Binge eating disorder, commonly referred to as BED, affects more people than anorexia and bulimia combined. An estimated 3.5% of American women and 2% of American men have binge eating disorder. (Hudson, et.al, 2007). BED is characterized by repeated episodes of binge eating without the use of purging or other compensatory measures following the binge. You cannot tell by looking at someone whether they have BED; people struggling with this disorder may be normal weight, overweight or obese and come from diverse racial and ethnic backgrounds. With the realease of the DSM-V in Spring 2013, BED was refined from “an area of suggested further study” to a formal diagnosis.
Diagnostic criteria for Binge Eating Disorder from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)
- Recurrent episodes of binge eating .
- Binge eating episodes are associated with three or more of the following:
a. Eating much more rapidly than normal
b. Eating large amounts of food when not feeling physically hungry
c. Eating until feeling uncomfortably full
d. Eating alone because you are embarrassed by how much you’re eating
e. Feeling disgusted with oneself, depressed, or very guilty after overeating
- Marked distress regarding binge eating.
- The binge eating occurs, on average, at least 1x/week for 3 months.
- Binge eating is not associated with the regular use of inappropriate compensatory behavior and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa
What is a binge?
Many people overeat on occasion – mild or occasional overeating does not constitute a binge. A binge is defined as eating an amount of food, that is definitely larger than most would eat, within a relatively short amount of time, usually considered to be a span of 2 hours or less. However, the defining characteristic of a binge is that the individual experiences a sense of lack of control, and they generally feel powerless over how much or what type of food they are eating. During a binge episode, a person may want to stop eating but feels unable to do so despite physical discomfort and other negative consequences of the binge.
Signs & Symptoms of Binge Eating Disorder
The onset of binge eating typically occurs in late adolescence or early 20’s and commonly develops soon after significant weight loss from dieting. Some people with binge eating disorder have also struggled with anorexia or bulimia during earlier periods of their life. Without treatment, binge eating disorder is often a chronic illness so it’s important to be aware of the warning signs and seek help early.
Weight & Shape Concerns – Individuals who struggle with binge eating often report negative body image and low self-esteem, a history of failed diet attempts and an ongoing battle with their weight and their body image. You may notice the following thoughts, symptoms and experiences in individuals with binge eating disorder:
- Negative body image
- Avoidance of activities because of negative thoughts related to weight/shape
- Frequent negative and self-critical comments about one’s body/weight
- Thoughts/comments about how “life would be so much better if I could just lose weight”
- Possible history of weight-based bullying/teasing
- Desperation to control weight
- Weight gain as a result of binging
Food & Eating Behaviors – For individuals who binge eat, food can simultaneously be a source of stress and comfort. The binging is typically done secretly or alone, yet you may notice some of the following behaviors:
- Evidence of binge eating, including disappearance of large amounts of food in short periods of time or the existence of wrappers and containers indicating the consumption of large amounts of food.
- Eating until the point of discomfort or pain
- Eating alone/in secret, or eating normally around others, but gorging when you’re alone
- Hiding or hoarding food
- Rapid or fast eating during binges
- Difficulty identifying body’s natural hunger/fullness cues
- Eating continuously throughout the day, with no planned mealtimes
- Planning elaborate binges in advance of stressful situations
- Eating unusual combinations of foods or foods that would typically be considered inappropriate food (i.e. eating parts of moldy food, taking food out of the trash, eating condiments)
Changes in Personality and Social Behavior – Bingeing on food is another maladaptive coping skill on the continuum of eating disorder behaviors. Each individual’s experience is different but some common explanations for binging include using food to numb or protect against intense emotions, attempting to fill a void or emptiness inside, and sometimes the binging serves as a form of self-punishment. Unfortunately, binge eating can intensify feelings of loneliness and shame which perpetuates negative thoughts and can lead to some of these effects on mood, personality and social behavior:
- Changing lifestyle, daily schedules or establishing rituals to make time for binges
- Avoiding mealtimes or social situations involving food for fear of losing control/bingeing in a public setting
- Withdrawal from usual friends and activities
- Feeling stress or tension that is only relieved by eating
- Embarrassment over how much you’re eating
- Feeling numb while bingeing—like you’re not really there or you’re on auto-pilot.
- Lying about food eaten and/or making up excuses to try to hide behaviors
- Feeling guilty, disgusted, or depressed after overeating
- Symptoms of depression and anxiety (this can be a sign of an underlying co-occurring disorder )
- Insomnia, low energy and fatigue
- Substance Abuse
Health Consequences & Medical Complications of Binge Eating Disorder
In addition to the symptoms of binge eating discussed above, you may also notice significant physical changes related to this disorder. Binge eating disorder (BED) is much more prevalent than either anorexia or bulimia. BED often results in many of the same health risks associated with clinical obesity yet people with BED can be of normal weight. Some of the potential health consequences of BED include:
- High blood pressure
- High cholesterol levels
- Heart disease as a result of elevated triglyceride levels
- Type II diabetes mellitus
- Obstructive sleep apnea
- Edema (swelling)
- Kidney disease
- Gall bladder disease
- Arthritis (degenerative) – caused by hormonal imbalances and vitamin deficiencies as well as increased stress on the joints
- Various forms of cancer
- Increased rates of irritable bowel syndrome (IBS), fibromyalgia and insomnia have also been reported