Binge Eating Disorder

The most common type of eating disorder in the United States, binge eating disorder affects 3.5 percent of women and 2.0 percent of men. This is more common than anorexia nervosa and bulimia nervosa combined. People with binge eating disorder engage in binge eating episodes in which large amounts of food are eaten in a short period. This becomes compulsive behavior, producing feelings of guilt and shame about the eating, and a feeling of not knowing how to stop binge eating. Unlike bulimia nervosa, binge eating episodes are not accompanied by compensatory purging behaviors. Binge eating disorder treatment is widely available, and follows the same continuum of  care employs in other forms of eating disorder recovery programs. Binge eating disorder was added to the DSM-V in 2013.

Signs and Symptoms of Binge Eating Disorder

 Typically developing during adolescence and early adulthood (although it is known to begin during middle age and later), binge eating disorder causes people to eat large amounts of food, often in secret and when they are not hungry. Continuing to eat when full, eating to the point of discomfort, and distress about eating are all symptoms of this disorder. The major diagnostic difference between binge eating disorder and bulimia nervosa is that people with binge eating disorder do not use disordered purging behaviors like vomiting, exercising excessively, or laxative abuse to compensate for the food eaten.

A binge eating episode can happen at any time, but is often triggered by stress or anxiety. Binge eating episodes produce dopamine and serotonin, and act as disordered coping mechanisms for these negative emotions. Over time, the binge eating episodes become compulsive, with the individual becoming unsure how to stop binge eating. The combination of guilt over binge eating and the temporary relief during the episides often leads to a cycle of binge eating and dieting that can be difficult to break.

According to the DSM-V, here are the diagnostic criteria of binge eating disorder: 

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

          a. 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 circumstance

         b. 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)

     2. Intense fear of becoming overweight or gaining weight even while being underweight.

     3. Restriction of energy intake relative to the body’s requirements, which leads to a low                         body weight.

For more detail and the full diagnostic criteria, please see the DSM-V here. There are other behavioral symptoms of binge eating disorder that aren’t listed by the DSM-V, however, that family and friends can remain on the lookout for. Other behavioral characteristics of binge eating disorder include:

  • Stockpiling food 
  • Eating normally when around family and friends but binge eating later in private
  • Thinking about eating constantly
  • Withdrawing from social events to spend more time alone 
  • Weight fluctuations
  • Distress over weight/body size
  • Improper nutrition

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Pathophysiology of Binge Eating Disorder

In 2018 Oliver-Pyatt Centers (OPC) began a comprehensive research study, approved by an Institutional Review Board, in order to assess treatment outcomes in our Residential, PHP and IOP levels of care. Specifically, clients who consent to participate in our research study complete a series of questionnaires upon admission, transfer to a new level of care (stepping up or down), as well as upon discharge from our eating disorder treatment programs. Additionally, we obtain follow-up data for clients who consent at specified time-points after their discharge.

The purpose of these questionnaires is multifaceted. Primarily, it represents our commitment to personalized treatment planning. This data provides a snapshot of each individual’s distinctive symptom presentation on measures of eating disorder symptoms, depression, anxiety, functional impairment, and trauma reactivity. This information deepens our understanding of the clinical challenges specific to each client and as a roadmap for exploration of the factors that may be maintaining the eating disorder.

What Causes Binge Eating Disorder?

Binge eating disorder arises from multiple risk factors including psychiatric, genetic, and social influences.

Social factors contributing to the development of binge eating disorder include unrealistic presentations of the ideal body in media and culture, and the presentation of weight loss as a positive in the media and “diet industry.” Dieting contributes to hunger pangs which can act as ta trigger for the symptoms of binge eating disorder. Attitudes about body size from family and ppers can also lead to a disordered body image and binge eating disorder.

Psychiatric factors contributing to the development of binge eating disorder include anxiety, depression, and obsessive-compulsive disorder. The latter may have some relation to binge eating disorder, although the research is not yet clear. All of these traits can increase the likelihood of an individual to develop an compulsive attitude about food and eating, leading to binge eating episodes. There is no psychiatric medication designed for binge eating disorder specifically, but during eating disorder treatment, psychiatrists may prescribe antidepressants or anti-anxiety medication to alleviate co-occurring disorders.

Finally, some researchers believe that genetic factors may also contribute to the development of binge eating disorder. Certain individuals may have genes that are more prone to developing disordered eating behaviors. As with other mental health disorders, an individual’s family background also contributes to the risk for binge eating disorder. People whose parents have or had binge eating disorder are much more likely to develop the disorder themselves, indicating that there is a genetic as well as learned aspect to its development.

An Overview of Binge Eating Disorder Treatment

Binge eating disorder treatment begins with a medical assessment to determine what physical health complications need to be addressed, followed by counseling sessions guided by therapists and recovery coaches who understand how difficult and stressful it is to cope with binge eating disorder. Behavioral therapy for binge eating disorder revolves around helping clients to rediscover their core sense of self, how to differentiate between their “healthy self” and “eating disorder self” and the underlying causes of their disorder. Evidence-based psychotherapeutic techniques address underlying conflicts fueling binge eating disorder by providing coping tools. Common co-occurring disorders such as PTSD, anxiety, depression, and substance abuse disorder that often co-present with binge eating disorder are also addressed during treatment.

Staff members facilitate binge eating disorder recovery by cultivating  empathy and trust with their clients. Each of our treatment programs for binge eating disorder focus on mindfulness, self-awareness, and recapturing the joy and fulfillment of intuitive eating. Nutrition and meal planning are also central facets of a binge eating disorder recovery plan. Cognitive behavioral therapy, dialectical behavioral skills training, acceptance and commitment therapy and art, music, and other experiential therapies may also be included in the treatment program.

You can see more on our blog about binge eating disorder here. 

Effective binge eating disorder treatment programs are available. If you or a loved one is struggling with an eating disorder, please contact us today.