Binge Eating Disorder: A Perspective

By Erica Lesperance, RD, LD

The phrase “eating disorder” typically brings to mind two different scenarios: anorexia and bulimia. Anorexia is marked by the refusal to eat and an obsession with thinness. Bulimia is characterized by binging and purging, meaning that a person gorges on high-calorie foods and then intentionally vomits or uses laxatives or diuretics to prevent weight gain. Bulimics are often normal weight or slightly overweight. While these eating disorders can be life-threatening and deserve all of the attention they are given, they do not account for the majority of people suffering from eating disorders in this country. In fact, the most common eating disorder is Binge Eating Disorder (BED), which presents itself in normal-weight, overweight, and obese people. We now know that as many as 4 million Americans suffer from Binge Eating Disorder.

More than the Occasional Splurge

Almost everyone overeats on occasion. At times, you find yourself at a party where the food is too good to stop eating, or you’re watching a movie, and before you know it, you scarf down an entire bag of chips without even realizing it. You may feel uncomfortably full for a few hours, but you then return to your normal eating pattern. However, for those who suffer from Binge Eating Disorder (BED), overeating becomes a way of life. A person with Binge Eating Disorder (BED) exhibits the following symptoms:

  • Periodically does not exercise control over consumption of food.
  • Eats an unusually large amount of food at one time.
  • Eats much more quickly during binge episodes than during normal eating.
  • Eats until physically uncomfortable.
  • Eats large amounts of food even when not really hungry.
  • Usually eats alone during binge eating episodes, in order to avoid discovery of the disorder.
  • Often eats alone during periods of normal eating, owing to feelings of embarrassment about food.
  • Feels disgusted, depressed, or guilty after binge eating.

Cause not Clear

The exact cause of Binge Eating Disorder (BED) is not clear, though most experts believe there is a combination of factors that lead the development of the disorder. Research shows a link to depression and other negative emotions, with 50% of binge eaters suffering from depression. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known. Emotions may also play a role, triggering binge eating as a coping mechanism. Many binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat. It is also possible that frequent dieting and strange eating patterns can trigger binges in some people. Finally, some preliminary research suggests there is a genetic component to binge eating, since the disorder tends to run in families.

Consequences of Binge Eating Disorder (BED)

Binge Eating Disorder (BED) can result in physical, psychological, and social consequences. The foods chosen for bingeing are typically high in fat and sugar and are devoid of important nutrients. Being overweight or obese as a result of Binge Eating Disorder (BED) comes with an increased risk for diabetes, heart disease, high blood pressure, gallbladder disease, and some cancers. Binge eaters are also plagued with guilt and shame because of their disorder, often turning to alcohol or drug abuse to sooth their depression. They often skip social events in order to be alone and binge, which makes them less likely to have a social support network.

Treatment

There are two potentially treatable dimensions to Binge Eating Disorder (BED). First, there is an underlying psychological cause of the disorder that must be addressed through psychotherapy.  Medication is often recommended to treat depression, making it easier for sufferers to combat their illness and reduce binge episodes. Cognitive behavior therapy is also used to teach binge eaters to change destructive habits and help them feel better about their body shape and weight. Second, the physical ramifications of binge eating must also be addressed. Many people with Binge Eating Disorder (BED) are obese and their health is at risk. Exercise is encouraged to help shed pounds and improve self-esteem.

While some combination of psychotherapy, cognitive-behavioral therapy, medication, and/or exercise may eventually allow binge eaters to stop bingeing and lose weight, sometimes more immediate and extreme treatments are advocated. To treat morbid obesity in binge eaters, gastrointestinal surgery is sometimes used, which reduces the size of a person’s stomach, thereby limiting how much he or she can eat. Dramatic weight loss usually occurs within months of the surgery. However, gastrointestinal surgery is not a cure for binge eating. The psychological factors behind the illness must be addressed, and counseling should be pursued simultaneously.

Get Help

Binge eating disorder is often mistakenly seen as less dangerous than anorexia or bulimia. In fact, it is quite dangerous and must be taken very seriously. If you are suffering from binge eating disorder, you are not alone. Quality treatment is available to you and can help you lead a happy and joyful life.

A Word on Compulsive Overeating

The terms Binge Eating Disorder and Compulsive Overeating are often used interchangeably. Though they are extremely similar, they are not exactly the same. Compulsive overeating involves consuming larger than normal quantities during everyday meals. The difference between the two disorders is the short period of time and the sense of lack of control over food consumption experienced during binge eating.

Sources:
1.    National Eating Disorder Association.
2.    Academy for Eating Disorders.
3.    Grilo, C.M. “The assessment and treatment of binge eating disorders.” Journal of Practical Psychiatry and Behavioral Health, 1998: Vol. 4, pp.191-201.

*This article is intended for general information purposes only, is not individual-specific, nor is it intended to replace the advice of your healthcare team.