Reviewed by Tanya Harrell, PhD, LPC, NCC
Eating disorders are certainly not new; virtually everyone has heard of eating disorders, even if they have not been touched by them directly or experienced symptoms of an eating disorder themselves. While there may be a far larger breadth of knowledge about eating disorders as a whole, there is often a focus on one or two types, while others fall through the cracks. Binge Eating Disorder is one that frequently falls through the cracks in terms of both understandings and awareness. What is Binge Eating Disorder?
Binge Eating Disorder: A Definition
Binge Eating Disorder is a mental disorder in which an individual feels a compulsive need to eat. Binge Eating Disorder, as its name suggests, does not merely involve eating, however; instead, people with BED will experience intense and consistent impulses to binge eat or eat food at a volume and speed far higher than would be considered typical, often to the point of feeling pain or discomfort. Binge Eating Disorder is also characterized by feelings of shame, humiliation, or fear following a binge and is often accompanied by avoidant behavior and a predilection toward hiding or deceiving others to keep their bingeing under wraps.
Binge Eating Disorder is differentiated from Bulimia Nervosa in one distinct and important way: BED does not involve purging or other compensatory behavior. While Bulimia Nervosa is known for periods of binge eating followed by periods of purging or engaging in excessive exercise to “make up for” the binge, Binge Eating Disorder involves uncontrolled and disordered eating but does not involve any type of compensation for that eating.
For binge eating to qualify as an eating disorder rather than a predilection toward overeating, it has to take place at least once per week for three months or longer. People with BED may experience binge-eating episodes more often than this. Still, episodes will virtually always be accompanied by feelings of shame and embarrassment and will likely be engaged in alone. People with BED are likely to struggle to eat in front of others (both during a binge and apart from a binge). They may hide the amount of food they are eating by ordering food and hiding receipts or stashing food around the home to avoid suspicion.
The Most Common Causes Of And Risk Factors For Binge Eating Disorder
The exact cause of BED has not yet been identified; instead, researchers have identified the most likely culprits of Binge Eating Disorder and eating disorders as a whole. One of the most successful predictors of developing an eating disorder is a prior history of restrictive eating or undue focus on physical appearance. Some of this has been attributed to an intense focus on media and subsequent comparison, and some have been attributed to family behaviors. People who have engaged in highly restrictive dieting, have struggled with weight loss, or have developed an unhealthy level of interest in exercise and diet are at higher risk for developing BED than those who have not had a history of these behaviors with food and exercise.
A family history of eating disorders and other mental disorders such as anxiety and depression are common risk factors associated with Binge Eating Disorder development. In conjunction with other risk factors such as a past history of dieting and a family history of eating disorders, these disorders can further exacerbate the likelihood of developing Binge Eating Disorder.
Women may also be more likely than men to develop Binge Eating Disorder. Seeking help can be difficult for some women with Binge Eating Disorder due to a feeling of “normalcy” regarding emotional eating. Although men are certainly not impervious to eating disorders, including BED, men do not have eating disorders with the same frequency as women.
Standard Treatment: Pharmaceutical Intervention
Anti-depressants and anti-anxiety medications (called “SSRI”s, typically) are frequent Binges Eating Disorder treatment options, in addition to co-morbid disorders. Because people with eating disorders are frequently assailed by other mental disorders, it can be helpful to utilize an approach that targets more than one disorder. The National Eating Disorder Association identifies some of the most common co-morbid conditions that accompany eating disorders, including anxiety and depression. Anti-depressants and SSRIs can also be useful in treating BED due to their active ingredients. Some of the components involved in anti-depressants and anti-anxiety medications can relieve feelings leading to binge eating, including feelings of restlessness and anxiety.
There is one dedicated BED treatment that has been approved for use by the FDA. Originally a treatment used for ADHD, this type of medication has some small bodies of evidence to support its use as a dedicated treatment for Binge Eating Disorder.
Standard Treatment: Psychotherapy
Cognitive Behavioral Therapy is a type of talk therapy that has been identified as the most effective type of psychotherapy for successful BED treatment. This is likely due to the core of Cognitive Behavioral Therapy, which asserts that negative thought patterns and subsequent behaviors can be replaced with healthier, more compassionate ones that support individual health and general wellness. CBT has been used for a wide range of disorders but is considered the best type of talk therapy for people with eating disorders.
In a given session, someone with an eating disorder might be encouraged to find the root of some of their triggers, identify the feelings they experience from that trigger, and identify any thought patterns that arise from that trigger. Someone might, for instance, feel the impulse to eat after watching a movie. That may then be traced to a feeling of shame and guilt, which could be further traced back to a family experience, in which they were encouraged to feel lazy, worthless, or gross for having taken some time to themselves to sit and watch a movie. Although this is a tiny example in a virtually limitless pool of potential triggers, it identifies one of the more powerful aspects of CBT: it seeks to find the root of the behaviors and compulsions to combat them at their source.
Typically, CBT practitioners will encourage patients to engage in at least 1 60-90 minute session per week, for a period of 12-16 weeks, to start. Once this initial period has been completed, patients may feel prepared to taper off and manage their disorder or need to continue therapy and engage other healing modalities. Cognitive Behavioral Therapy is a wonderful tool, but it may not be the only tool necessary to combat BED symptoms.
Alternatively Treatment: Supplemental Treatment Options
Improving general health could aid in the effective treatment of BED, and people with BED may take part in general healing modalities, such as acupuncture, meditation, and exercise, all of which have the potential to improve health as a whole and support the mind and body of someone with BED.
Although there are no recognized alternative healing modalities supported by research or medical professionals, people with BED may find themselves gravitating toward any and every possible healing source.
A Word Of Caution: Diet And Exercise
Although changing dietary habits and implementing an exercise routine are frequently encouraged for people suffering from mental illness, this can be a dangerous move for someone with BED. Disordered eating frequently arises from a history of dietary restrictions, intense exercise, and a heavy focus on weight and appearance, so willfully engaging in practices that might reinforce the notion that weight and diet are required to be healthy, happy, and attractive could actually be detrimental. People with BED should not make severe changes to diet or exercise habits without first consulting their doctor, receiving a relatively clean bill of mental health, or while under close supervision, as might be found in an eating recovery center designed to treat people with eating disorders.
Living With Binge Eating Disorder
Binge Eating Disorder is often misunderstood by those who have not worked with or experienced an eating disorder themselves. It is often erroneously excluded from the general concept of having an eating disorder. This is often due to the nature of the disorder and its effect on weight and appearance;. At the same time, Bulimia Nervosa and Anorexia Nervosa are frequently associated with a gaunt appearance. Binge Eating Disorder typically has the opposite effect, and people with BED might appear to be of normal weight or overweight or obese. This can be isolating for BED people, who may not feel that they fit in with the typical “poster child” of eating disorders.
Because Binge Eating Disorder is often misunderstood and overlooked, it is vital for the loved ones and closest confidants of people with BED to be supportive and encouraging in their healing journey. One of the most significant symptoms associated with BED is the presence of intense shame and self-disgust following a bingeing episode, which can be exacerbated by family and friends who regard BED with disbelief or minimize the serious nature of the disorder.
Binge Eating Disorder is frequently misunderstood or even ignored an eating disorder. Because many people with the disorder do not fit into the typical image of a person with an eating disorder, BED may be overlooked and ignored. Fortunately, mental health practitioners have the know-how and foresight to recognize the presence of Binge Eating Disorder, even when others don’t. If you are concerned you or a loved one are exhibiting Binge Eating Disorder symptoms, you can find some peace of mind in an online test or take the steps today to seek professional help.