What is Binge Eating Disorder?

Mar 13

Binge eating is when a person eats a large amount of food within a short amount of time. They generally eat past fullness or when they are not hungry.

A person often feels out of control about what or how much they are eating during a binge eating episode.

People with binge eating disorder do not purge their bodies of the excess food they have eaten.

Binging is often done in secrecy and there is often a sense of guilt, shame and/or depressed feelings after a binge eating episode.

If you are binge eating at least once a week for 3 months or more, you may be struggling with binge eating disorder.

How Common is Binge Eating Disorder?

Binge eating disorder is the most common eating disorder in the United States.

Roughly 1.25% of adult women and 0.42% of adult men are diagnosed with binge eating disorder. Studies also report that 1.6% of teenagers ages 13 to 18 years old are also affected.

Eating disorders in general do not discriminate. They affect people of all ethnic and racial groups.

Statistically, an even larger percentage of teens and adults have reported binge eating episodes or a loss of control with food and eating past fullness, but did not meet the full criteria for a binge eating disorder diagnosis [1].

Binge Eating Disorder Symptoms

The Diagnostic and Statistical Manual of Mental Health (DSM-5) is the latest edition of the American Psychiatric Association’s professional reference book for diagnosing various mental health disorders.

Below is the diagnostic criteria for binge eating disorder. All categories must be met to be diagnosed with this mental health condition.

Criterion 1: Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

Criterion 2: Binge-eating episodes are associated with three (or more) of the following:

Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of being embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or very guilty after overeating

Criterion 3: Marked distress regarding binge eating is present.

Criterion 4: the binge eating occurs, on average (must meet one of the following),

at least 2 days a week for 6 months (DSM-IV frequency and duration criteria)
at least 1 day a week for 3 months (DSM-5 frequency and duration criteria)

Criterion 5: The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

Severity Grading: DSM-IV does not include a BED severity grading scale. Applicable to DSM-5 only, BED severity is graded as follows:

Mild: 1 to 3 episodes per week
Moderate: 4 to 7 episodes per week
Severe: 8 to 13 episodes per week
Extreme: 14 or more episodes per week

Who is at Risk for Binge Eating Disorder?

Studies reveal that more than half of people with binge eating disorder are women of all racial and ethical backgrounds. Females who diet increase their risk of developing binge eating disorder 12 times more than females who do not diet [2].

Biological risk is another risk factor. A person who either has a close relative with an eating disorder or a mental health condition may be more susceptible to developing binge eating disorder or an eating disorder in general.

Research has also found individuals with diabetes are at an increased risk, due to a complex relationship with food and diabetes management. Some psychological risk factors to consider are perfectionistic thinking patterns, cognitive inflexibility, impulsivity, emotional regulation challenges, avoidance motivation, and body image dissatisfaction.

Lastly, there are social factors to consider as potential risks.

Weight stigma is a form of discrimination and stereotyping based on a person’s weight. Weight stigma has been linked to “weight bullying,” which is bullying or teasing about weight.

Bullying or teasing, especially about a person's weight, is considered a major risk for a the potential development of an eating disorder.

For individuals from racial or ethnic minority groups, acculturation may increase a person's risk for an eating disorder. Acculturation is the act of assimilating to a different culture, most often the dominant culture a person is living in.

Individuals living in a Westernized society are more susceptible to Westernized messages around thinness.

These messages may lead to an individual restricting or overeating in secret.

In addition, a lack of social support increases loneliness and isolation, which are common risk factors for eating disorders.

Disclaimer: having one of the following risks above does not guarantee an eating disorder, but could increase the likelihood of one developing.

Complications Related to Binge Eating Disorder

John Hopkin Medical centers share the following complications from binge eating disorder include:

Overweight or obesity
People with binge eating disorder are at higher risk for depressive mood disorders, anxiety, and substance use disorder.

Increased risk for:

High cholesterol

High blood pressure

Diabetes

Gallbladder disease

Heart disease

Some types of cancer

Treatment for Binge Eating Disorder

When it comes to treating binge eating disorder or any eating disorder, creating a team of support can create the most success to a person’s recovery. Treatment plans may include one or more of the following: