Binge Eating Disorder

Binge eating disorder is a serious condition characterized by uncontrollable eating and resulting weight gain. People with binge eating disorder frequently eat large amounts of food (beyond the point of feeling full) while feeling a loss of control over their eating. Often, these habits are a way of coping with depression, stress, or anxiety. Although the bingeing behavior is similar to what occurs in bulimia nervosa, people with binge eating disorder do not engage in purging by vomiting or using laxatives.

Many people who have binge eating disorder use food as a way to cope with uncomfortable feelings and emotions. These are people who may have never learned how to deal effectively with stress, and find it comforting and soothing to eat food. Unfortunately, they often end up feeling sad and guilty about not being able to control their eating, which increases the stress and fuels the cycle.

What Are the Symptoms of Binge Eating Disorder?

Most people overeat from time to time, and many people say they frequently eat more than they should. Eating large amounts of food, however, does not mean that a person has binge eating disorder. People with binge eating disorder have several of the following symptoms weekly for at least 3 months:

  • Frequent episodes of eating what others would consider an abnormally large amount of food
  • Frequent feelings of being unable to control what or how much is being eaten
  • Eating much more rapidly than usual
  • Eating until uncomfortably full
  • Eating large amounts of food, even when not physically hungry
  • Eating alone out of embarrassment at the quantity of food being eaten
  • Feelings of disgust, depression, or guilt after overeating

People who have binge eating disorder also tend to have:

  • Fluctuations in weight
  • Feelings of low self-esteem
  • Loss of sexual desire
  • Frequent dieting

What Causes Binge Eating Disorder?

The exact cause of binge eating disorder is still unknown, and researchers are just beginning to understand the consequences of the disorder and the factors affecting its development. Like other eating disorders, binge eating disorder seems to result from a combination of psychological, biological, and environmental factors.

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Binge eating disorder has been linked to other mental health disorders. Nearly half of all people with binge eating disorder have a history of depression, although the exact nature of the link is unclear. Many people report that anger, sadness, boredom, anxiety, or other negative emotions can trigger an episode of binge eating. Impulsive behavior and certain other psychological problems also seem to be more common in people with binge eating disorder.

Eating disorders, including binge eating disorder, tend to run in families, suggesting that a susceptibility to eating disorders might be inherited. Researchers also are looking into how brain chemicals and metabolism (the way the body burns calories) affect the development of binge eating disorder.

People with binge eating disorder often come from families that overeat or put an unnatural emphasis on food; for example, using it as a reward or as a way to soothe or comfort.

How Common Is Binge Eating Disorder?

Although only recently formally recognized as a distinct condition, binge eating disorder is probably the most common eating disorder. Most people with binge eating disorder are obese (more than 20% above a healthy body weight), but normal-weight people also can be affected.

Binge eating disorder probably affects 1-5% of all adults. Among mildly obese people in self-help or commercial weight loss programs, 10% to 15% have binge eating disorder. The disorder is even more common in those with severe obesity.

Binge eating disorder is slightly more common in women than in men. The disorder affects African-Americans as often as Caucasians; its frequency in other ethnic groups is not yet known. Obese people with binge eating disorder often became overweight at a younger age than those without the disorder. They also might have more frequent episodes of losing and regaining weight.

How Is Binge Eating Disorder Treated?

Treatment of binge eating disorder is challenging because most people feel ashamed of their disorder and try to hide their problem. Often they are so successful that even close family members and friends don't know they binge eat.

Eating disorders require a comprehensive treatment plan that is adjusted to meet the needs of each patient. The goal of treatment for binge eating disorder is to help the person gain control over his or her eating behavior. Treatment most often involves a combination of the following strategies:

  • Psychotherapy: This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating disorder. Treatment includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way the person responds to stress and difficult situations.
  • Medication: The stimulant drug Vyvanse is currently the only FDA-approved medication for the treatment of binge eating disorder. Other types of medicines have begun to receive research attention to possibly help reduce bingeing behavior, such as the anticonvulsants Topamax (topiramate) or Zonegran (zonisamide). Certain antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) might be used to help control anxiety and depression associated with an eating disorder.
  • Nutrition counseling: This strategy is designed to help restore normal eating patterns, and to teach the importance of nutrition and a balanced diet.
  • Group and/or family therapy: Family support is very important to treatment success. It is important that family members understand the eating disorder and recognize its signs and symptoms. People with eating disorders might benefit from group therapy, where they can find support, and openly discuss their feelings and concerns with others who share common experiences and problems.

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What Are the Complications of Binge Eating Disorder?

The poor eating habits that are common in people with binge eating disorder can lead to serious health problems. The major complications of binge eating disorder are the conditions that often result from being obese. These include:

In addition, people with binge eating disorder are extremely distressed by their binge eating. In some cases, people will neglect their jobs, school, or social activities to binge eat.

What Is the Outlook for People With Binge Eating Disorder?

Like other eating disorders, binge eating disorder is a serious problem that can be solved with proper treatment. With treatment and commitment, many people with this disorder can overcome the habit of overeating and learn healthy eating patterns.

Can Binge Eating Disorder Be Prevented?

Although it might not be possible to prevent all cases of binge eating disorder, it is helpful to begin treatment in people as soon as they begin to have symptoms. In addition, teaching and encouraging healthy eating habits and realistic attitudes about food and body image also might be helpful in preventing the development or worsening of eating disorders.

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WebMD Medical Reference Reviewed by Joseph Goldberg, MD on January 15, 2017

Sources

SOURCES: 

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: "Binge Eating Disorder."

National Eating Disorders Association: "Binge Eating Disorder."

National Association of Anorexia Nervosa and Associated Disorders: "Binge Eating Disorder."

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