What is binge eating disorder?

Binge eating disorder is part of a group of mental illnesses known as eating disorders. It is grouped with anorexia nervosa, bulimia, avoidant/restrictive food intake disorder (ARFID) and other specified feeding or eating disorder (OSFED), all of which are conditions where patients display unhealthy relationships with food and disordered eating patterns. 

Those with an eating disorder may find themselves eating too much or too little, or worrying excessively about weight or body image. While anyone can get an eating disorder at any time of life, binge eating disorder is most common in those in their late teens and early twenties.

Binge eating disorder is characterized by eating large amounts of food in a short space of time. These so-called ‘binges’ are often planned ahead of time, involve ‘special’ or usually restricted foods, and are undertaken alone. There is often a lot of shame and emotional turmoil associated with a binge session, and a binge may be followed by a period of restriction in an attempt to ‘get back on track’. 

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Here, we’ll look into the symptoms of binge eating disorder, treatments and diagnostic processes, as well as available support. This article is for informational purposes only and is not meant to offer medical advice. A medical doctor or GP should always be the first step in helping assess the severity of an eating disorder and providing support.

What is binge eating disorder?

According to a review in the journal of Psychiatric Clinics of North America, binge eating disorder as the most common eating disorder, with the Osteopathic Family Physician journal stating that less than half of people with binge eating disorder will receive treatment. Additionally, 3.5% of American women and 2% of American men will experience an eating disorder at some point in their lifetimes, as stated in the journal of Biological Psychiatry.

Darren Woodward, a qualified psychotherapist and the principal of livelife, outlines binge eating disorder and the warning signs that someone may be developing this condition. “Binge eating disorder is when a person eats in a short period of time (for example, within any two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances,” he says. “When people eat these large quantities of food, they can feel like they are not in control.” 

What are the symptoms of binge eating disorder?

Marianna Ashurova, a medical doctor and interim physician-in-charge for the Eating Disorders Program at Cohen Children’s Medical Center in New York, explains symptoms that raise flags for eating disorder professionals. “Binge eating disorder is a clinical diagnosis made by a trained provider that includes symptoms such as eating larger amounts of food than the average person may in one sitting, along with feeling a lack of control over consumption,” she says. 

“People will often describe eating past being comfortably full, eating rapidly or in secret, and feeling disgusted by their food consumption. This occurs about once a week for three months. Binge eating disorder is associated with different risk factors including being overweight, high dissatisfaction with body image, and dieting behaviors. A history of emotional or physical abuse, as well as food insecurity and lack of availability in childhood, are implicated as risk factors as well. For many, binge eating can be used as a method of emotional regulation, placing more emotionally vulnerable populations at higher risk.” 

Despite the prevalence of eating disorders in certain populations, black, indiginous and people of color are half as likely to receive treatment than white people, according to a Harvard School of Public Health report into the economic cost of eating disorders. A NEDA report into eating disorders in the LGBTQ+ community found that gay men are seven times more likely to report binge-eating and 12 times more likely to report purging than heterosexual men. Another study in the Journal of Child Psychology and Psychiatry found that 20-30% of adults with eating disorders also have autism.

Woodward explains that secrecy is often an element in binge eating disorder. “This could involve eating when not hungry and eating alone or secretly,” he says. “Sometimes people might have a particular or favorite type of food to binge. Binges can often be distressing and involve eating a larger amount of food that the person wanted to eat.”

How is binge eating disorder diagnosed?

“Binge eating disorder is one of the most common eating disorders,” says Woodward. “Both men and women can get it, but it typically starts in teenage years or when someone is in their 20s.

“It’s important to note that binge eating disorder affects everyone differently; behaviors will not be the same and they fall within a spectrum. This could be infrequent emotional overeating, which would be classed as ‘eating behavior’, to frequent, distressing and compulsive binge eating, which can be classed as an eating disorder. The GP or medical doctor will be the first step in helping assess the severity and next step of support. This may include a referral to psychiatry for a psychiatric assessment. This will involve being asked about your eating habits and how you’re feeling, leading to potential diagnosis and support.”

What are the risks of binge eating disorder?

A review in the Annals of the New York Academy of Sciences indicates that while binge eating disorder often occurs in non-obese individuals, it is often associated with weight gain over time and a higher risk of diabetes. As disordered eating habits are often tightly woven with negative body image, weight management in those with binge eating disorder is particularly difficult, and treating the underlying psychological condition is more important than enforced weight loss.

Woodward says that binge eating disorder often goes hand-in-hand with other mental health conditions. “If people have binge eating disorder, they may have other mental health issues, such as depression, anxiety and low self-worth,” he says.

“Binge eating disorder may contribute to the worsening of these symptoms. People may feel trapped in a cycle of feeling distressed and compulsive binge eating, which could mean they feel more depressed or have lower self-esteem. It can often, but not always, cause weight gain and there are a number of related health risks associated with this  — high blood pressure, high cholesterol, type 2 diabetes, for example.” 

A review in the Nutrients journal also indicates that maladaptive emotion regulation plays a significant role in the development of binge eating disorders. Those who experience symptoms of binge eating disorder tend to suppress their emotions, and eating disorders have been linked to other forms of maladaptive emotion regulation strategies, such as substance abuse and self-harm. 

What are the treatment options for binge eating disorder?

A review in the Annals of Internal Medicine supports cognitive behavioral therapy (CBT) as an effective treatment for those with binge eating disorder and also indicates the usefulness of medications, such as lisdexamfetamine, SGAs, and topiramate to help reduce binge eating. A combination of medication and therapy is often the most effective approach, but therapy on its own is also a powerful tool in treating binge eating disorder. 

Lauren Salvatore, a doctor of psychology and the clinical director of the Eating Disorders Day Treatment Program at Cohen Children’s Medical Center, says that cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are the best treatment options available. 

“The best treatment options are CBT, which helps you change your thoughts and behaviors around binges, or DBT, which can treat the underlying emotion dysregulation that can lead to binges,” she says. “These therapies can be delivered individually or in a group format by licensed mental health professionals. Most importantly though is finding a provider who you trust and who makes you feel comfortable.”

Woodward says that you may need to go to your doctor for diagnosis before attempting therapy. “Start with booking an appointment with the GP. It can be hard to take this first step, as sometimes people might struggle to admit they are finding things difficult,” he says. 

“Some people find it helpful to bring a friend or family member to the appointment for additional support. When it comes to specific treatment options, some people might prefer to explore guided self-help programmes: this will include working through self-help books alongside sessions with a therapist. For others, CBT might be the best option. This can take place one-to-one or in a group session. This will involve talking to a therapist about patterns of thoughts, feelings and behaviors which might be leading to your binge eating disorder. This also could involve discussions about triggers, meal planning and changing negative thoughts – as well as building new habits,” he says. 

Support for binge eating disorder

Salvatore recommends the National Eating Disorders Association (NEDA) for specialist, judgment-free support. “There, you can find resources on treatment, providers and how to know when to seek help,” she says. 

The NEDA also has a helpline for those in acute crisis, or you can text if you prefer.. It has a quick screening tool available for those concerned about themselves or a loved one to see if it’s time to seek professional help. The National Association of Anorexia Nervosa and Associated Disorders (ANAD) also has a daytime helpline and can set you up with an eating disorder support group, or mentor, to help you to take steps towards recovery. 

This article is for informational purposes only and is not meant to offer medical advice.