What is Binge Eating Disorder?
Binge eating disorder (BED) is a newly characterized, severe and life-threatening eating disorder defined by excessive, uncontrollable eating. Binge eating disorder embodies features of compulsive disorders and eating disorders. Now, physicians list binge eating disorder in the Diagnostic-Statistical Manual of the American Psychiatric Association’s 5th edition, published in 2013.
Characteristics of BED
A psychiatrist or physician who specializes in eating disorders is the best person to properly diagnose binge eating disorder. There are emotional and behavioral characteristics, as well as physical signs. To be diagnosed, the patient must have at least one binge eating episode per week for at least three months straight.
Emotional and Behavioral Symptoms
Secret recurring food binges
Stockpiling, hoarding or stealing food
Fear or discomfort eating in front of others
Significantly changing schedules or habits to make time for binging
Withdrawing from friends and usual activities
Body dysmorphic disorder: an extreme belief that one’s body is severely flawed
Lack of control over eating habits
Feeling guilt, disgust and helplessness about overeating
Rapid changes in weight
Risk Factors for BED
It is not clear what causes binge eating disorder, but there are risk factors that may play a role.
Hormones and chemicals affect eating behaviors and patterns. Binge eating produces a surge of dopamine and serotonin that increases pleasure and generates a sense of well-being that alleviates psycho-emotional pain. BED is associated with chemical releases in certain parts of the brain.
For example, the hypothalamus is a small, pea-sized part of the brain that maintains body temperature, blood pressure, stress and hormones that control hunger and feeling full after eating. By regulating hormones from the hypothalamus, the body maintains an even keel. It’s possible that binge eating disorder results when the hypothalamus fails to send correct messages to the brain about hunger.
Although the hypothalamus responds to a variety of signals, it can get out of balance itself. The hypothalamus connects to the amygdala through an area of the brain called the bed nucleus of the stria terminalis (BNST). It normally helps the hypothalamus regulate hunger by releasing and inhibiting hormones from the hypothalamus. Research shows that a malfunctioning BNST may interrupt hypothalamus function.
Age & Gender
Binge eating disorder affects men and women disproportionately. More than half of all BED patients are women, which is more than 3 percent of the U.S. population. However, some women face a higher risk than others. Women who diet are more at risk than those who don’t and it usually affects younger women more than older women. It often develops in women in their 20s.
Other Risk Factors
Emotional or physical abuse
Health Complications of BED
People with eating disorders tend to suffer in silence until their behavior is discovered. There’s a sense of shame and guilt that accompanies BED. A person with binge eating disorder usually has weight fluctuations, but ultimately, obesity may eventually solidify.
BED often causes other emotional and mental hurdles, such as anxiety and depression. Research suggests that anxiety may play a role in the disorder. One study concluded that 13 percent of BED patients had general anxiety disorder, 22 percent had social phobia and 46 percent had major depressive disorder.
Overcoming binge eating with therapy and medication can help break the binge cycle eating. A compulsion to eat uncontrollably remains that: a compulsion. Binge eating may be treated with cognitive-behavioral therapy (CBT) and/or medications.
Antidepressants like Zoloft or Prozac may treat BED if the patient has underlying depression. Vyvanse is currently the only FDA-approved drug on the market that specifically treats severe binge eating disorder.
Treatment often combines pharmacological and psychological treatments to address underlying emotional issues that provoke and sustain binge eating to help the patient achieve long-lasting remission. For example, dialectical behavior therapy (DBT) is an effective method to treat compulsive binge eating. Studies have shown a six-month cessation rate of 59 percent. DBT attempts to help the patient adapt emotionally to stressors, to which the individual has difficulties adapting and uses overeating as an outlet.
Strategies for weight control do not specifically address any underlying causes of binge eating. But, combined with therapy and medication that aim to address mental health issues, it may help the patient practice more healthy eating patterns.
It is important to note that treatment for binge eating in itself is not necessarily a treatment for obesity or overweight. Likewise, treating obesity alone in a BED patient does not resolve the deeper causative issues that trigger binge eating disorder.
Supplements for Healthy Weight Control
Supplements are not a direct treatment for binge eating disorder, but they may help to promote weight control in a healthy way. Always consult a doctor before adding supplements to your diet.
The Bottom Line
Binge eating disorder (BED) is a condition with characteristics of eating disorders and compulsive disorders. It causes excessive, recurrent and harmful bouts of food consumption called binges. Other characteristics include stealing and hiding food, low self-esteem, lack of control over eating habits and feelings of guilt and shame about overeating. BED may cause further health complications such as obesity, diabetes, insomnia and high blood pressure. It may also cause complications with menstruation and pregnancy.
There is no known singular cause. Instead, research attributes it to a collection of risk factors including biological chemical imbalance, depression, anxiety and trauma. The best way to treat binge eating disorder is with a combination of medication and therapy to address underlying emotional risk factors and promote healthy eating habits. Although they are not a replacement for medical advice or treatment, supplements may help patients control their weight in a healthy way. Always consult a physician before experimenting with supplements.