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What is binge eating disorder?
Binge Eating Disorder (BED) is an eating disorder where an affected person will repeatedly consume large quantities of food in a short period, often to the point of physical discomfort. Individuals experiencing BED frequently feel a loss of control during these binge episodes, which are commonly followed by intense feelings of distress, shame, or guilt.1
Unlike individuals with Bulimia Nervosa (BN), individuals with BED do not typically engage in compensatory behaviors, such as vomiting, excessive exercise, or misuse of laxatives. This absence of purging behaviors distinguishes BED from other eating disorders and contributes to its unique psychological and physical challenges.
Eating Disorders are serious mental health conditions and can affect people of all ages, racial and ethnic backgrounds, body sizes and shapes, genders, and sexual orientations.
Symptoms of binge eating disorder
The body size of individuals with binge eating disorder can vary from person to person, and people with binge eating disorder are not more likely to be overweight than the community at large. This can make the condition difficult to recognise.2
People with binge eating disorder will demonstrate bingeing behaviors one or more times per week, on average. These episodes involve consuming a large amount of food (>1000 calories) in a short period, usually less than 2 hours. Stressful situations or emotions might be the cause of these episodes.
Other associated behaviors include eating very rapidly, eating past the point of being full, eating when not hungry, and eating alone. People with binge eating disorder might also hide food to eat later or plan binges.
People with binge eating disorder tend to have significant dissatisfaction with their weight or body size and often engage in cycles of weight loss and weight gain.
People with binge eating disorder often have other mental health conditions. Depression, anxiety, alcohol use disorder, and PTSD are all common.3
Diagnosis of binge eating disorder
Binge eating disorder is diagnosed by a clinician who can take a comprehensive history of the bingeing episodes, other eating disorder behavior, and other medical conditions. Clinicians will ask for specific information about bingeing episodes and underlying stressors that may play a role in the disease.
A key part of the diagnosis of binge eating disorder is distinguishing BED from other medical and psychiatric conditions. For example, some people with anorexia nervosa may also engage in bingeing behaviors but will also experience weight loss and difficulty maintaining appropriate body weight.
Medical conditions like Cushing syndrome may cause unusual hunger or weight gain but will not include the discrete binge episodes of BED.
Causes of binge eating disorder
All eating disorders are complex illnesses that have many underlying causes.
While researchers are still working to understand what causes eating disorders, we know that binge eating disorder is caused by the interaction of genetic, biological, psychological, and social factors.4
People with binge eating disorder are many times more likely than people without BED to have experienced childhood mistreatment.
Additionally, individuals with BED show greater activity in reward centers of the brain in response to food than individuals without BED.5
Finally, individuals with BED are more likely to have a family history of eating disorders than individuals without BED.
Treatment of binge eating disorder
Treatment of binge eating disorder begins with a holistic assessment of a patient’s psychiatric, nutritional, and medical status. Binge eating disorders can only be effectively addressed when the contributing factors are well controlled, including social and relationship stressors and underlying mental health conditions.
A trained mental health professional may employ one of several techniques to address BED, including cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavioral therapy (DBT), and others. Family therapy may also be used to help engage support systems and develop positive behavioral patterns.
In addition, some medications have shown promise in treating BED. These antidepressants, anti-seizure medications, and other medications help regulate the hunger response.
Even individuals with binge eating disorders who have larger bodies may be suffering from nutritional deficiencies. These may be addressed with dietary changes and supplements with the help of a medical provider and nutritionist.
Binge eating disorder may be managed as an outpatient or in a daytime therapy program. Rarely, individuals with BED may require inpatient hospitalisation for management of associated medical issues.
Prognosis of binge eating disorder
Recovery from binge eating disorder is possible, although it is important to recognise that this process will look different for everyone. Working with a multidisciplinary team that specialises in eating disorders is crucial for recovery.
Additionally, having a reliable support system in place can help patients successfully navigate the ups and downs of recovery.
Questions to ask your doctor about binge eating disorder
Are my eating habits and behaviors a sign of BED or another eating disorder?
What medical or psychiatric problems might be contributing to (or caused by) my eating disorder?
Can you recommend nutrition and/or therapeutic professionals for my eating disorder?
Do you think I would benefit from a referral to an integrated eating disorder program?
Does my insurance cover treatment for BED, and if not, can you help me identify resources for affordable care?
Support & resources for binge eating disorder
National Institute of Mental Health (NIMH)
American Psychological Association (APA)
