One of the binge eating facts many people do not know is that binge eating disorder (BED) was only recently recognized as a separate and distinct eating disorder diagnosis by the American Psychiatric Association. Prior to 2013, BED was under the umbrella of Eating Disorder Not Otherwise Specified (EDNOS, now OSFED). Bulimia nervosa and BED share the same binge symptoms, but differ in that in BED compensatory/purging behaviors are not present. Depending on which source you use it is estimated between 4 and 9 million American suffer from BED.
Binge Eating Facts
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which informs diagnosis and treatment of all eating disorders, binge eating disorder is characterized by episodes of binge eating (with a frequency of at least once per week for three months). The amount of food consumed is larger than what most people would eat under the same circumstances and in the same time frame and is characterized by a lack of control over the food consumption. Eating is often done secretively and, those affected often eat until they are uncomfortably full. Sufferers typically feel great shame, self-loathing, disgust, and guilt after a binge.
Lizabeth Wesely-Casella, founder of Binge Behavior provides additional insight on the negative emotions involved in BED by sharing that those who engage in binge eating often describe feelings of shame or unworthiness after eating a moderate or even small portion of food when they are actively struggling with their eating disorder. It is the feeling of shame after eating that is important.
Causes of Binge Eating Disorder
As with all eating disorders, binge eating disorder is the result of a complex interplay of genetics and environmental factors. Environmental risk factors for the development/triggering of BED include dieting, weight suppression (the difference between a person’s current weight and highest weight) mood disorders, depression, anxiety, addictions, bullying (especially surrounding weight), abuse or neglect, troubled relationships, sexual trauma and other environmental influences.
Results of a study conducted in 2006 suggested, that during the year prior to the onset of disturbed eating, people with BED experience a larger than usual number of stressful events in their lives, and that these events were usually interpersonal in nature. Future studies could look into the psychobiological mechanisms that facilitate the connection between life stress and the cause of BED.
Binge-eating disorder can increase risk for a multitude of health complications including:
- Heart disease
- High blood pressure
- Certain types of cancers
- Joint diseases
- Gallbladder disease
- Mobility issues
- Trouble sleeping
- Shortness of breath
- Menstrual problems
As with all eating disorders, health complications can occur in bodies of all sizes. It is important for those affected to receive treatment for their BED.
As with bulimia, Cognitive Behavioral Therapy has strong evidence for efficacy, as do Interpersonal Psychotherapy and Dialectical Behavioral Therapy. Behavioral Weight Loss therapy has not yet shown the same effectiveness, especially when behaviors are intense and frequent. Guided self help may help some individuals with binge eating. In January of 2015 the FDA approved a drug therapy specifically for BED, Vyvanse or lisdexamfetamine dimesylate. Antidepressants are a common adjunct treatment along with therapy. Researchers are working to learn more about the neural pathways involved in eating disorders, including BED.
Challenging the stereotype that eating disorders happen only in white females or that obesity is a sign of laziness and gluttony is an important part of the work being done in eating disorder advocacy in general and around BED in particular. In contrast to other eating disorders, BED affects males and females at similar rates. Research on non-Western populations is limited and sorely needed. Many people, including medical professionals, have misconceptions about eating disorders including BED. This can require sufferers to do their own research and advocate for themselves with their physician.
Because Binge Eating Disorder is a newer diagnosis there are fewer specialists who treat BED specifically. You may need to interview several specialists before you find someone knowledgeable. The National Eating Disorder Association (NEDA) is working to increase clinician education through their conferences and also maintains a database of clinicians and treatment centers knowledgeable about BED.
BEDA – Binge Eating Disorder Association. (n.d.). Retrieved August 30, 2015.
Pike, K. M., Wilfley, D., Hilbert, A., Fairburn, C. G., Dohm, F.-A., & Striegel-Moore, R. H.
(2006). Antecedent life events of binge-eating disorder. Psychiatry
Research, 142(1), 19–29.
What You Should Know About Binge Eating Disorder: 3 Doctors Discuss. (n.d.).
Retrieved August 30, 2015.
About The Author:
JD Ouellette is an educator and the mother of a young adult in strong recovery from anorexia. She is a member of the UCSD Eating Disorders Center’s Parent Advisory Committee, a parent mentor for UCSD, an active member of Eating Disorder Parent Support, a co-ed online support community, and co-administrates International Eating Disorder Action and a member of the Joint Commission’s Behavioral Health Care Professional and Technical Advisory Committee.
Written – 2015