Binge Eating Disorder

(BED)

The Facts

Binge eating disorder (BED) is an eating disorder where a person has recurrent episodes of binge eating. During these episodes, the individual eats a large amount of food quickly and feels a lack of control over this eating. BED is different from bulimia nervosa in that people with binge eating disorder do not engage in purging behaviour (such as throwing up or overuse of laxatives) to try to get rid of the calories they have consumed. It occurs more commonly among people with a higher-than-normal body weight. Women are more affected by BED than men. Having binge eating disorder can cause significant impairment in a person's work life, personal life, and social life.

Binge eating disorder affects people of all ages, races, ethnicities, and socio-economic statuses. It can affect children as young as 10 years old, and there is an increasing recognition that it affects people in middle age as well. Binge eating disorder is distinct from obesity and overeating.

The Causes

While the exact causes of binge eating disorder are not clear, its development seems to be associated with genetic, biological, psychological, and environmental factors. Binge eating disorder may signal that an individual is having difficulties coping with their identity and self-esteem issues. Stress, depression, or extreme dieting may cause a change in brain activity which could led to BED.

Symptoms And Complications

During binge episodes, people with BED tend to eat much larger amounts of food than most others would eat in the same time period under similar circumstances. They usually have a sensation of lacking control over their eating during the episode. Most people with BED are distressed by the disorder. Unlike people with bulimia nervosa, people with BED do not purge after overeating .

Binge eating disorder often occurs together with conditions such as mental illnesses. People with BED may experience weight gain over time, which puts them at a higher risk of developing conditions associated with obesity. These include high blood pressure, high cholesterol, heart disease, type 2 diabetes, and gallbladder disease. However, the health consequences of BED are not solely based on the associated weight gain. Binge eating disorder is associated with type 2 diabetes even when comparing people who have the same weight. This means weight gain alone does not explain the association between diabetes and BED.

Making A Diagnosis

To diagnose binge eating disorder, your doctor will need to clinically assess you. Your doctor will ask about your symptoms and take a comprehensive history, as well as assess your medical, mental, and nutritional statuses. To be diagnosed with binge eating disorder, binge eating should occur, on average, at least once a week for 3 months, in addition to experiencing a lack of control with regards to eating. In addition, 3 or more of the following symptoms must be present:

eating until you feel uncomfortably full
eating alone because you're embarrassed
eating much more rapidly than normal
eating large amounts of food, even when you're not physically hungry
feeling depressed, disgusted, or guilty after overeating

Your doctor may also order tests to rule out other conditions that may cause similar symptoms, or to evaluate health consequences of BED.

Treatment And Prevention

Many people with binge eating disorder do not seek treatment. Some are embarrassed or ashamed of their eating; others do not realize BED is a real condition with treatments available.

Treatment goals should be tailored to each individual, and can include:

lowering the number of binge eating episodes
reducing excess weight
enhancing self-acceptance of one's body or reducing concerns with body image
treating coexisting psychiatric or medical conditions
improving daily functioning

Studies have shown that psychotherapy and structured self-help based on cognitive-behavioural interventions are most effective in the treatment of binge eating disorder. Cognitive-behavioural intervention is a form of counselling that focuses on the way you think and behave. You learn to recognize triggers that lead to binge eating and develop strategies to cope with them. Interpersonal psychotherapy is also effective in treating binge eating disorder, especially if the condition is more severe. In some cases, medications (e.g., certain antidepressants, lisdexamfetamine) may be used in addition to psychotherapy, if depression or anxiety is thought to trigger episodes of binge eating. With the support of health care professionals, family, and friends, it is certainly possible to treat binge eating disorder and return to normal work, personal, and social life.