Reviewed by Tanya Harrell, PhD, LPC, NCC
Feeding or eating disorders are not always about food alone, so they may be traced to deeper issues related to the psychology of affected individuals. Consequently, people may develop conditions like anxiety, depression, and other additional health issues. Therefore, recognizing BED symptoms may be a key approach to recovery.
What is binge eating disorder?
According to the American Psychological Association binge eating disorder is a disorder characterized by frequent or recurrent binge-eating episodes. People with BED often have a compulsion to overeat or consume abnormal amounts of food. Usually, they have a feeling of being unable to control their urges. Affected individuals can eat a lot of food in a short while, even when they’re not hungry. As a result, BED may be a severe and life-threatening but treatable condition.
Through the intensive analysis of psychiatrist Albert Stunkard in 1959, “binge eating disorder” was defined to explain similar eating behaviors. Although binge eating can occur in individuals of normal weight, it often results in weight gain, obesity, and diabetes mellitus. With such changes, emotional distress or stress could be a trigger, causing a person to feel relieved during a binge, but feel shame or guilt afterward. Therefore, the negative feeling that often accompanies binge eating pushes individuals to use food as a coping mechanism, resulting in a vicious cycle.
Binge eating is an array of distorted or irregular eating, often characterized by uncontrollable eating episodes. It is a leading symptom of an eating disorder, including but not limited to binge eating disorder. When a person has episodes of food binges, they may:
- Eat alone or secretly
- Eat very fast without control
- Eat when not hungry
- Eat until it causes a discomfort
- Feel ashamed or depressed after the episode.
- May have no recollection of what was eaten during the binge
- Plans ahead (or purchase special binge foods)
SYMPTOMS OF BINGE EATING DISORDERS
Binge eating disorder symptoms can be both emotional and behavioral. They include:
- Fear of eating in public with others
- Frequent dieting
- Extreme concerns for body weight or shape
- Withdrawal from usual activities
- Stealing or hoarding food
- Secret recurring episodes of food binges
- Disruption of regular eating routines – skipping certain meals, sporadic fasting, or eating throughout the day
- Developing food rituals
- Fluctuations in weight
- Stomach cramps etc.
Please note that a person with BED may not take steps to counter the effects of a binge episode. They may not throw up, exercise, or take laxatives.
CAUSES OF BINGE DISORDERS
Like most eating disorders, BED is seen as expressive since it could manifest deeper psychological challenges. The disorder is considered a side effect of depression, as people turn to food for comfort when they’re feeling low. Furthermore, people with the condition are found to exhibit weight bias, low self-esteem issues, general body dissatisfaction, etc. Presently, the causes of BED are understudies and may not yet be fully elucidated, but the following are considered as risk factors;
Genetics: individuals with BED may exhibit elevated sensitivity to dopamine, a hormone responsible for reward and pleasure feelings. Therefore, this indicates a risk of inheritance through genes.
Gender: in the United States, 3.6% of women experience BED at some point in their lives compared to 2.0% of men. This risk factor could be classified as a biological factor.
Body size: a good number of individuals with BED have obesity. Therefore, weight problems may be related to the disorder.
Dieting: restricting calories could induce the urge for binge eating, especially in people with symptoms of depression.
Emotional Trauma: traumatic situations like sexual abuse, death, separation from a family member, or car accidents could result in a higher risk of binge eating. Social pressures, including influence by media, may also be a trigger. Those who experience harsh comments about their weight and body are especially vulnerable.
The consequences of BED can involve physical, social, and emotional challenges. So, people with the condition could exhibit other psychological disorders like
- Depression/ Anxiety
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder
- Substance abuse
- Cardiovascular diseases
- Type II diabetes
- Insomnia or sleep apnea
- Gallbladder disease
- GIT difficulties
- Muscle and joint pain
RELATED HEALTH RISKS
BED is known to be associated with significant physical, social, and emotional risks. As a result, about 50% of the affected population has obesity. The disorder is a risk factor for weight gain and, ultimately, obesity. Singularly, obesity is implicated in the risk of diabetes, cancer, heart diseases, and other related conditions. There is evidence supporting the claim that people with BED are at a greater risk of developing these problems than people of the same weight without BED.
In women, BED is associated with fertility challenges, pregnancy complications, and even the development of polycystic ovary syndrome (PCOS). Again, sleep problems, chronic pain, asthma, and irritable bowel syndrome are suspected too. In addition to this, a study reports that people with BED may exhibit social interaction challenges when compared to people without the condition. Even though the mentioned health challenges are significant, there are several effective treatments to manage the disorder.
Almost everyone tends to overeat on occasion. During thanksgiving, parties, or special holidays, excessive eating may occur. Such occasional events do not translate to BED. However, when it gets out of control, and a pattern ensues, there may be a cause for alarm. Typically, BED commences in the late teen or early twenties, but it could occur at any age. For diagnosis, a person must record at least one binge eating spectrum in a week for three months.
The severity of an individual case could range from mild to severe, and one to three episodes per week characterize mild. An extreme case could have up to 14 or more cases in a week.
Treating BED depends majorly on the cause and severity of the condition. Sometimes, individual goals may be considered as a factor since people target different aspects of the condition or a combination of excessive weight, mental health challenges, eating behaviors, and body weight. Treatment options include cognitive-behavioral therapy, interpersonal psychotherapy, dialectical behavior therapy, weight loss therapy, and medication. However, traditional approaches may also be considered.
CBT has been demonstrated to be the more effective treatment for BED since as much as 50% of affected individuals could achieve complete remission. A study found that after about 20 sessions of the therapy, 59% of participants had successful results after one year. The therapy focuses on analyzing relationships between feelings, thoughts, behavioral patterns related to eating, body weight, and shape. When the cause of negative emotion or thought is identified, certain strategies are devised to change the affected individuals.
Even though the specific intervention strategies are tailored to meet individual needs, they often include goal-setting, self-monitoring, creating regular meal schedules, changing thoughts, and healthy weight-control habits. Alternatively, participants could opt for self-help CBT. This method includes works guided by a manual, alongside additional meetings with a therapist who acts as a guide. The self-lead option is readily accessible, affordable, and can be done on the phone based on website and mobile apps offerings.
IPT employs the idea that binge eating is a coping mechanism for buried or unresolved personal matters. Although the therapy may treat depression, it focuses on relationships between the affected person and other people. These issues include grief, conflicts, changes, and underlying social challenges. The concept is to specifically identify problems, acknowledge them, and work on constructive changes.
Interpersonal psychotherapy may be in a group or a private session with a professional. It may be combined with CBT. Private interaction begins with an interview and can continue for 12 to 20 weeks. Usually, this therapy focuses on the present realities of current situations. There is evidence to show that the effects of IPT are both short-term and long-term regarding binge eating. Ultimately, it may be more effective for people with severe binge eating disorder symptoms or those with low self-esteem issues.
DIALECTICAL BEHAVIOR THERAPY
The dialectical approach sees binge eating as an emotional response to negative or traumatic experiences. DBT teaches regulation of emotional responses by helping people cope with negative situations. Treatment areas may include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. A research study including 44 women with BED report that 89% stopped binge eating after therapy. However, a six months follow-up study showed a drop to 56%.
WEIGHT LOSS THERAPY
Weight loss therapy helps people lose weight and ultimately improves their body image and self-esteem. The idea is to use gradual lifestyle changes, especially in the areas of diet and exercise, to help. Often, monitoring food intake and thoughts about food throughout the day is effective. Although weight loss therapy is a commendable approach for improving body image and fostering weight loss, it is not as efficient as CBT or IPT. Similar to weight loss treatment for obesity, weight loss therapy achieves short-term or moderate-term effects.
No medications are currently as efficient as behavioral therapies, but several medications have been found to help manage binge eating. They are both cheaper and faster than conventional therapies. Antidepressants, antiepileptic drugs like topiramate, and drugs traditionally recommended for hyperactive disorders are options. A research study reported that medications prove more successful than placebos for short-term effects. They are also shown to be as effective as 48.7%, while the placebo takes 28.5%. Also, most studies with data supporting the claims were conducted over a short period, so data on long-term effects may be lacking. However, because people suffering from BED are predisposed to other mental health conditions, they may be given additional medication to the effect.
BED recovery tips
The first step to overcome a binge eating disorder is to talk to a professional. Expert opinions can help determine the severity of the case by diagnosis and appropriate recommendations. Also, you may consider going for an assessment test to have comprehensive information on the case. Presently, the best therapy is CBT. However, it may be done in addition to others. Regardless of the therapy approach you choose, making healthy life and diet choices could help.
FOOD AND MOOD DIARY
Binge impulses could be recognized before it escalates. Therefore you may consider recording your mood in a diary to help manage the eventualities or recognize patterns. On the other hand, a food diary could serve as a meal planner. So breaking meals into three per day prevents the urge for binge eating that could come from excessive hunger.
Exercising is said to keep the mental and physical states of an individual as sharp as possible. It could help improve body image, enhance the mood, deal with weight gain, and reduce certain adverse symptoms.
CHOOSE A HEALTHY AND BALANCED DIET.
First, you want to avoid skipping meals or following a strict diet regimen altogether. Skipping meals could build up craving and eventually lead to overeating. A study showed that eating a large meal per day increased the blood glucose level and ultimately stimulated the hunger hormone ghrelin compared to eating three meals a day. Therefore, when you eat, consider adding more proteins and vegetables to your meals. Also, opt for healthy fats and avoid compromising on nutrients.
Lack of adequate sleep has been implicated in higher calorie intake and irregular eating patterns. It is recommended that 7-8 hours of sleep per day is ideal for the human body. Sleeping regularly and well keeps your body and mind refreshed.
Mindfulness is a dimension of meditation, and it could help prevent overeating. When you listen to your body and mind, you can recognize the need for the moment and deal with it accordingly. A review study reveals that mindful meditation reduced binge and emotional eating. So mindfulness could have positive effects on energy.
Yoga incorporates both body and mind exercises to enhance relaxation and consequently nurture positive energy. A survey of 50 people with BED practicing yoga for a period of 12 weeks led to a reduction in binging. Another research shows that yoga reduces stress hormones, thus preventing binge eating and help recovering people set their minds at ease.
Seeking professional support or treatment from experts can be an effective way of addressing BED. It would be best to concentrate on emotional triggers and opt for proper guidance since addressing the core cause of the condition is paramount. Take an assessment test here.