What is Binge Eating Disorder (Binge Eating)?
Binge eating disorder, often known as BED, is a condition where a person consumes abnormally large amounts of food during short periods. These episodes usually happen every week for around three months. It’s important to realize that BED is a separate condition from bulimia nervosa, another eating disorder.
BED can be associated with various psychological and physical issues and can somewhat or severely impair everyday life. It often comes along with general health issues like obesity, diabetes, hypertension, and chronic pain. While it’s more common in overweight individuals, it doesn’t only affect them. The most frequent concern in those with BED is weight gain. It’s worth noting that the likelihood of having this disorder goes up as body weight increases, with obesity a common related condition.
What Causes Binge Eating Disorder (Binge Eating)?
Binge eating disorder can be caused by a mix of psychological, social, cultural, and biological factors. There are many things that may increase the risk of developing this disorder. For instance:
1) Being obese as a child
2) Struggling to control what you eat from a young age
3) Having an extreme desire for everything to be perfect
4) Exhibiting behavioral issues
5) Abusing substances
6) Being exposed to a family who is overly worried about weight and has eating issues
7) Experiencing family conflicts or poor parenting
8) Having parents with mental disorders
9) Suffering physical or sexual abuse
10) Having other mental health problems
11) Having certain genes involved with the mu-opioid receptor (e.g., OPRM1) and the dopamine receptor (e.g., DRD2)
12) Perceiving your body image inaccurately
13) Changes in the microbes that live in your intestine
Risk Factors and Frequency for Binge Eating Disorder (Binge Eating)
Binge eating disorder tends to appear more frequently in women than men, usually around the age of 23. In the United States, about 2.6% of the population is affected by this disorder during their lifetime. Nearly 79% of these individuals also experience at least one other psychiatric disorder, and almost half have had two or more such disorders. Common disorders that often occur along with binge eating include:
- Specific phobia (37% of cases)
- Social phobia (32% of cases)
- Post-traumatic stress disorder (26% of cases)
- Alcohol abuse or dependence (21% of cases)
Furthermore, among those with more than one diagnosis, a significant percentage also suffer from anxiety disorders (65%), mood disorders (46%), impulse-control disorders (43%), and substance use disorders (23%).
Signs and Symptoms of Binge Eating Disorder (Binge Eating)
If someone might have binge eating disorder, the doctor will ask about certain things to help figure out if that’s the case. These could include things like:
- When the person started having episodes of binge eating
- How often these episodes occur
- How long each episode lasts
- How much food is typically consumed
- How the person feels about their binge eating
- Whether the person tries to make up for the binging by doing things like vomiting, taking laxatives, or working out a lot
- Whether the person also has other problems, like mental health issues or diseases such as obesity or diabetes
- What emotional events trigger the binge eating
- How much societal pressure and media influence the person feels
- Whether the person was emotionally abused or had food or eating restrictions as a child
- If the person has thoughts of suicide or misuses substances
- If the person has been physically or sexually abused
- How the person perceives their body image
- If there’s a history of binge eating in the family
The doctor will also want to perform a physical examination to look for health problems related to obesity caused by binge eating. This could include checking the person’s blood pressure and blood sugar levels regularly, as well as looking for signs of physical or sexual abuse if there are reasons to think these might be present.
Finally, the doctor might use certain tools to help determine whether someone has binge eating disorder. These tools might include:
- The Binge Eating Scale
- The Three-Factor Eating Questionnaire
- The Body Shape Questionnaire
- The Eating Disorders Examination
- The Structured Clinical Interview for the Diagnosis of DSM Disorders
- The Questionnaire of Eating and Weight Patterns
Testing for Binge Eating Disorder (Binge Eating)
When someone shows signs of binge eating disorder, a diagnosis involves three assessments: mental health, physical health, and nutrition.
During the mental health assessment, the doctor will be checking for related issues such as depression or a substance use disorder, how the person views their body shape and weight, and their self-esteem.
In a physical health assessment, they’ll be looking at conditions and factors often linked with obesity and being overweight. This includes measuring the waist, height, and weight to calculate the body mass index, checking for high blood pressure and high cholesterol levels, and diagnosing ailments like diabetes, acid reflux, liver and gallbladder disease, heart disease, sleep apnea, and underactive thyroid glands.
The nutritional assessment requires understanding the person’s dietary habits and fitness levels. The professional will ask about the person’s dieting history, their exercise patterns, what foods they usually eat as well as the severity and regularity of binge eating episodes. They’ll also be interested in the ways the person overeats, such as whether they mostly binge during meal times, late at night, or by all-day “grazing”.
Treatment Options for Binge Eating Disorder (Binge Eating)
The treatment for binge eating disorder tends to vary depending on the individual’s specific needs and goals. These objectives could include dealing with issues such as:
1) Overweight issues
2) Episodes of binge eating
3) Concerns about body image
4) Managing additional mental health conditions, like anxiety, substance abuse, and depression
There several main treatment methods for binge eating, which are:
1) Psychotherapy
2) Medications
3) Weight loss treatments
1) Psychotherapy:
Psychotherapy is usually the first choice for treating binge eating. Evidence from several studies shows that it often has a stronger effect than medication alone. Some common types of therapy used are cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and dialectical behavioral therapy.
A) Cognitive Behavioral Therapy (CBT):
CBT is often chosen for treating binge eating as it’s been shown by research to be quite effective. CBT can be led by a therapist or pursued independently through a self-help program. The therapy focuses on creating regular eating patterns, monitoring food habits, learning self-control techniques, and improving problem-solving abilities. Materials may include instructions, educational content about binge eating disorder, and can be delivered via books, websites, workbooks, or mobile apps.
B) Interpersonal Psychotherapy:
This therapy can be provided individually or in a group setting. The therapy doesn’t directly aim for weight loss, but due to reducing binge eating, some weight changes may occur. Interpersonal therapy aims to identify and address problematic areas in the patient’s life (often interpersonal), that might be contributing to the binge eating issue.
C) Dialectical Behavioral Therapy:
This therapy approach equips patients with the needed skills to control behaviors associated with emotional instability. The therapy helps patient balance varying emotions, behaviors and thoughts. Some skills taught are mindful eating, emotional regulation, tolerance for unpleasant circumstances, and methods to prevent relapses.
2) Medication:
Medication should be considered as a first-line treatment for patients who don’t have access to psychotherapy, are not able or willing to do psychotherapy, or prefer medication. Certain drugs can be beneficial for managing binge eating disorder, including Selective serotonin reuptake inhibitors (SSRIs), antiepileptic drugs, medication for attention deficit hyperactivity disorder (ADHD), and even drugs used for shift work disorder. SSRIs in particular should be considered the first line of medication treatment. Other options, like antiepileptic or ADHD medications, may be used if there were unsuccessful attempts with one or two courses of SSRIs.
3) Weight loss treatment:
Most patients with binge eating seek treatment to lose weight rather than stop binge eating. Every patient who is obese should be assessed for binge eating disorder. Best options for weight loss include low or very low-calorie diets and exercise. There are also medications available that can help with short-term weight reduction in obese patients. Another option is bariatric surgery, which can also be beneficial for obese individuals with binge eating disorder. However, it’s worth noting that psychotherapy is usually not effective in reducing weight in obese patients dealing with binge eating disorder.
What else can Binge Eating Disorder (Binge Eating) be?
When trying to diagnose binge eating disorder, doctors consider several other conditions that have similar symptoms. These conditions are:
- Bulimia nervosa: This condition is like binge eating disorder, but after eating, people with bulimia use harmful methods (like vomiting on purpose, overusing laxatives, or fasting) to avoid gaining weight.
- Anxiety disorder: People with anxiety disorder often eat too much, but they are only diagnosed with binge eating disorder if they have episodes of overeating every week for three months.
- Kleine-Levin syndrome: People with this disease have episodes of overeating that go together with sleeping too much.
- Mood disorder: People with this condition have episodes of overeating, along with other mental health issues related to their mood.
The doctor needs to rule out these similar conditions to ensure the diagnosis of binge eating disorder is accurate.
What to expect with Binge Eating Disorder (Binge Eating)
Studies show that the long-term prognosis of binge eating disorder is generally more favorable compared to other eating disorders, having a higher chance of remission. It is also less likely to transition into other eating disorders, with only a small number of studies suggesting a potential escalation to bulimia nervosa. However, binge eating disorder can still have serious mental health consequences, including symptoms of depression and substance abuse.
Binge eating disorder during childhood can lead to excessive weight gain in teenage and young adult females. Furthermore, it can independently heighten the risk of health complications associated with obesity, such as metabolic syndrome.
Possible Complications When Diagnosed with Binge Eating Disorder (Binge Eating)
People with binge eating disorder are often overweight, with both the disorder and obesity usually occurring together and causing similar health problems. These can include:
- Muscular pain
- Pain in the neck, shoulders, and lower back
- Physical disability due to health problems, even when body mass index (or BMI, a measure of body size) is taken into account
- High blood pressure
- Diabetes
- Respiratory issues, like asthma
- Heart problems, such as coronary artery disease and heart failure
- Hyperlipidemia, or abnormally high levels of fats in the blood
- Weight gain
- Problems with menstrual cycles, like missed or irregular periods
- Issues with cortisol hormones, which can disrupt the body’s response to stress
- Certain types of cancer, like colon, breast, and endometrial cancer
- Osteoarthritis, a type of arthritis that commonly affects the knees, hips, and lower back
- Sleep apnea, a disorder that causes periods of stopped breathing during sleep
- Obesity hypoventilation syndrome, a condition that causes poor breathing and decreased oxygen in the blood
- Non-alcoholic fatty liver disease, which is caused by too much fat build-up in the liver
- Gallbladder disease
- Metabolic syndrome, a group of conditions that raise your risk of heart disease, stroke, and type 2 diabetes
Preventing Binge Eating Disorder (Binge Eating)
Patients who are wrestling with this disorder need to have a good understanding of what causes their binges and how to handle them. Becoming aware of their bingeing behavior and learning the techniques to control it can help them break the cycle of bingeing, feeling guilty, then bingeing again. Overthinking about shape and weight can lead to unhealthy dieting and eating habits, which sets up a bad cycle of being more susceptible to binge eating.
Patients should consider these steps to manage their condition:
1. Keep track of what and when they eat, including meals, snacks, and binge behavior. It’s helpful to note what triggers each binge episode too.
2. Be aware of triggers, like eating too little, taking in things that weaken self-control, breaking their own or their doctor’s food rules, or experiencing emotional upset.
3. Establish a routine where meals are three to four hours apart. They should slowly adapt to this pattern over time.
4. Stay away from locations, activities, and people that might set off a binge.
5. Learn how to tackle problems that might be causing their binges. This involves identifying the problem, coming up with different solutions, thinking each one through, and acting on one solution at a time.
6. Identify any particular food that tends to provoke binge episodes.
7. Recognize specific events that typically lead to an episode.
8. Weigh themselves once a week. This helps to prevent frequent weight checking, which can be distressing, or completely avoiding it, which isn’t beneficial either.
