What is Binge-Eating Disorder?

Binge-eating disorder (or BED) is characterized by regularly and compulsively eating large amounts of food, often rapidly, and to the point of discomfort or pain from an overfilled stomach. It affects more than 3.5% of women and 2% of men in the United States, making it the most common eating disorder in the country.

Binge eaters are emotional over-eaters. While other disorders are typically twice as common in women, BED is less discriminatory— roughly 40% of those with the condition are men. In women, it most commonly occurs in early adulthood; in men, as they reach middle age. BED affects people of every age, gender, race, ethnicity, body type, and cultural background. Most, but not all, who suffer from BED are overweight.

One factor that distinguishes BED from normal, occasional overeating is a feeling that you have no control over your eating habits. You may eat too much, too quickly, when you are not hungry, and even continue eating after you’re full to the point of discomfort. You may try to eat in alone or secretly in order to hide how much you’re eating, and feel embarrassment, shame, or guilt about your eating behavior. Although you vow to stop, you find yourself binge eating again and again. If you experience this type of binge eating at least once a week for three consecutive months, you may be diagnosed with BED.

What is the Difference Between BED and Bulimia?

Bulimia is characterized by overeating and purging, or trying to compensate for consuming too many calories by vomiting, using laxatives or overexercising. If you have BED, you don’t routinely use any of these methods to try to “undo” any weight gain you might experience from overeating. But even though it is uncommon, you can have BED and not be overweight, thanks to your individual genetic makeup or a particularly fast metabolism.

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What Causes BED?

Although BED is associated with underlying emotional issues, the exact cause is unknown. The condition can likely be attributed to a combination of psychological, behavioral, and environmental influences. Some known factors that can increase your risk of developing BED include:

  • A family history of eating disorders. If your parent or siblings have, or had, an eating disorder, you are at a greater risk of developing one.
  • A history of psychological issues or negative self-worth. Certain thought patterns and mood disorders are closely associated with BED, including depression, anger, anxiety, a strong need to be in control, perfectionism and rigidity, a need to please others, and negative feelings about yourself, your body, and your accomplishments.
  • A history of dieting. While people with BED have a range of body types, they often have a long history of restricting calories.
  • Significant loss, relationship problems or traumatic experiences. BED can be a way of trying to deal with stress and distance yourself from emotional pain.
  • Experiences with sexual abuse, physical abuse, weight discrimination, and/or bullying. Studies have found that people with BED and other eating disorders often report a personal history of abusive events. 1

How BED Affects Your Health and Well-Being

BED stems from, and can cause, a variety of emotional, physical, and psychological issues. You may ultimately experience physical complications such as:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Type II diabetes
  • Gallbladder disease
  • Fatigue
  • Joint and muscle pain
  • Osteoarthritis
  • Certain cancers
  • Sleep apnea

You may also experience psychological and emotional conditions that are often linked with BED, including:

  • Feeling bad about yourself or your life
  • Poor quality of life
  • Problems functioning at work, in your personal life, or while socializing
  • Anxiety, depression, bipolar disorder, and substance abuse disorder

Where to Get Help and What to Expect

BED is an illness that requires proper diagnoses and treatment. You didn’t choose to have the condition, but you can choose to seek advise and get medical attention, if necessary, as soon as you recognize the symptoms. Left untreated, BED can steadily get worse and, in extreme cases, can also be life-threatening.

If you don’t already have a mental health care provider, you can start by speaking to your primary care physician. Describe your binge eating symptoms, and the feelings that you associate with your behavior. It may be helpful to make a list of symptoms that you are experiencing before the appointment. Be sure to include all relevant personal information, like any family history of eating disorders, major stress, recent life changes, and a typical day’s eating patterns. In addition to a physical exam, including tests to evaluate whether you are suffering any physical effects from binge eating, your physician may ask questions about your daily food habits, your thoughts and your thoughts and feelings about your weight and appearance. Don’t hesitate to discuss your emotions, thoughts, or other information that may seem unrelated to binge eating; it is important to give your provider a full picture of your mental and physical health.

If necessary, your physician should be able to refer you to a licensed mental health professional. It is important to seek treatment from someone with the appropriate education, training and experience to treat BED. Be sure you agree with their approach to treating BED and understand their proposed treatment plan and what they see as your primary goal for recovery. If you are not satisfied with their answers or feel comfortable working with this person, consider seeking a second opinion.

Mental health professionals who treat BED may draw from different styles of therapy and use various tools to help you move on to a state of recovery. The first line of treatment is usually individual cognitive behavioral therapy (CBT), one-on-one, relatively short-term talk therapy that can help you understand the connections between your thoughts, feelings, and eating behaviors. Your therapist will teach you to normalize your eating behavior and your thinking patterns, with the goal of eliminating or at least reducing episodes of binge-eating. At the same time, CBT offers tools for coping with stress and helping you address and reorient negative thinking patterns about yourself, your body type and your weight.

Some research suggests that another form of talk therapy originally developed to great depression, known as interpersonal psychotherapy (ITP), might also help people suffering from eating disorders in which binge-ing behavior is present. ITP focuses less on food behavior and more on interpersonal relationship issues that may play a role perpetuating binge-purging behaviors. Some researchers feel that identifying and resolving these relationship issues may help reduce the frequency of those behaviors. ITP may be used in place of, or in conjunction with CBT, though studies have shown CBT to be the more efficient form of therapy.

In addition to psychological counseling, other treatments and approaches can help alleviate some of the symptoms and improve the behaviors associated with BED. Antidepressant or anti-anxiety medications may be prescribed to help with mood issues and, in cases of obesity, medications that induce weight loss may be used in conjunction with CBT. A registered dietitian or clinical nutritionist can help you achieve or maintain a healthy weight by teaching you more about good nutrition and helping you develop and follow a balanced eating plan. Your health care providers may also suggest adjunctive therapies like movement classes, meditation and mindfulness instruction, yoga, equine therapy, or art therapy. These programs won’t cure BED, they can help lower your stress levels, elevate your mood, improve your body image, and teach you to have a better sense of control over your life.

Successful treatment of BED most often relies on a combination of therapeutic approaches. A team of mental health care providers, medical providers, nutrition counselors, and other experts can all contribute to a safe and effective treatment plan.

If you need help and you cannot get it from someone in your immediate support circle, call the National Eating Disorders Association helpline toll-free at 1-800-931-2237

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Last Updated: Oct 2, 2020