Binge Eating Disorder

Binge eating disorder (BED) was first mentioned in the Diagnostic and Statistical Manual edition 4 (DSM-4) in 1994 where it was listed only as a feature of “eating disorder not otherwise specified,” or EDNOS. It wasn’t until 2013 that the DSM-5 recognized binge-eating as a stand-alone disorder.

Signs and Symptoms

To be diagnosed as having BED you must fit the DSM-5 criteria above. The signs and symptoms of BED are common among those who have BED, but may not be all-inclusive. Some people without BED may experience some of the same symptoms, while others who are diagnosed as having BED, do not experience all of the same symptoms as others. It is best to see a psychologist or therapist if you believe you have a binge eating disorder.

Common signs and symptoms are

  • Embarrassed by how much you eat
  • Prefer eating alone
  • Depressed, disgusted, ashamed, guilty or upset about your eating habits
  • Sneaking, stealing, or hiding food from others
  • Low self-esteem
  • Poor body image
  • Being overweight
  • Dieting without losing weight

diagnosis

Binge eating disorder is much different from simply overeating at a Thanksgiving dinner or a night out with friends. It is where individuals frequently feel compelled to eat large quantities of food that is not normal for a regular person. They also feel unable to stop themselves from continuing to eat.

The DSM-5 has five criteria for diagnosing binge eating disorder (BED).

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

  1. 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
  2. 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:

  1. Eating much more rapidly than normal
  2. Eating until feeling uncomfortably full
  3. Eating large amounts of food when not feeling physically hungry
  4. Eating alone because of being embarrassed by how much one is eating
  5. 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,

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

The severity scale is as follows:

  1. Mild: 1-3 binge eating episodes per week
  2. Moderate: 4-7 binge eating episodes per week
  3. Severe: 8-13 binge eating episodes per week
  4. Extreme: 14 or more binge eating episodes per week

Risk Factors

  • Being female. An article from Mayo Clinic stated that binge eating disorder “is more common in women than in men. Although people of any age can have binge-eating disorder. “
  • Being 17-23 years old. The same article said that those in their late teens to early twenties are more at risk of developing a binge eating disorder although it can occur during different ages as well.
  • Family history. You are more at risk if you have family members who have or have had an eating disorder.
  • A history of dieting. Many people with eating disorders have a long history of dieting, especially those that drastically restrict their caloric intake. Those who have binge eating disorder tend to restrict and then binge.
  • Poor self-image. Those who have a poor self-image and feel negative about themselves are at risk of developing an eating disorder.

Prevalence

The National Eating Disorders Association did a study in 2007 where they found that 3.5% of women and 2.0% of men had a binge eating disorder during their life.

They went on to say, “This makes BED more than three times more common than anorexia and bulimia combined. BED is also more common than breast cancer, HIV, and schizophrenia.”

BED is by far the most common form of eating disorders, yet most people do not receive treatment. The same research from the National Eating Disorder Association stated that more than half of those with BED did not receive treatment at any point in their lives.

If many people do not seek treatment for binge eating disorder, it would make sense that it would have a higher prevalence compared to the other eating disorders.

But why wouldn’t they seek treatment?

One reason why many do not seek treatment could be that a lot of people who have BED may not even know they suffer from it. Instead of realizing they have a disorder, they simply think they lack self-control and don’t know how to diet properly.

Another reason why they might not reach out for help is that they are ashamed of their problem and afraid of the stigma and labels that are associated with those who have mental health problems.

Treatment

The main goals of treating a binge eating disorder are to help the client gain control over their eating binges, learn healthier eating habits, work on depression if present, and work on positive self-image or self-confidence.

There are various methods of treating binge eating disorders if seen by a mental health professional. The Mayo Clinic suggested the following types of therapy.

  • Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns.
  • Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends, and co-workers. This may help reduce binge eating that’s triggered by problematic relationships and unhealthy communication skills.
  • Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.”

To find a therapist in your area you can go to Psychology Today at www.psychologytoday.com/us/therapists.

From there, make sure to check the specialties of the therapists you look at or try calling their offices to see if they work with eating disorders. If you or a loved one suffer from BED, getting help is always the best option.


Leave a Reply