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What is binge eating?
Binge eating is an eating disorder where an individual eats a very large amount of food within a limited amount of time. This time limit that the individual gives is “usually less than 2 hours” (Dyanne 2013), and often the individual has no control over their urge to consume a large amount of food.
Binge eating is not commonly talked about, but it does affect “3.5% in women and 2.0% in men” (Dyanne 2013), which is much higher than the rate of anorexia and bulimia. “Binge eating is a subcategory of bulimia nervosa, but the difference is that an individual with bulimia nervosa will practice “inappropriate weight control behaviors such as self-induced vomiting, laxative abuse, excessive exercise, or extreme dieting or food restriction” (Yale 2019). Individuals with binge eating will eat, but they will not try to expel the food afterward. This lack of weight control behaviors can often lead to a combination of obesity, which is common among individuals who binge eat.
Binge eating is usually associated with the following symptoms:
● Eating rapidly (well above an average speed)
● Eating until uncomfortably full
● Eating large amounts, even when not hungry
● Eating alone, due to feeling embarrassed about the way you eat or how much you eat
● Feeling depression, guilt, or disgust after overeating
● Being unable to stop yourself from eating large quantities in a short amount of time
Binge eating can arise from several different factors, which include genetics, the environment, and individual factors. These can include parental depression, criticism, high expectations, physical abuse, etc. The more a person is exposed to these circumstances, the more they are at risk of developing binge eating later in life. Unlike other eating disorders such as anorexia or bulimia, this eating disorder can affect people of all ages, and it is common in both men and women. Some important risk factors also include “a family history of eating disorders, childhood obesity, a history of maltreatment and stressful life events, poor self-esteem, negative body image, and unhealthy diet practices” (Yale 2019). Being around others who show a lack of self-esteem coupled with an unhealthy diet can trigger symptoms of binge eating, and these symptoms can worsen as time goes on.
More often than not, people with binge eating disorders are either not diagnosed, or are not diagnosed properly. Most individuals with the disorder do not realize it is a serious medical problem, and this is both because some healthcare providers lack knowledge of eating/weight concerns, and some individuals with a binge eating disorder are ashamed of seeking help from others. For these reasons, most individuals do not get the help they need or they may be misdiagnosed by healthcare providers as only obese. It is recommended to see a clinician who can ask “about eating and weight concerns in a sensitive and non-judgmental manner” (Yale 2019) and recognize the signs of binge eating.
As with other eating disorders, binge eating is associated with concerns about body image. Most people with a binge eating disorder “are overly concerned with their weight and shape” (Yale 2019), as psychologically their self-worth is pinned onto their weight and shape rather than their accomplishments. It is important to note the symptoms, get help, and take steps to combat them.
How does binge eating affect the body and mind?
In a community-based study, individuals with a binge eating disorder were observed, and their risk factors were recorded. Almost 35% of children were shown to have a negative self-evaluation, and 32% would repeat comments about their shape/weight that were said by others. Psychological problems are shown to arise in individuals that develop this eating disorder, and these problems can also trigger the start of binge eating symptoms.
Other physical complications can come with this disorder. Obesity is a common symptom of binge eating and can come with its own complications. These can include trouble sleeping, skin problems, and the wearing down of joints (also known as osteoporosis). Obesity coupled with binge eating can also lead to other complications such as becoming overweight at a younger age, experiencing “negative affect in response to perceived evaluation by others of weight-related behavior” (Dingemans 2002), the consumption of unhealthy foods, such as desserts, etc.
How can binge eating be monitored and controlled?
There are several treatments that can “rapidly eliminate or significantly reduce binge eating, improve psychological functioning, and bring lasting change and improvement” (Yale 2019) to individuals.
There are three major forms of treatment that have been determined to be “the most effective in reducing binge eating in the long term” (Dyanne 2013). The most popular treatment is cognitive behavior therapy (CBT). During CBT, individuals are “encouraged to set eating goals, to employ self-monitoring, and to modify negative views of themselves to reduce binge eating” (Dyanne 2013). This can be done with a therapist, or it can be self-guided. Self-guided CBT is based on “Fairburn’s book Overcoming Binge Eating”(Wilson 2010), which includes information about binge eating, and a “step-by-step self-help program” (Wilson 2010). The other options are pharmaceutical or surgical interventions. Pharmaceutical intervention is when pharmaceuticals are prescribed. For binge eating disorders, these medications are usually not FDA approved. Antidepressants were shown to be effective only over a short period of time, and other medications had “unpleasant side effects” (Dyanne 2003) or “did not affect the frequency of binge episodes” (Dingemans 2002). The last treatment, surgical intervention, is done through bariatric surgery. This is a process where a surgeon will remove part of the stomach, which would reduce food intake and help with weight loss.
The normal amount of episodes an individual with binge eating has is around two each week. The goal for all of these treatments is to reduce the number of episodes an individual has binge eating, normalize good eating patterns, and improve psychological well-being/weight. Some other treatments that deserve an honorable mention include BWL and interpersonal psychotherapy. BWL, or behavioral weight loss treatment, includes both moderate caloric restriction and exercise, which is a level of dieting coupled with exercise. The exercise usually lasts for a few hours each week, and the amount of exercise as well as the type of exercise changes with the individual’s improvement. Interpersonal psychotherapy helps individuals to look into their psychology. In this treatment, the individual analyses how and why their eating disorder developed. This helps them to locate the areas that they need to work on so they can begin to make a regimen for themselves and get a solid routine going.
Although binge eating is not as commonly talked about as other eating disorders, it is still important to stay knowledgeable about how it can affect people. More often than not, these individuals feel alone in their complications, so understanding exactly what they are going through and taking steps to help them get assistance can mean the world. Note the symptoms above to see if you or a loved one could be suffering from this disease. If you do find yourself or someone else going through these complications, you can take the first steps to find help. As with many other disorders and diseases, talking to a doctor (or in this case, a clinician) early can help to keep symptoms under control.
References:
1. Dingemans, A., Bruna, M. & van Furth, E. Binge eating disorder: a review. Int J Obes 26, 299–307 (2002). https://doi.org/10.1038/sj.ijo.0801949
2. Dyanne P. Westerberg, Margot Waitz, Binge-eating disorder, Osteopathic Family Physician, Volume 5, Issue 6, 2013, Pages 230-233,ISSN 1877-573X, https://doi.org/10.1016/j.osfp.2013.06.003.
3. Fairburn CG, Doll HA, Welch SL, Hay PJ, Davies BA, O'Connor ME. Risk Factors for Binge Eating Disorder: A Community-Based, Case-Control Study. Arch Gen Psychiatry. 1998;55(5):425–432. doi:10.1001/archpsyc.55.5.425
4. Wilson GT, Wilfley DE, Agras WS, Bryson SW. Psychological Treatments of Binge Eating Disorder. Arch Gen Psychiatry. 2010;67(1):94–101. doi:10.1001/archgenpsychiatry.2009.170
5. Yale Medicine. (2019, November 12). Binge eating disorder. Yale Medicine. Retrieved October 15, 2021, from https://www.yalemedicine.org/conditions/binge-eating-disorder
Contributors:
Author: Kayjah Taylor
Editor: Anum Khan
Health scientist: Aseelah Saiyed