Binge Eating Disorder

Binge Eating Disorder, as defined by the Diagnostical and Statistical Manual of Mental Disorders, is the tendency to eat unusually large amounts of food in a short time period while experiencing a loss of control.1 Once categorized as an Eating Disorder Not Otherwise Specified, binge eating disorder is now recognized as its own eating disorder. It is important to distinguish the differences between general overeating, which many people experience occasionally, and Binge Eating Disorder. Binge Eating Disorder is more severe and, being a mental disorder, causes psychological distress in the sufferer. It’s characterized by ‘loss of control eating’ in which the sufferer feels intense cravings and continues to eat after becoming full.

In Binge Eating Disorder, binging occurs at least once a week over a period of three months.1 Unlike the purging behaviors seen in bulimia nervosa, sufferers of Binge Eating Disorder binge without compensation.2 With a lifetime prevalence of 1.9% in women and 0.3% in men in Europe, and 3.5% in women and 2.0% in men, it’s clear that this is a disorder that has had an impact on many lives.5 Because this disorder isn’t centered around an obsession with attaining thinness, more men may be impacted. In societies where women are encouraged to be thin, they may have greater risk of developing an eating disorder due to societal pressure, but the obsession with food as seen in Binge Eating Disorder can affect those of either gender.

Symptoms

Binge Eating Disorder has a variety of psychological and behavioral symptoms. Sufferers often experience intense food cravings.4 Many eat alone or in secret, often out of embarrassment.2 Eating quickly or when not hungry is a common facet of Binge Eating Disorder.1 Sufferers may experience social difficulties because of the need to eat alone or nonstop, and battle intrusive thoughts concerning food. Additionally, the frequent buying of fast food or extra grocery trips can create a financial burden. A combination of these symptoms may induce feelings of guilt, stress, and self disgust.1,2 People affected by binge eating disorder often suffer in silence. Because of the shame and embarrassment associated with the disorder, many are reluctant to tell others about their symptoms or related habits.

Causes

Binge Eating Disorder, like many psychological afflictions, has no explicit cause. It is likely due to a combination of lifestyle factors and personality traits. 

  • Impulsivity has been shown to be a common trait among sufferers, especially impulsivity towards food. Those with Binge Eating Disorder also score higher on self-reported trait impulsivity in general.Binging episodes are characterized by ‘loss of control eating’ and typically occurs when the sufferer is sad or stressed. Binge Eating Disorder is often co-morbid with other mental disorders, such as anxiety, substance abuse, and mood disorders.
  • Binge eating disorder is a facet of a society where food is readily available, and therefore typically affects those in Western cultures. Humans have evolved to prefer foods with sweet or savory flavors, because these foods tend to have high caloric value. In earlier human foraging societies, where food was scarce, one had to eat at every possible opportunity in order to survive. The resulting human tendency towards ‘comfort foods’ causes many to overeat and is therefore maladaptive in societies where famine is not of constant concern.3 
  • Unhappiness with one’s body may be a major facet of binge eating disorder. An individual who binges will afterwards likely experience feelings of discomfort due to being full, and therefore may perceive bloating and excessive fullness as their having gained weight. Often, binges can stem from feelings of sadness, and those who binge eat may experience sadness caused by dissatisfaction with their figure. The accumulation of extra calories due to binging typically leads to weight gain, leading the sufferer into a cycle of self-hatred and continued binging as a result. 
  • Food may be a compensatory behavior for one with binge eating disorder. When sad or stressed, the sufferer may turn to food as a source of comfort. One may view food as the one source of consistency in their life, and therefore turn to it in times of distress. Because weight gain, secrecy, and guilt from either eating another’s food or spending excessively to support one’s binging may lead to additional self-hatred and distress, they continue to binge as compensation for the unhappiness it causes. 
  • A need to maintain control over one’s life may also affect sufferers of eating disorders. Those with binge eating disorder, unlike anorexics who exercise control through restricting their diet, may experience the need to binge as an outlet for an otherwise rigidly controlled life. Food, and binging on food, may be something to turn to in times of distress.

Binge Eating Disorder and Obesity

While many sufferers of Binge Eating Disorder are obese, it’s important to realize that these conditions are simply correlated. However, Binge Eating Disorder does often lead to obesity, and therefore increased mortality. The onset typically occurs during one’s teen years, and diagnosis and intervention doesn’t occur until much later, sometimes in one’s twenties but usually in their 30s-50s.2 It’s important to look out for the symptoms of Binge Eating Disorder, and to understand that this disorder can affect many people, especially in a society where food is so readily available.

Treatment

The goal of treatment is to control binging and lose excess body weight. Treatments include psychotherapy, pharmacologic intervention, and/or diet and lifestyle modification. However, these are often not effective and many people are able to stop binging but are unable to lose excess body weight. This disorder is highly psychological, and therefore changing habits or mindsets is incredibly difficult to do. Often, the most helpful treatment is learning to view food differently, and learning to appreciate moderate portions of healthy food. 

 

References

1. American Psychiatric Association. “Binge Eating Disorder." Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Arlington: American Psychiatric Association, 2013. 372-78. Print.

2. Crow, Scott, MD. "Treatment of Binge Eating Disorder." Current Treatment Options in Psychiatry (2014): 307-14. 9 Oct. 2014. Web. 20 Jan. 2016. 

3. Gaulin, Steven. “Mismatch and the EEA”. November 2014. Lecture Module.

4. Schag, K., J. Schönleber, M. Teufel, S. Zipfel, and K. E. Giel. "Food-related Impulsivity in Obesity and Binge Eating Disorder – a Systematic Review." Obesity Reviews 14 (2013): 477-95. Web. 20 Jan. 2016.

5. Smink, Frédérique R. E,, Daphne Van Hoeken, and Hans W. Hoek. "Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates." Curr Psychiatry Rep 14 (2012): 406-14. Springer, 27 May 2012. Web. 20 Jan. 2016. 

Last Updated 20 January 2016.

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