Sometimes you help yourself to a third plate from the buffet. Or you polish off an entire bag of cookies in one sitting. You may wonder if you could have binge eating disorder (BED).
Everyone overeats from time to time. But there’s a big difference between the occasional splurge and BED.
How Is BED Different From Other Eating Issues?
Symptoms of BED may overlap with some other eating-related problems. But there are ways to tell them apart.
You’re watching a movie when you suddenly realize you’ve polished off that entire bag of chips. The difference between this mindless eating and BED is that with mindless eating, you aren’t compelled to consume a large amount of food. You also don’t feel like you can’t stop eating.
Stress or emotional eating is common. Nearly one in three Americans say they eat as a way to cope with stress. BED isn’t a once-in-a-while splurge. You overeat at least once a week for months and feel distressed about it. Stress or anxiety may not be triggers for people with BED.
Food addiction causes a loss of control around food, but losing control doesn’t happen in a short window of time like it does with BED. People who are addicted to food may overeat all day long. They also are less likely to think about how food affects their weight and then restrict foods than are those with BED.
After a binge, someone with bulimia will try to purge the calories by vomiting, using laxatives, or exercising excessively. A person with BED wouldn’t do that.
How Is BED Diagnosed?
Diagnosing eating disorders can be challenging because secrecy, shame, and denial are part of them. So the disorder might not be noticed for a long time. In most cases, binge eating disorder is discovered when a person gets professional help with weight loss. Other times it is identified when the person sees a doctor for an obesity-related health problem, or a mental health problem like depression or anxiety that might be linked to the illness.
If binge eating disorder is suspected, the doctor will likely start an evaluation by doing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose eating disorders, the doctor might use diagnostic tests, such as blood and urine tests and other laboratory procedures, to rule out physical illness as the cause of the symptoms. These tests may also help find the medical effects of an eating disorder, such as changes in digestive enzyme levels, liver functioning, or electrolytes (the normal salt concentrations in blood).
You may also be referred to a psychiatrist or psychologist, health care professionals specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate whether you have binge eating disorder.
You can be diagnosed with BED if you:
- Binge regularly -- on average, at least once a week for at least three months
- Eat a large quantity of food (more than others would eat) in a short amount of time, such as two hours, while feeling like you can’t stop or control how much you’re eating
- Eat when you’re not hungry
- Eat until you feel uncomfortably full
- Eat more quickly than usual
- Eat alone out of embarrassment
- Feel upset about your binges
- Feel guilty, depressed, or disgusted afterward
You may also:
- Feel angry, anxious, or worthless before the binge
- Adjust your schedule to make time for binges
- Hide, steal, or hoard food
- Diet, skip meals, or eat very little to make up for binges
What Are the Risk Factors of BED?
While experts aren’t sure exactly what causes BED, they do know some things may increase your risk of having it:
- Family history. You’re more likely to have an eating disorder, including BED, if your parents or siblings have or had one. Research suggests your genes may play a role.
- Personality traits. Being a perfectionist, having low self-esteem, or being depressed may increase your odds.
- Childhood issues. Painful experiences, such as being made fun of for your weight or body, are linked to BED.
- Unhealthy relationship with food. Dieting and cutting calories in unhealthy ways, such as skipping meals, can lead to this condition.
What Should You Do If You Think You May Have BED?
See a doctor. BED can take a toll on your physical and mental health. It can lead to stress, depression, and even suicidal thoughts. It also can set the stage for headaches, digestive problems, muscle pain, weight gain, and obesity.
A doctor can refer you to a psychologist or psychiatrist. You may need counseling or cognitive behavioral therapy to change the thoughts and actions that lead to binges. The medication lisdexamfetamine (Vyvanse) has been FDA-approved for BED. Doctors might also prescribe medications usually used for seizures, and some antidepressants. The drug Contrave (naltrexone HCI and bupropion HCl), which helps to control cravings, is prescribed for chronic weight management in patients with a high BMI.