Binge Eating Disorders: Symptoms and Treatment

What is Binge Eating Disorder?

Binge eating disorder (BED) is the most common of all eating disorders and is characterized by episodes of eating very large amounts of food over a short period, also known as binging.

While anyone can develop this disorder, it’s more common among females and usually develops after 20 years of age. Research indicates that approximately 3% of the American population is living with binge eating disorder.

How is Binge Eating Disorder Diagnosed?

A diagnosis of binge eating disorder is made after an assessment and interview by a qualified healthcare provider. There are no laboratory or diagnostic tests available to help make this diagnosis. Healthcare providers will use diagnostic criteria listed in the DSM-5 in addition to self disclosed symptoms to reach the correct diagnosis.

Indications that a person is experiencing a binge eating disorder include having episodes of eating a greater amount of food than most people would within a limited period, usually one to two hours, and having at least one such episode per week for several consecutive months.

Persons with binge eating disorder also express a feeling of compulsion or lack of control associated with eating. They often have feelings of distress and/or self loathing about it.

Signs and Symptoms of Binge Eating Disorder

It’s not uncommon for people who don’t have this disorder to engage in binge eating on occasion. However, when binge eating becomes a regular occurrence, especially if it begins to impact your health or overall quality of life, then you may have binge eating disorder.

Signs and symptoms of binge eating disorder include:

• Eating past the point of satisfaction and to the point of discomfort. 
• Eating too fast to notice how much you’re eating or how it feels.
• Eating large amounts of food when they are not hungry or after recently finishing a meal.
• Eating in response to emotional stress, referred to as emotional eating. 
• Eating alone and in secret and avoiding social eating.
• Organizing your schedule around binge eating sessions.
• Hoarding or stashing food in hidden places to consume later.
• Hiding your eating from others because you’re embarrassed about how much you’re eating.
• Having obsessive thinking about food and specific food cravings.
• Dieting frequently, leading to weight fluctuations.
• Experiencing guilt, remorse, shame and self esteem issues related to binge eating. 
• Feeling that you don’t have control over your eating.

FAQs

What are the Health Consequences of Binge Eating?

Like every eating disorder, binge eating can negatively impact an individual’s mental and physical health.

Some of the detrimental social, emotional, physical, and psychological effects of binge eating disorder include:

• Antisocial behavior, such as secrecy, avoidance and lying.
• Erratic behavior, such as stealing and hoarding food. 
• Depression, anxiety and body dysmorphia.
• Emotional distress, self loathing, and low self-esteem
• Substance use disorders and risk of self harm.
• Complications related to obesity to include
• Type 2 diabetes
• Cardiovascular disease
• Gallstones
• Fatty liver disease
• Kidney disease
• Osteoarthritis 

How Do I Stop Binge Eating?

It’s important to remember that binge eating disorder is a mental illness and something that an individual does not choose for themselves. Seeking the appropriate support is the first step toward recovery. Treatment for binge eating disorder includes nutritional counseling, medical care and psychotherapy.

How are Binge Eating Disorders Treated?

Treatment for binge eating disorders involves a multidisciplinary approach to care.

Psychotherapy is a critical component of treating binge eating disorders. Research has shown that the most effective behavioral therapies include cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).

As well, people have benefited from dialectical behavior therapy (DBT), psychodynamic therapy, individual psychotherapy and group therapy. Most individuals find that talk therapy significantly reduces binge eating.

Diet and nutrition counseling is also helpful in the treatment of BED. Nutritionists or registered dietitians can assess individuals for nutrient deficiencies and put interventions into place to correct them.

Although people with binge eating disorder may appear well-fed, they may still be lacking certain micronutrients such as vitamins and minerals. In some cases, these deficiencies may actually motivate binge eating. A binge eater may feel an almost insatiable hunger that is, in fact, the body’s craving for the nutrients it lacks.

Correcting the nutritional deficiency may help reduce the urge to binge eat. Nutritionists and clinicians can help to create a structured, nutritionally balanced meal plan. This ensures that any nutrient deficiency is reversed and also helps to alleviate the stress of making decisions about food.

Another issue that diet and nutrition counseling may address is obesity. Eating a healthy diet on a structured schedule may be all that is needed to help a person lose weight and, in turn, reduce the risk of obesity-related medical complications.

Medication may be helpful for some people with binge eating disorder.Antidepressants may be helpful, especially when used in conjunction with psychotherapy and behavior modification.

For clients who don’t respond well to antidepressant therapies or for whom SSRIs and related antidepressants are contraindicated, medications like Vyvance (lisdexamfetamine) may be a better option.

The medication was originally developed to treat attention deficit hyperactivity disorder (ADHD) but has been shown to reduce the impulse to overeat in those with binge eating disorder. Vyvance may also help prevent relapse, especially in the early stages of recovery.

In some cases, antidepressants or anxiety medication may be helpful to treat any underlying conditions that may worsen the patterns of binge eating. Appetite suppressants may be appropriate for some people.

It’s important to remember that medications alone are not the cure for binge eating disorder. Medications should always be used in conjunction with other supportive therapies.

What Conditions Commonly Co-Occur with Binge Eating?

Research has shown that 55-97% of people with eating disorders also have at least one more mental health condition.

Conditions that are commonly seen with the condition include mood disorders such as major depressive disorder, anxiety disorders including obsessive compulsive disorder (OCD) and social anxiety disorder, and personality disorders including borderline personality disorder (BPD) and obsessive compulsive personality disorder (OCPD).

Binge eating disorder is also commonly associated with unresolved trauma and PTSD, substance use disorder, sexual dysfunction, nonsuicidal self injury, and suicidal ideation.

Finding Treatment for Binge Eating Disorder

Organizations such as the National Alliance on Mental Illness (NAMI), National Eating Disorders Association (NEDA) and the National Association of Anorexia Nervosa and Associated Eating Disorders (ANAD) are excellent resources for those who are experiencing binge eating disorder. These organizations provide education and support and can assist clients in accessing the care they need.

Reaching out to a primary care provider can be another important step toward recovery. Your healthcare team can assist with diagnosis, the development of a treatment plan, or coordination with a qualified eating disorder specialist.

Treatment will likely include psychotherapy that utilizes the appropriate modality to promote healthy coping skills, address stressors or triggers and support individuals in developing a healthy relationship with food.

Depending on the severity of symptoms and any co-occurring disorders, some individuals may benefit from more intensive treatment programs including intensive outpatient programs (IOP) or partial hospitalization programs (PHP).

In recent years online or virtual therapy has gained popularity. This type of therapy allows for convenience and flexibility in scheduling and in some cases may be the only option for people who live in underserved areas. Research is indicating that virtual therapy is just as effective as in-person care.