Binge Eating Disorder

Binge eating disorder is characterized by repeated and uncontrollable bouts of consuming abnormally large amounts of food.¹ This behavior often results in feelings of guilt, disgust, or depression and causes the person engaging in the behavior significant distress.¹ For many people, this behavior begins after being exposed to certain stressors earlier in life.² However, many do not seek treatment for binge eating disorder and instead suffer with this illness in silence.³

The following is a list of notable binge eating disorder statistics:^3,4,5

• Binge eating disorder is the most common eating disorder in the United States.
• 2.8% of American adults will struggle with binge eating disorder in their lifetime.
• Eating disorders have the highest mortality rates of any mental disorder.
• Many people who are suffering from binge eating disorder will have at least one medical diagnosis that could be life-threatening.
• At least 50% of the risk for developing binge eating disorder is genetic.
• Almost 50% of people with binge eating disorder suffer from some sort of mood disorder, such as depression or bipolar disorder.
• More than 50% of people struggling with binge eating disorder have an anxiety disorder, most commonly generalized anxiety disorder.
• 1 in 10 people who have binge eating disorder also abuse substances, most often alcohol.
• Less than half (43%) of people dealing with a binge eating disorder seek treatment. 

How Does It Develop?

Binge eating disorder has only recently been recognized by the American Psychiatric Association as a distinct, clinically significant mental health disorder.¹ Because of this, researchers and clinicians should know more about the causes and development of the disorder within the next few years with the help of newly funded research. However, right now that information is limited.²

The research that has been done begins to explain some of the risk factors that increase the likelihood of someone developing a binge eating disorder at some point, including:^2,5 

• Genetics: If you have a family member who has had binge eating disorder, then you are more likely to experience it as well.
• Style of parenting: Children who grow up in homes where parents were not involved or affectionate but were highly critical of their children’s weight are more likely to struggle with binge eating.
• Social: People who have been bullied, teased, or discriminated against because of their weight are more at risk of binge eating disorder.
• Eating patterns: Those who practice dieting, irregular eating, or restrictive eating patterns are more likely to have a binge eating disorder.
• Mental health: Anyone who deals with a mood disorder, anxiety disorder, or substance abuse disorder is more likely to engage in binge eating.
• Trauma: Those who have experienced sexual, physical, emotional abuse, or neglect, or any other significant trauma are more likely to have a binge eating disorder at some point in their life.

If you identify with many or all of the above risk factors, it does not necessarily mean that you will suffer from a binge eating disorder.

This is not meant to be a comprehensive list, so if you do not identify with any of the above risk factors, that does not mean that you will not ever suffer from a binge eating disorder. Likewise, if you identify with many or all of the above risk factors, it does not necessarily mean that you will suffer from a binge eating disorder at some point in your life. Since the causes of binge eating disorders are not fully understood, just like any other mental health issue, binge eating is a very personal experience. 

Signs and Symptoms

According the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is used by clinicians to diagnose and treat mental health disorders, a binge eating disorder involves recurring episodes of binge eating that are characterized by:¹

• Consuming an amount of food that is abnormally large for the average person.
• Consuming that food in a very short time, usually a period of 2 hours or less.
• A sense of loss of control over eating while excessively consuming the food.

Loss of control, while an easy enough concept to understand, is much more specific as it relates to a binge eating disorder episode.¹ Loss of control is defined by the DSM-5 as having at least 3 of the following 5 symptoms:¹

• Consuming food faster than normal
• Consuming food until you are uncomfortably full
• Consuming large amounts of food even when you are not hungry
• Isolating yourself from other people when consuming food out of embarrassment
• Feeling depressed, guilty, or disgusted after binge eating

This binge eating behavior must happen at least once per week over a period of at least 3 months and cause significant distress to the person engaging in the binge eating behavior to be considered a diagnosable condition.¹

In addition to the clinical signs and symptoms of a binge eating disorder, binge eating disorder can cause extreme physical damage the longer a person engages in the behavior.⁵ This damage can range from mild and uncomfortable to severe and life-threatening.⁵ Some of the known medical complications that result from prolonged binge eating include:⁵

• Type 2 diabetes.
• High cholesterol.
• High blood pressure.
• Joint and muscle pains.
• Gastrointestinal problems.
• Sleep apnea.
• Osteoarthritis.
• Gallbladder disease.
• Heart disease.
• Certain types of cancer.
• Polycystic ovary syndrome.

While binge eating disorder shares most of its characteristics with bulimia, it is different in that people who are binge eating do not behave in ways to compensate for their binge eating episodes.¹ Compensatory behavior would be anything that is meant to offset the potential weight gain from the binge eating episodes.¹ Whereas a person who has bulimia may abuse laxatives or make themselves vomit in order to get rid of part of the caloric load from a binge, people with binge eating disorder will not do this on a regular basis.¹ This is not to say that someone with binge eating disorder will never vomit or use laxatives after a binge eating episode; it just won’t happen on a regular basis like it would for someone with bulimia.¹ 

Treatment Options

It is estimated that anywhere from 10-50% of people who have an eating disorder and do not seek treatment will relapse at some point in their lifetime.⁶ This fact, combined with the damaging psychological and physical effects of binge eating disorders, makes treatment and aftercare an essential part of recovering from the disease. If you’re seeking help for binge eating, you have many options available to you, including: 

• Inpatient Treatment: For binge eating, inpatient treatment may begin at a medical center if there are medical issues that need to be stabilized, or at a residential mental health treatment center. Medical inpatient focuses only on stabilizing medical complications, while residential mental health can help you begin to resolve the binge eating behaviors and any mental health issues that may be driving the disorder. Residential treatment typically provides group, individual, family, nutritional, and recreational therapy.
• Partial Hospitalization (PHP)/Intensive Outpatient (IOP): PHP and IOP are intensive group therapy provided on an outpatient basis. PHP is a full-day program with medication management provided, while IOP is typically a half day without medication management.
• Individual Therapy: When dealing with binge eating, it is important to find someone who is trained and experienced in counseling people with eating disorders. Cognitive-behavioral therapy for eating disorders is the modality that has been proven most effective; it helps you understand what is driving the eating disorder, what negative patterns, thoughts, and triggers are associated with the eating disorder, and how to prevent a relapse.⁷
• Psychiatrist or psychiatric nurse practitioner (NP): Many people recovering from eating disorders suffer from depression, anxiety-related disorders, and substance abuse.^2,5 Psychiatric professionals, either at the doctorate or NP level, can help you with these common psychiatric symptoms. This is important because untreated anxiety or depression can drive a relapse to an eating disorder or substance use and can interfere with your ability to follow an aftercare plan. The use of psychiatric medications does not always have to be permanent, but having them as part of your arsenal while in the acute stages of recovery can help.
• Group Therapy: Group therapy is an important piece of inpatient, outpatient, and aftercare treatment. Group therapy can help you to slowly build interpersonal trust, which can eventually extend beyond the group setting. Group therapy also provides an environment where others understand what you are dealing with and will not judge you, but support you during your recovery. The National Eating Disorder Association can provide more information about support groups in your area.
• Nutritionist: Learning healthy nutrition is crucial to someone recovering from an eating disorder. Often, there are inaccurate thoughts and feelings around food that must first be confronted and dealt with in therapy so you can establish a healthy perspective on and relationship with food. A nutritionist can help you slowly incorporate nutrient-dense foods into your diet and help you to experiment with food in ways that you may not be able to on your own.