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Binge Eating Disorder

What is Binge Eating?

A binge eating episode is when very large quantities of food are consumed in a short period of time. Everyone can experience times where they overeat,for example, having second or third helpings during a holiday meal. When this behavior becomes frequent or if there are feelings of guilt and shame, then it could indicate that there is a bigger problem.

What is Binge Eating Disorder?

Binge eating becomes binge eating disorder (BED) when the person experiencing the binge episode feels out of control. They might express “zoning out” or feeling like they can’t stop eating. Binge eating is generally associated with feelings of shame, guilt, anxiety, depression, anger, and/or fear. It is important to note that people with binge eating disorder do not regularly use compensatory or “purging” behaviors to counteract the food consumed.

According to the National Eating Disorders Association (NEDA), binge eating disorder is the most common eating disorder in the United States. binge eating disorder does not discriminate, it can affect individuals of all genders, races, sexual identities, and socioeconomic status. There is no weight criteria for diagnosing binge eating disorder, meaning that someone with binge eating disorder can be at any weight. Surprisingly, binge eating disorder is more prevalent in people who are trying to lose weight. An explanation for this phenomenon is accredited to the cyclical relationship between restrictive eating behaviors (dieting and intentional weight loss efforts) and binging. Other factors that increase risk of binge eating disorder is family, psychological, and dieting history.

Some Symptoms of Binge Eating: 

  • Overeating large amounts of food during a short period of time (~2 hours)
  • Eating past the point of feeling full and getting uncomfortable
  • Eating alone or in secret
  • Feeling shame, guilt, anxiety or depression about your eating
  • Eating rapidly or more quickly than others
  • Eating when you are full or not hungry
  • Feeling that you aren’t normal

A medical professional can diagnose binge eating disorder by performing a psychological evaluation to determine whether the disorder is present. There are specific criteria (DSM-V) that must be present for an official diagnosis. Your healthcare provider may also want to check for other health concerns that can co-occur from the eating disorder and those tests may include a blood or urine test, physical exam, and/or sleep study .

Treatment for Binge Eating Disorder

The goal of treatment for binge eating disorder is to reduce binges, reduce feelings of guilt, shame, and anxiety that follow eating, and achieve sustainable and neutral eating habits. If co-occurring mental health illnesses exist, a multidisciplinary team will be necessary to address all facets of the disorders. For that reason, a therapist, registered dietitian, psychiatrist, and medical doctor are all part of the team for an individual with BED.

Psychotherapy

There are several therapeutic modalities that are commonly used in the treatment of binge eating disorder. Three are listed below but many other modalities exist to treat the eating disorder, co-occurring mental health disorders, and/or complex trauma.

  • Cognitive Behavior Therapy (CBT) helps reduce instances of binge eating by teaching better coping strategies when negative feelings about our body or weight occur.
  • Interpersonal Psychotherapy focuses on relationships that may involve family, friends, coworkers, or partners. If core issues from your eating disorder stem from poor communication, poor boundaries, or other relationship issues, this therapeutic modality aims to heal those connections.
  • Dialectical Behavior Therapy (DBT) is a therapy based on behavior and the ability to learn skills that will help you handle stressful situations in a healthier way. This allows you to improve your relationship with others which can in turn reduce the reason to turn to food for soothing or coping.

Lifestyle and Home Remedies

Generally, treating an eating disorder isn’t effective on your own. In addition to professional help, these tips will help to reinforce your treatment plan:

  • Avoid dieting– Dieting can cause more stress and anxiety and make the problem worse. Sometimes dieting can even cause you to compulsively eat more. Fad diets are extremely common in the United States but, have a 95% failure rate, which can in turn deepen disordered eating behaviors.
  • Eat breakfast– Many people with binge eating disorder skip breakfast altogether. They may think they ate too much the day before if a binge occurred, which could disrupt hunger upon waking or create a thought that skipping breakfast will prevent binges. However, going long stretches of time without eating, especially breakfast, may be a factor in binges later in the day.
  • Stick to treatment– Seek help from a therapist and dietitian and stay consistent with appointments and recommendations.
  • Balancing food intake– Work with a dietitian to include foods from all food groups to ensure a wealth of micro-nutrients and adequate macro-nutrients. Satiety is a important factor of binge eating disorder recovery and your dietitian can help you find foods and food combinations that create satisfaction. Also, consistently nourish yourself throughout the day as to not let yourself get too hungry.
  • Stay active– Ask a medical professional what the best physical activity is for you. Take part in activity that you enjoy and creates a feeling of wellness, not a feeling of punishment.
  • Get connected-Find a local or virtual support group and stay connected with the people in your life who you have built a trusting relationship with.

Coping and Support

A large part of recovery is developing a new relationship to food and your body. Although food may become a source of pain throughout your eating disorder, we must develop a relationship to food where it is providing nourishment in a peaceful way. Every person’s recovery looks different in this sense. Urges and challenges may arise on a daily basis as we must eat multiple times per day to stay alive. It’s important to find ways to cope with stressful situations in healthy, productive ways. Try to be gentle with yourself as the internal critical voice may be powerful. You are rediscovering an entire lifestyle of nourishment and respect with food. 

Get the Help You Need

There are support groups out there that can help with talking about binge eating disorder. People in these groups understand what you’re going through and can offer encouragement, hope and advice. Many times there are mentors in support groups that have established recovery and can help a person early on in their journey.

You can also reach out to treatment centers that treat eating disorders. There are many options out there- take your time to find the right place that treats you as a whole person and individualizes care to your needs.

References:

DSM-V, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. https://www.psychiatry.org/psychiatrists/practice/dsm

Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627

NEDA, National Eating Disorder Association. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

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