Eating disorders are not just about eating too much or too little. Instead, they are serious psychological illnesses that cause disturbances in a person’s everyday diet. For example, binge eating disorder, or BED, is an overeating disorder in which a person eats a huge amount of food over a short period. This behaviour is accompanied by a feeling of loss of control over overeating.
Unlike people with bulimia nervosa, those with BED do not follow any compensatory behaviours to avoid weight gain. That is part of the reason why many binge eaters are overweight or obese. Therefore BED can cause deadly health problems related to obesity. People with binge eating disorder usually eat alone because of the shame or guilt about their behaviour.
Binge eating disorder symptoms can be difficult to identify since they are easily misunderstood as general overeating. Therefore, it is important to raise public awareness of BED symptoms to support patients or loved ones that struggle with this problem. In addition, BED treatment plans involve behavioural and pharmacological therapies due to the complex interplay of psychological and physiological complications seen in this condition.
It is reported that 2% of all adults in the USA have binge eating disorder. Also, this condition is more common in females than in males.
Binge eating disorder symptoms
There are two types of binge eating:
- Deprivation sensitive binge eating – Arise as a reaction to food deprivation after someone goes on a diet.
- Addictive binge eating – Arise from a need to ease oneself through food.
Some BED symptoms can be seen in both types. These BED symptoms are associated with several unusual eating behaviours:
- Consuming an abnormally large amount of food in a specific short period.
- Eat more quickly than usual.
- Eat alone or secret because of embarrassment.
- Fluctuation of the weight of weight.
- Eat without any physical hunger.
- Eat until the stomach is stretched out and painful.
- Eating behaviour is out of control of themselves.
- Hiding food.
- Loss of sexual desire.
- Feeling discussed depression of guilt after binge eating.
- Impaired social and occupational functioning.
- Poor interpersonal relationships due to distress about they are eating and weight.
- Over concerning about weight.
- Greater body dissatisfaction.
- Higher urges to binge in response to negative emotions.
However, people with BED do not purge while suffering from this disorder. Therefore they do not follow compensatory behaviours such as self-induced vomiting, use of laxatives, fasting, or strenuous exercises to prevent weight gain.
Hence, if you see any binge eating disorder symptoms, it is advisable to seek medical help as soon as possible.
Causes for binge eating disorder
There is a vicious cycle of bingeing that goes like this:
- You feel guilty, disgusted, and embarrassed after binge eating.
- You take actions such as restricting food to control eating.
- These actions again make you feel depressed and fearful.
- You take action to avoid these stressful conditions and discomfort by bingeing again.
- The cycle continues as you feel embarrassed and guilty about binge eating.
However, some people believe that BED is just an obsession with food and eating. But this condition can be developed as a combined effect of several factors such as psychological and personality traits, culture and families, life-changing stressful events, and the biological makeup of a person.
Psychological and personality traits
In many ways, eating problems are an outward manifestation of the mental problems of a person. Those with binge eating disorder use unusual eating behaviours to avoid their problems and distract themselves. Also, people with poor self-esteem and low self-worth about their body image set extreme goals to lose weight. As a result, binge eating disorder can be developed at some point in response to continuous starvation. BED is more likely to be present in people with mental health problems such as depression and obsessive thinking. It is reported that about half of people with BED have had depression.
Culture and family
Nowadays, many people mistakenly believe that they cannot be pretty or healthy unless they are thin. These feelings of body inadequacies are usually caused by social media influence and parental pressure.
This pressure on youth to achieve a perfect body makes them follow extreme and unhealthy diet plans. Furthermore, people with this mentality may feel so guilty and terrible about themselves if they fail to reach their expected weight goals. And because of that, they eat more. Therefore limiting food intake as a part of a strict diet can lead to bingeing.
Life-changing stressful events
Traumatic or stressful events that change someone’s day-to-day life, such as starting a new job, losing a loved one, sexual abuse, ending a relationship, or a car crash, can bring up feelings of sadness or anger.
Sometimes, instead of dealing with it, an eating disorder can be a method for someone to hide from his pain. In that case, they use food to deal with tension and other emotions they want to avoid.
Genetics and brain chemicals
Genes play a vital role in deciding how people inherit certain physical and behavioural traits. A few studies have suggested that genes have a considerable effect on developing eating disorders as well. Also, family members and relatives of people with BED are at greater risk for developing this condition.
Brain chemicals such as dopamine and serotonin are responsible for feelings of pleasure and fullness. Therefore people with altered dopamine and serotonin levels tend to manifest unusual eating behaviours that encourage them to eat more.
Binge eating disorder Risk factors
As with most mental disorders, there is not one specific reason to develop a binge eating disorder. However, exposure to psychological, physiological, and social risk factors at greater levels increases the chance of developing this condition.
Biological risk factors:
- Problems in appetite regulation
- Metabolic disorders
- The temperament of a person
- Genetics
- Impaired neurobiological activities
- Gender
Psychological risk factors:
- Poor body image
- Maladaptive eating attitudes
- Maladaptive weight believes
- Stress and posttraumatic depression
- Autonomy problems
Social risk factors:
- Improper family attitudes on eating and body weight
- Pressure to be thin
- Body relevant insults and teasing
- Family dysfunction
- Social isolation
- Poor support network
- Maladaptive cultural values to avoid some food.
Complications associated with BED
Physiological complications
Obesity is one of the most common health complications among individuals with BED. Binge eaters consume large quantities of food quickly without using compensatory behaviours to reduce calorie intake. Also, Individuals who binge eat tend to go toward fat and sugar-based food during bingeing. Consumption of these foods without any control can lead them to be obese. Moreover, obesity is associated with some potentially fatal health problems.
- Cardiovascular diseases – Obese individuals require a higher blood supply to get adequate oxygen and nutrients. As a result, it predisposes a person to develop high blood pressure, heart failure, and stroke.
- Diabetes – Being obese increases the risk of developing type 2 diabetes.
- Cancer – Excess fat in your body increases the risk of developing colorectal, uterine esophageal, and pancreatic cancers. Excess fat around visceral organs affects biological processes in your body.
- Reproductive failures – The risk of infertility, low conception rates, miscarriage, and other pregnancy complications are high in obese women.
- Sleep apnea – Fat deposition in the upper respiratory tract narrows the airways by decreasing the muscle activity in that region, causing difficulty in breathing and hypoxic conditions.
- Osteoarthritis
- Breathing problems
- Body pain and difficulty with physical functioning.
In Addition, binge eating disorder can cause several GIT problems. Frequent bingeing episodes cause several gastrointestinal disturbances. Individuals with BED eat until they feel uncomfortably full. Therefore those with this disorder may experience excessive bloating, abdominal pain, and nausea. Also, constipation, irritable bowel syndrome (IBS), and diarrhea can occur as long-term effects.
Emotional complications related to binge eating disorder
Those who suffer from binge eating disorders live with shame and guilt for their compulsive eating behaviours. Therefore they often try to hide them from others which may cause severe emotional and psychological consequences including:
- Severe anxiety
- Depression
- Self-hatred
- Social isolation
- Personality disorders
- Obsessive-compulsive disorder
- Alcohol and substance abuse
Diagnosis and tests
The diagnosis of binge eating disorder is carried out according to DSM-5 diagnostic criteria. DSM-5, or the diagnostic and statistical manual of mental disorders, 5th edition is the 2013 publication of the American psychiatric association classification and assessment tool. It contains diagnostic criteria for mental health disorders. Hence, clinicians use this diagnostic method for an effective and accurate diagnosis of BED.
Criterion 1
- Episodes of binge eating should occur repeatedly.
- The following two major features should be visible within a bingeing episode.
- Eat a considerably large amount of food within a discrete period. (usually about 2 hours)
- Lack of control over overeating.
Criterion 2
Three or more of the following symptoms should be visible in episodes of binge eating:
- Eating faster than normal.
- Eating until they are uncomfortable full.
- Feeling disgusted after eating.
- Eating when not hungry.
- Eating alone due to embarrassment.
Criterion 3
There is significant stress associated with binge eating.
Criterion 4
Binge eating should take place usually at least once a week for three months.
Criterion 5
There is no compensatory behaviour to avoid weight gain as in bulimia nervosa and should not occur concurrently with bulimia nervosa and anorexia nervosa.
The level of severity is categorised as:
- Mild: 1 – 3 bingeing episodes per week.
- Moderate: 4 – 7 bingeing episodes per week.
- Severe: 8 – 13 bingeing episodes per week.
- Extreme: 14 or more bingeing episodes per week.
After considering the above diagnostic method, your clinician will run several examinations and tests to identify other related medical complications caused by BED.
1.Physical examinations to check:
- Heart rate
- Blood pressure
- Temperature
- Diabetes
- Height and weight
- Skin condition
2.Lab tests such as:
- Complete blood count
- Urine test
- X-ray
- Ultrasound
- Electrocardiogram
After gathering basic facts, the therapist does a psychological examination also. This assessment may include:
- Eating habits and feelings about food
- Feelings about shape and weight
- Emotions
- Exercise habits
- Past or current substance abuse
- Sexually active level
- Past experiences about depression and anxiety
Binge eating disorder treatment and medicine
Based on the examinations and tests, the clinician will recommend an appropriate BED treatment plan. A patient can successfully recover through the collective help of doctors, therapists, nutritionists, and family members. The therapy options include both medication and psychological treatments.
Medical treatment
A Doctor’s primary goal is to treat complications related to bingeing and obesity. Therefore it is advisable for bingers with high blood pressure, diabetes, heart diseases, or other obesity-related problems to be hospitalized before their condition worsens.
Medications used to treat BED.
- Antidepressants – Serotonin levels in the brain regulate when one feels full. Unfortunately, patients with binge eating disorder usually do not have sufficient serotonin, so they continue to eat until they are uncomfortably full. Therefore, antidepressants like Prozac and Luvox are used to discourage binge eating by increasing serotonin levels in the brain.
- Lisdexamfetamine dimesylate – Control the impulsive behaviour and number of episodes of binge eating.
- Anti-seizure drugs – Anti-seizure drugs such as Topamax might help some people stop bingeing.
Even though these medications are helpful in the short term, they are generally not as effective as behavioural and psychological treatments. Moreover, these medications may cause some side effects including, headaches, stomach problems, and sleep disturbances.
Psychological treatments
Psychotherapies are critically required to achieve successful results from a BED treatment plan. In psychological therapy sessions, the focus is mainly on the underline causes of binge eating disorder. Once causes for these unusual eating patterns have been identified, suitable strategies are implemented to help patients control their habits.
There are three main approaches to effective psychotherapy:
1.Cognitive-behavioural therapy
This approach helps people change how they think and behave. It is achieved by replacing negative thoughts about eating and body image with positive ones.
Also, this evidence-based treatment model restructures an individual’s thoughts, feelings, and behaviour to obtain more productive actions.
This therapy method focuses on three main phases of treatment:
- Behavioural phase
During this phase, the patient and the therapist develop a close positive relationship. It allows the therapist to understand patients’ feelings and communicate well with them. Also, patients are provided with education and awareness about their eating behaviours.
- Cognitive phase
Patients are encouraged to challenge their negative thoughts about their body image and self-worth. During this phase, patients identify their unhealthy negative feelings and eliminate them by increasing hopefulness and self-esteem.
- Maintenance and relapse prevention phase
This space is mainly focused on maintaining the skills and positive habits obtained in the previous treatment stages.
2.Interpersonal therapy
Focus on how binge eating is connected to relationship issues and life-changing experiences. Patients are taught how to handle them healthily without provoking compulsive behaviours.
3.Dialectical behavioural therapy
This method is an evidence-based psychotherapy that provides patients with new skills to manage emotional conflicts and stress. It helps people with BED to accept their unusual behaviour and work towards changing them. There are several therapeutic strategies used in this therapy.
- Mindfulness,
- Distress tolerance,
- Interpersonal effectiveness,
- Emotional regulation.
Coping and support
Changing your eating behaviours might be difficult. But with good coping skills and a support system, you can achieve some degree of control over them. Here are several coping strategies that may help with recovery:
- Do not be obsessed with food.
- Stop feeling bad or guilty about what you eat.
- Always keep your mind busy with other things besides food
- Try to eat at a restaurant whenever possible
- Try to eat in front of other people
Support from parents and family members is also essential to control the compulsive behaviour of the person with BED. Here are the things family members can do:
- Encourage healthy eating habits.
- Avoid using food as a reward.
- Help your child/sibling to avoid or manage thoughts that trigger binge eating.
- Pay attention to what the patient is eating and notice when they are full. But do not continuously monitor them even if they ask. Allow them to take responsibility for their health.
- Always be affectionate and encouraging to the person with the disorder.
Lifestyle and home remedies
Some changes in your lifestyle can help you during and after your recovery from BED.
1. Reduce stress – Learning to manage stressful situations and emotions is essential to prevent compulsive eating.
2. Try meditation and yoga – They are incorporating meditation and yoga into your daily routine to help you in several ways.
- Reduce symptoms related to compulsive behaviour.
- Reduce the number of binge episodes.
- Improve confidence.
- Reduce tough feelings.
- Improve your happiness and gratitude.
- Reduce blood pressure, cholesterol, blood sugar, and cortisol level.
3. Keep a journal and write in it every night to stay more aware of your daily behaviour
4. Put motivational messages around the house
5. Find different methods to do your day-to-day activities. It will help you stay more aware of your surroundings.
Preparing for your appointment
Admitting that you have a problem with eating is the first step of treatment. With the help of friends and family members, you can seek medical advice to begin a treatment program as soon as possible. You may feel nervous or fearful about your first appointment.
To feel more relaxed and confident about talking to your therapist, write down a list of questions you want to ask, any eating behaviour you are worried about, and family history of psychiatric issues if present. Take your notes with you and refer them during the discussion. Bring one or two family members along with you to the appointment. Also, allow extra time for your first session. It is better to go a few minutes early.
Prevention methods.
- Get educated about eating disorders – the more you know about your negative eating behaviour the easier it will be to prevent them.
- Know the media is not always right – know that media often creates insecurities in people.
- Communicate about your real feelings with parents or close friends.
- Be realistic and learn from your mistakes.
- Learn to admire the inner qualities of a person as honesty, patience, and kindness than appreciating the physical appearance.
References and citations
• Overcoming Your Eating Disorder A Cognitive-Behavioral Therapy Approach for Bulimia Nervosa and Binge-Eating Disorder Guided Self-Help Workbook W. Stewart Agras • Robin F. Apple
• Eating disorders examining anorexia, bulimia and binge eating – Marylou Ambrose And Veronica Deisler
• The Revolutionary Technique for Conquering Emotional Overeating, Cravings, Bingeing, Eating Disorders,
and Self-Sabotage – By Gary Craig
