In observance of Eating Disorder Awareness Month, Gozamos is examining eating disorders (EDs) in a pair of posts this February.  In this post we explore the most common eating disorder today, binge eating disorder (BED).

What is Binge Eating Disorder?

When we think of eating disorders, anorexia and bulimia tend to come to mind as the two most popular EDs. But in recent years, binge eating disorder (BED) has been on the rise. As the name implies, binge eating disorder is characterized by eating too much, or binging. Binge eating is also a central feature of bulimia. Unlike with bulimia, individuals suffering from binge eating disorder do not perform compensatory actions (e.g., vomiting, use of laxatives) to offset the large quantities of food they consume during binges. In some situations and during some holidays, it is culturally sanctioned to overeat. However, what makes binge eating disorder different from “normal” overeating at your grandma’s dinner table, or going all in at a casino buffet, is that BED presents itself as a distressing pattern of emotional, psychological and behavioral symptoms.

The symptoms of BED include:

– Recurrent episodes of binge eating occurring at least twice a week for six months (frequently done in secret)

– Eating larger amounts of food than normal during a short time (typically over a two-hour period)

– Feeling that you can’t stop or control what or how much you’re eating

Additionally, the binge eating episodes themselves are associated at least three of the below criteria:

– Eating until feeling uncomfortably full

– Eating large amounts of food when not physically hungry

– Eating much more rapidly than normal

– Eating alone because you are embarrassed by how much you’re eating

– Feeling disgusted, depressed, or guilty after overeating

Growth in BED rates is in part due to the development of clearer identification and diagnostic criteria. The binge eating disorder category was only recently added last year to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the official guidebook clinicians use to diagnose mental disorders. Of course, binge eating and compulsive eating behavior have been extensively documented in many different cultures, in many different periods of history.

Who Gets Binge Eating Disorder, and Why?

Among the general population, about 3.5% of women and 2% of men have been diagnosed with BED.  Research suggests that both men and women suffer from BED at the same rate–but men are less likely to be included in eating disorder research and men are also less distressed by their binge eating behavior.  The majority of individuals affected by BED are obese (65%) or overweight (20%).  It has been reported that there are no significant differences in the presentation of BED among based on ethnicity–however this may be attributable to unequal representation of some groups in ED research studies.  There is a solid body of research, though, that points to the idea that culture and ethnicity do influence feelings of related to embarrassment and loss of control, which in turn influence likelihood to seek treatment.  Thus, some groups of people may be more or less likely to acknowledge their symptoms and get appropriate treatment.

Like other eating disorders, the causes of BED are complex. Eating disorders have biological, environmental and psychological roots. Binge eating has typically been examined as a food addiction, and compulsive overeaters display many of the same emotional and behavioral issues we would find among alcohol and substance abusers. Similarly, a majority of individuals with BED also suffer from depression, anxiety, or substance abuse disorders. An inability to cope with negative emotions and cognitive distortions related to body shape and weight are also associated with BED. While some studies point to BED running in families, it is unclear as to whether his is due to genetics or traditions in the home that use food and eating emotionally (e.g., to ease stress, to show affection).

Prevention and Treatment

Complications from BED include the development of diabetes, high blood pressure, high cholesterol, sleep apnea, heart disease, obesity and many other health conditions. Mental health complications can also include anxiety related to ED status, depression, and even suicidal thoughts. Although prevention will be an increasing concern among epidemiologists and health specialists as BED rates are seen to increase, there is little empirical data available now regarding how to reduce BED on a macro-level. In terms of help for individuals, there are promising treatments available.  These include:

– Cognitive Behavioral Therapy (CBT) to teach individuals how to observe their negative eating habits and change them into positive ones. Also helps with cognitive distortions regarding body and size.

– Interpersonal psychotherapy helps individuals change problematic areas in their relationships with friends and family.

– Drug therapy, such as antidepressants may work for some (irregularities in dopamine and serotonin transmission have been implicated in binge eating)

If you believe you may have a binge eating problem, please seek a consultation with a medical doctor or psychiatrist.  For additional information:

Resources for EDs

Resources for obesity

– Self-help locations in Chicago (Overeaters Anonymous)

[Photo via Getty Images]

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