Binge Eating Disorder
Binge eating disorder (BED) is a type of feeding and eating disorder that’s now recognized as an official diagnosis. It affects almost 2% of people worldwide and can cause additional health issues linked to diet, such as high cholesterol levels and diabetes.
Binge eating disorder is compulsive overeating. People who binge use food as a way to cope with unwanted emotions or stress. Available treatments for binge eating include individual counseling, nutrition counseling, group/family therapy, and sometimes medication.
Most people have had times when they ate too much, especially during a special occasion or holiday. Binge eating disorder is different.
You feel like you can't stop, even if you're already uncomfortably full. You may eat a lot, quickly, even if you're not hungry. You feel ashamed about it. Unlike bulimia, you don't try to make yourself throw up or exercise a lot after a binge.
You can overcome that out-of-control feeling with treatment. Talking with a specialist (such as a psychiatrist or psychologist) who treats people with eating disorders is key. For some people, taking medication also helps.
It helps to have emotional support from family and friends, too. Their backing makes it easier to change the way you think about food.
Causes
Experts don't know why some people develop binge eating disorder. It's more common in women than in men. In the U.S. about 3.5% of women (5.6 million) and 2% of men (3.1 million) have it.
People who are obese are at a higher risk of getting binge eating disorder, although people of normal weight can also get it. About two of every three people in the U.S. who have the condition are obese
If you have binge eating disorder, you may have trouble handling your emotions or feel out of control in other ways. You may use food as a way to comfort or reward yourself. Skipping meals and other severe dieting may trigger a backlash of binge eating.
The disorder often goes hand-in-hand with depression. Researchers are studying whether brain chemicals or metabolism (the way your body uses food) play roles.
The disorder also runs in some families. Women are more likely than men to have it.
Some people with binge eating disorder have gone through emotional or physical abuse, or had addictions, such as alcoholism. If that sounds like you, getting help with those issues will be part of getting better.
The causes of BED are not well understood but likely due to a variety of risk factors, including:
- Genetics. People with BED may have increased sensitivity to dopamine, a chemical in the brain that’s responsible for feelings of reward and pleasure. There is also strong evidence that the disorder is inherited .
- Gender. BED is more common in women than in men. In the United States, 3.6% of women experience BED at some point in their lives, compared with 2.0% of men. This may be due to underlying biological factors .
- Changes in the brain. There are indications that people with BED may have changes in brain structure that result in a heightened response to food and less self-control .
- Body size. Almost 50% of people with BED have obesity, and 25–50% of patients seeking weight loss surgery meet the criteria for BED. Weight problems may be both a cause and result of the disorder
- Body image. People with BED often have a very negative body image. Body dissatisfaction, dieting, and overeating contribute to the development of the disorder .
- Binge eating. Those affected often report a history of binge eating as the first symptom of the disorder. This includes binge eating in childhood and the teenage years .
- Emotional trauma. Stressful life events, such as abuse, death, separation from a family member, or a car accident, are risk factors. Childhood bullying due to weight may also contribute .
- Other psychological conditions. Almost 80% of people with BED have at least one other psychological disorder, such as phobias, depression, post-traumatic stress disorder (PTSD), bipolar disorder, anxiety, or substance abuse .
Symptoms
If you have binge eating disorder, you:
- Eat more food than other people do in the same situation.
- Feel like you can't control how much you eat.
- Feel upset after you binge.
- Have an eating binge at least once a week for 3 months, on average.
You also have three or more of these symptoms:
- Eat much more quickly than normal.
- Eat enough to be uncomfortably full.
- Even when you're not hungry you eat a lot.
- Eat alone so no one will see how much food you're having.
- Feel guilty, disgusted, or depressed about your eating.
People with binge eating disorder don't try to throw up after overeating. You can get other health problems related to gaining weight or unhealthy eating, too, such as type 2 diabetes, high blood pressure, or heart disease.
You also may have trouble sleeping, muscle and joint pain, and digestive problems. Women may have irregular or infrequent menstrual periods.
Getting a Diagnosis
Your doctor may ask you questions such as:
- Once you start eating, can you stop?
- How do you feel about how much you eat?
- Do you eat really fast?
- Do you keep eating even after you're uncomfortably full?
- Have you ever lied to someone about how much you eat?
- Do you want to eat alone? Why?
People with eating disorders often try to hide it. In order to get diagnosed, though, you need to be open with your doctor. She's on your side.
Your doctor may consider binge eating mild if it happens 1-3 times a week, moderate if it happens 4-7 times a week, severe if it happens 8-13 times a week, or extreme if it happens 14 or more times a week.
Questions for Your Doctor
- Have you worked with many people with binge eating disorder?
- What treatment do you recommend? How long will it last?
- Do I have any other conditions or issues that need to be treated?
- How can my family or friends help me?
Treatment
Beating binge eating disorder is not about willpower.
Sometimes medications such as lisdexamfetamine (Vyvanse) will be prescribed to suppress the desire to binge eat. It is the first FDA-approved drug to treat moderate to severe binge eating by curbing the binge eating episodes. You also need the help of a specialist, such as a psychiatrist or psychologist.
She may use an approach called cognitive behavior therapy, which focuses on what you do and how you feel. It can help you change your thoughts about eating and understand what triggers your binges.
Your therapist may suggest that you include your family in counseling so they can learn about the disorder, spot sources of stress at home, and know how to support you.
Ask your doctor or therapist about finding a support group in your area. It can help to talk to other people who know what you're going through.
You also may need help with other conditions, such as depression or anxiety. A doctor may prescribe an antidepressant, a drug to help manage the urge to binge (such as the anti-seizure drug topiramate), or other medications. A new medication, naltrexone hcl/bupropion hcl (Contrave), helps with weight loss.
Taking Care of Yourself
Feeling stressed makes it more likely that you'll binge eat, so you'll need positive ways to manage that. Yoga, meditation, exercise, and massage therapy can help you feel calm.
Ask your doctor or therapist to recommend a nutritional counselor who can teach you about healthy eating. If you have type 2 diabetes or high cholesterol, you may need to limit certain types of foods or lose weight. You need your doctor's advice on how to lose extra weight without triggering binge eating.
The goal is to get healthier. It's not about numbers on a scale or serving sizes. It's also about how you relate to food and to your own body.
What to Expect
If you feel stuck in a cycle of binge eating, take heart: Most people can overcome this disorder with treatment. It's possible for you, too.
Most importantly, be patient with yourself. People with binge eating disorder often blame themselves. As you work toward recovery, you may have setbacks. Those bumps in the road aren't unusual as you gradually gain more control over your eating.
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