Binge Eating Disorder

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Empty dirty plates and cutlery

A person with binge eating disorder (BED) engages in repeated episodes of binge eating. Binge eating is defined as eating a very large amount of food over a short period of time. During these episodes the person feels out of control and unable to stop eating. Binge eating episodes occur regularly; at least once per week over at least three months. Unlike those with bulimia nervosa, people with BED do not engage in compensatory behaviours to prevent potential weight gain (e.g. over-exercising, self-induced vomiting). 

Common triggers for an episode of binge eating include low mood, negative body image, stress, and not eating enough over the day. Binge eating is often used as a way to deal with strong and distressing emotions; it is a coping mechanism. People with BED often feel embarrassment, guilt, or shame about their eating behaviours. Many with BED also have negative thoughts about their body weight and shape, low self-esteem, and may struggle with other emotional issues such as anxiety or depression. 

People with BED can get stuck in a cycle of binge eating, then feeling guilt and shame, and then restricting the amounts and types of food they eat. This restriction can cause them to crave food, which then increases the chance of binge eating. 

BED is thought to be caused by a mix of biological, psychological, social, and cultural factors. There is a genetic component, meaning those with a family history of BED have a higher chance of developing the disorder. The presence of other mental health conditions and being on a restrictive diet can also increase the risk of developing BED.

Common symptoms
  • Binge eating - Eating a very large amount of food over a short period of time [less than 2 hours]. During a binge the person feels out of control and unable to stop eating.
  • Binge eating occurs regularly - at least once per week over at least three months.
  • Not engaging in behaviour to prevent weight gain after binge eating. Such as self-induced vomiting, over-exercising, laxative use, etc.
  • Feeling embarrassed, ashamed, or guilty about eating behaviours.
  • Experiencing distress, anxiety, or depressive symptoms after binge eating.
  • Eating alone or hiding eating behaviours.
  • Low self-esteem.
  • Negative thoughts about body shape and weight.
  • Withdrawing from family and friends.
  • Changes in weight.
How common is in the general population
An estimated 2% of the general population will experience BED.
Gender differences
BED is slightly more common in females. Compared to other eating disorders, the number of males and females who experience BED is more equal.
Onset
BED commonly begins in adolescence or early adulthood. However, it can begin at any stage of life.
Typical Course
The course of BED varies. It is possible to fully recover from BED but if untreated the condition can last for years. The intensity of symptoms and frequency of binges may vary over time (e.g. worse when stressed).
Common Comorbid (concurrent) Conditions
Depression, anxiety disorders, bipolar disorders, substance use disorders.
Common treatments

If you think you have BED it is important to talk to a medical professional such as your GP. BED is associated with an increased risk of heart disease, diabetes, kidney problems, osteoarthritis, obesity, high cholesterol and high blood pressure. There is also an increased risk of developing other mental health conditions and substance abuse. The earlier you start treatment, the better your chance of full recovery.

Psychological Therapy:

Several forms of psychological therapy, or talk therapy, have been shown to be effective in treating BED. Treatment aims to identify what is triggering episodes of binge eating, help establish regular eating patterns and better eating habits, find healthier ways to cope with strong emotions and stress, and address any issues around body image. BED is often accompanied by other mental health conditions, emotional issues, and low self-esteem. It is important to treat these issues as well. 

Cognitive behavioural therapy (CBT) is the recommended treatment for BED. CBT is a structured form of talk therapy which aims to identify and change negative thoughts and behaviours. CBT helps you identify and address the thoughts and feelings that can trigger binge eating, develop better ways to cope with emotions, establish regular eating patterns, and address other emotional issues and negative body image.

Interpersonal psychotherapy (IPT) is a talk therapy which aims to improve relationships, interpersonal skills, and communication. This is used as a treatment for BED in cases where relationship issues or interpersonal problems may be triggering binge eating.

Dialectical behavioural therapy (DBT) is another psychological treatment approach. DBT aims to help people learn how to tolerate and manage strong emotions and stress, rather than using harmful coping mechanisms such as binge eating. Through DBT the person learns skills to improve relationships, tolerate and regulate emotions, and develop healthy coping mechanisms.

Medication:

Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to treat anxiety and/or depressive symptoms which often accompany BED. Medication should be used alongside talk therapy.