as heart or gallbladder problems. These and other issues can result from binge eating.
People often find it hard to tell someone — including a doctor — that they have a binge eating disorder. However, treatment can help to resolve both the uncontrolled eating habits and any underlying emotional issues that may be causing them.
The person may have feelings of embarrassment and isolation. Addressing underlying issues, such as anxiety and depression, can help to solve the problem.
The exact cause of binge eating disorder is not clear, but biological factors, personality traits, and environmental influences — such as body shaming — may all contribute.
Researchers have linked a number of risk factors with binge eating disorder:
Age: Binge eating disorder can happen at any age, but the first signs of binge often start in the late teens or early twenties. A study of college students found that binge eating disorder is relatively common among men as well as women, and it may go together with excessive exercising and concern about body image.
Personal and family history: Body shaming, in which a person receives criticism for their body shape or size, appears to increase the risk of an eating disorder, including binge eating. If the individual has had another eating disorder, depression, or any type of addiction, this, too, may increase the risk.
Other eating disorders: People who have or have had another eating disorder, such as anorexia or bulimia, have at a higher risk of developing binge eating disorder.
Related conditions: Some medical conditions, such as Prader-Willi syndrome, can trigger binge eating. This syndrome affects the hypothalamus gland and, as a result, the production of hormones, including a mechanism that controls appetite. The person's body does not tell them when they are full, and so they continue to eat.
Dieting: According to the OWH, women who diet are 12 times more likely to have a binge eating disorder compared with those who do not diet. Some people with an eating disorder have never dieted, while others have a history of dieting. More studies are needed to confirm dieting as a risk factor.
Mental health issues: People with binge eating disorder feel that they lack control over their eating. It is not uncommon also to have problems coping with stress, anxiety, anger, sadness, boredom, and worry, and there may be a link with depression.
Personality traits: Being a perfectionist or having an obsessive personality type or disorder, such as obsessive-compulsive disorder (OCD) can make an eating disorder more likely.
Sexual abuse: Some people with the disorder report experiencing sexual abuse when they were young. NEDA quotes statistics suggesting that up to 35 percent of females and 16 percent of males with a binge eating disorder had experienced sexual trauma.
Society's expectations: The focus of the media, including social media, on body shape, appearance, and weight may be a trigger for binge eating disorder. An intense focus on being slim, possibly due to social or professional pressure, may increase the risk.
Biology: Biological and genetic factors may play a role. The impact of genetic changes on appetite may affect a person's eating habits. Some researchers believe that gut microbiota may have an impact.
Treatment usually aims to:
- reduce the frequency of binges
- improve emotional well-being
Treatment for an eating disorder often involves several aspects.
Talking therapy can help a person to address feelings such as guilt, shame, and low self-esteem, as well as anxiety, depression, and other issues.
Cognitive behavioral therapy (CBT) can teach people new ways to approach and resolve conflicts and other challenges. Nutritional counseling can help a person to develop more healthful ways of eating.
A selective serotonin reuptake inhibitor (SSRI) antidepressant, such as Prozac, may help if a person has an underlying condition, such as depression, social phobia, obsessive-compulsive disorder (OCD). The doctor may also prescribe appetite suppressants.
Support groups: Joining and attending self-help and support groups can help to remove a sense of isolation.
Weight control: The main focus of treatment is to address the mental health issues that underlie the condition. However, developing healthful eating habits will also help the person to lose weight in the long term, if necessary.
However, the United Kingdom's (UK) National Health Service (NHS) advise people not to diet during treatment, as it can complicate treatment and make symptoms worse.
Eating little and often and keeping a food diary may help to prevent binge eating disorder.
There is no way to prevent binge eating disorder, but individuals who feel they are are at risk can take steps to reduce the risk and to prevent complications.
An eating disorder can be very serious and detrimental to a person's health, and anyone experiencing signs of a problem should consider seeking medical help.
The following may help an individual who is at risk of the disorder to control their eating:
- Keeping a food diary: This can help a person to identify whether they have a problem with their food consumption, and, if so, which eating patterns, or types of food, tend to trigger a sudden and false sense of hunger.
- Eating low-sugar foods: Foods with a low glycemic index will release sugar more slowly and more consistently throughout the day. Sugary foods, alcohol, and caffeine can all contribute to glucose fluctuations.
- Less food, more often: Consuming smaller meals more frequently can help to maintain a sense of fullness throughout the day and prevent blood sugar spikes, which are a risk factor for diabetes.
The American Psychological Association (APA) urge anyone who is concerned that they may have a binge-eating disorder to seek help from a licensed psychologist who specializes in eating disorders.
Is it important to seek help because the consequences of any eating disorder, including binge eating, can be serious, but treatment — although it can take time — can help.