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Binge Eating Disorder

Binge Eating Disorder (BED) is a recognised eating disorder in which a person, due to underlying issues and other risk factors, develops a pattern of binge eating which they come to rely on a a way of coping. In the same way as someone with anorexia nervosa and bulimia nervosa, the person with binge eating disorder feels compelled to continue with the disordered eating, i.e. binge eating, as a way of coping with emotional turmoil. It must be recognised that as with the other eating disorders, a person diagnosed with binge eating disorder cannot be treated by diet alone. All the eating disorders are serious mental disorders which require timely and appropriate treatment and support.

Core features

characterised by:

  • Repeated episodes of binge eating
  • A sense of a lack of control over eating during the episode (a feeling that one cannot stop eating or control what or how much one is eating)

Binge episodes may be underlined by the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty after overeating
  • Periods of binge eating or overeating.

The person affected by binge eating disorder may diet frequently, however they will not engage in purging behaviour (getting rid of food) after a binge. Over time this can, but may not always, result in significant weight gain.

Binges almost always occur in secret, and an appearance of ‘normal’ eating is often maintained in front of others. The food that is eaten is usually filling and high in calories. It tends to be food that people regard as fattening, and which they are attempting to exclude from their diet. The food is usually consumed very quickly, and is seldom tasted or enjoyed.

While in binge eating disorder there is no purging, there may be sporadic fasts or repetitive diets, and often feelings of shame or self-hatred surface after a binge.

A person affected by binge eating disorder may find themselves trapped in a cycle of dieting, binging, self-recrimination and self-loathing. They can feel particularly isolated which can contribute to the prolonging of their experience.

Binge eating disorder is almost as common among men as it is among women, and is thought to be more common than other eating disorders such as anorexia nervosa and bulimia nervosa.

People with binge eating disorder may also have:

  • A mood disorder
  • Substance use disorder
  • ADHD
  • PTSD.
Behaviours

  • Out-of-control eating
  • Eating more than the body needs at any one time
  • Eating much more quickly than usual during bingeing episodes
  • Eating until uncomfortably full
  • Eating large amounts of food, even when not hungry
  • Eating alone (often due to embarrassment at amount of food being eaten)

Emotional and psychological

  • Feelings of inadequacy and worthlessness
  • Feelings of guilt and shame
  • Depression and related symptoms
  • Low self esteem
  • Dissatisfaction with body image
  • Feeling out of control
  • Anxiety

Physical

  • Significant weight gain
  • Digestive problems
  • Joint and muscular pain
  • Breathlessness
  • Poor skin condition
Binge eating disorder has a significant impact on the physical, as well as the emotional, health of the person affected.

Health consequences may include:

  • Digestive problems such as bloating, stomach cramps, constipation or diarrhoea
  • Malnutrition because of the quality of foods consumed (high in fats and sugars, but lacking in vitamins in minerals)
  • Asthma
  • High blood pressure
  • High cholesterol levels
  • Intracranial hypertension
  • Heart disease
  • Diabetes
  • Gallbladder disease
  • Menstrual disruption, pregnancy complications and polycystic ovary syndrome (PCOS)

Most physical symptoms can be reversed with weight loss and normalisation of a balanced diet and eating habits.

Binge eating disorder is a serious mental health condition. Obesity is a weight classification – a symptom – which may occur as a result of binge eating disorder. While many of the health consequences associated with binge eating disorder are directly related to obesity, it is important to maintain a distinction between this symptom and the disorder itself.

  • Significant weight gain over time
  • Repeated dieting as weight loss measures that do no bring about long-term weight loss.
  • Bingeing in secret
  • Eating high calorie foods
  • Low self-esteem
  • Negative body image, desire to lose weight constantly
  • Feeling down to feeling depressed
  • Anxiety
People often try to control Binge Eating Disorder on their own, and if they fail they may feel demoralised and depressed. This may lead to further episodes, and consequent feelings of social isolation, missing work, school, etc.

More often than not, people who experience BED will need the help and support of a health care professional.

Consultation with a General Practitioner (GP) is an important first step towards self-care.  The GP will look at the physical effects of binge eating and, if necessary, can make a referral to a dietician or to a psychologist or a therapist.

Individual psychotherapy and family therapy can be useful in addressing the psychological and emotional issues that may be underlying the disorder.

Cognitive behavioural therapy (CBT) teaches people to look at their unhealthy patterns of behaviour and how to change them. Group CBT may be helpful.

Dialectical behaviour therapy (DBT).

For change to occur and to be lasting, a recovery approach which tackles both the physical and psychological aspects of the disorder will be required.

Binge Eating – Breaking the Cycle: a self help guide towards recovery, 2015. Available from Bodywhys. PDF
Overcoming Binge Eating, Fairburn C.G., The Guilford Press, 1995.
Getting Better Bite by Bite, Treasure J. and Schmidt U., Psychology Press, 1996.
Eating Your Heart Out, Buckroyd J., Optima, 1994.
Overcoming Overeating, Hirschman J.R. and Munter C., Cedar, 1996.
Breaking Free from Compulsive Eating, Roth G., Signet, 1986.
The Forbidden Body, Bovey, Pandora, 1994.
Depression and the Way out of your Prison, Rowe, Routledge, 1986.
Stress and Relaxation, Self-help Techniques for Everyone, Madders, Optima, 1993.
The Successful Self, Rowe, Harper Collins, 1996.
(Specifically for men) Making Weight: Men’s Conflicts with Food, Weight, Shape and Appearance, Anderson A., Cohn L. and Holbrook T., Gurze, 2000