What is Binge Eating Disorder?

Discussion of eating disorders often center around people whose disordered eating causes them to lose unhealthy quantities of weight or puts them in danger of malnourishment. However, about 5% of people with an eating disorder suffer from binge eating disorder (BED), a disorder that causes them to eat large and unhealthy quantities of food in a short period of time.

What is Binge Eating Disorder?

Although binge eating disorder has been recognized by many doctors since the 1950s, it's a new addition to the DSM-5, psychiatry's bible. People with binge eating disorder feel like they have little control over their binges, causing them to eat large quantities of food in a short period of time, often to cope with emotional distress. Unlike people with bulimia, who often vomit or use laxatives after binging, people with binge eating disorder do not use purging as a way to counteract their binge. 

Symptoms of binge eating disorder include:

• Recurrent episodes of binge eating. Everyone eats more than they should on occasion, but if binge eating is a weekly occurrence, it may suggest BED.
• Extreme and unhealthy binging. While some people might refer to a night spent eating cookies as a binge, people with BED may consume thousands of calories in a very short period of time; eating a single cookie or a small carton of ice cream doesn't typically denote binge eating disorder.
• Eating past the point of uncomfortable fullness. Individuals with BED will continue eating, even after they are physically very full, often due to emotional distress.
• Eating more rapidly than you otherwise eat. People with BED may not even notice the taste of their food, or may be so distracted by consuming food as quickly as possible that they don't notice the other physical sensations of eating.
• Eating even though you are not hungry.
• Feeling guilty or ashamed after binge eating.
• Eating outside the presence of others, or binging only when other people aren't' around.

When binge eating is accompanied by purging or occurs alongside extreme calorie restrictions, a diagnosis with anorexia or bulimia is frequently more appropriate.

Causes of binge eating disorder

We live in a world driven by food consumption. We're all subject to constant food marketing that features high-resolution images of tasty, yet usually unhealthy, food items. For people who use food to cope with emotional distress, our food-saturated culture can be a trigger for binging, though it is not the sole cause. Most research into eating disorders has focused on anorexia and bulimia, so researchers know much less about BED. 

Some potential causes of the disorder include:

• Psychological disorders and stress. Some people cope with stress by eating, and at periods of high stress or when a mental health issue is left untreated, these people may resort to binge eating.
• Rigid dieting practices. Our culture idolizes thinness and devalues people who are overweight. Asa result, many people – specifically women – are constantly trying to lose excess weight. Research has shown that restrictive diets can cause some people to react with binge eating.
• Age and sex. Women are more likely to develop BED, as are people in their 40s and 50s. This distinguishes the disorder from other eating disorders, which are most common among young women.
• Societal pressure. People who are under strong pressure to lose weight may react to this pressure by binging.
• Biological factors. Individual brain chemistry and even one’s genetics may influence the likelihood of developing binge eating disorder.

The risks of binge eating

Binge eating disorder poses serious health consequences, the most obvious of which is an increase in weight. Frequent bingers are at risk of gaining large quantities of weight, thus increasing their risk for a host of conditions, including arthritis, osteoporosis, diabetes, high blood pressure, cardiovascular challenges, and gall bladder dysfunction. People who binge eat frequently may also experience guilt and shame surrounding their binging, and may also develop low self-esteem or hatred of their own bodies.

Because binge eating disorder can result in weight gain, it also subjects people with the disorder to social sanctions. Research has repeatedly shown that society discriminates against people based on their weight in many ways, including by offering overweight people fewer jobs and lower wages. Overweight people are also more vulnerable to bullying, and some overweight people report that their doctors blame every symptom they have on their weight, making it more difficult for overweight people to get quality and accurate health care.

Treatment for binge eating disorder

Treatment for BED is similar to treatment protocols used for other eating disorders. Because BED can wreak serious physical havoc, treatment should begin with ensuring stability and undoing any major health concerns. For example, a patient with BED may need medication to regulate diabetes or assistance controlling blood pressure. Sometimes patients with BED are malnourished because they only binge on ‘junk’ foods. These foods usually contain a high number of calories, carbohydrates, and processed sugars. When this occurs, it may necessitate nutritional interventions. Regardless of a patient with BED's nutritional status, though, most need help with nutritional counseling and dietary choices.

Therapy can be highly effective at treating BED. In therapy, an individual will work to uncover the reasons they binge eat, while implementing strategies to cope with emotional distress and food cravings. Cognitive-behavioral therapy, which helps one to manage their emotions and understand how they may affect their behavior, and dialectical-behavioral therapy, which boosts one's ability to tolerate distress and choose healthy coping mechanisms, are both particularly helpful.  In addition, some newer medication options are available and the research looks promising.

If you or someone you love suffers from an eating disorder, you can get help now by contacting the National Eating Disorders Association's helpline at 1-800-931-2237.

References:

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4. Marx, R. (2013, June 5). New in the DSM-5: Binge eating disorder. Retrieved from http://www.nationaleatingdisorders.org/new-dsm-5-binge-eating-disorder
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