Last Updated on: 3rd July 2024, 11:02 pm
This article was written by Associate Registered Nutritionist (ANutr) Cherie Ko, and reviewed by Registered Dietitian, Sarah Idakwo
Understanding Binge Eating Disorder
Binge eating disorder (BED) is a type of Eating disorder. It is a complex mental health condition characterised by recurrent episodes of uncontrollable eating and often leading to feelings of guilt, shame, and distress.
Binge eating is a central feature of BED and individuals often feel a lack of control over eating during these episodes. People with BED often eat in response to emotional and physical triggers and continue eating even when not hungry, typically followed by feelings of guilt, shame, or distress. These binge eating episodes can occur frequently and are highly intense (1).
Binge eating vs Over eating
Unlike occasional overeating, BED involves a pattern of consuming large quantities of food in a short period, even when not physically hungry.
While binge eating and overeating might seem similar at first glance, they are distinct behaviours with important differences. Overeating is generally characterised by consuming more food than the body needs, often on special occasions like holidays or celebrations. On the other hand, BED involves a pattern of consuming large quantities of food in a short period, accompanied by a sense of loss of control while eating (2). Due to the intensity and out of control symptoms experience by BED survivors, BED is sometimes labelled as food addiction, this is a topic I have covered here.
Prevalence and significance of BED
Binge Eating Disorder is a significant public health issue across the globe. In the UK, BED is noted to be the most common eating disorder, affecting approximately 22% of individuals with eating disorders (3,4).
The age of onset for BED typically occurs in late adolescence to early adulthood, particularly between the 18-29 age group, but it can affect individuals of all ages (5). Women are more frequently diagnosed with BED than men, with approximately 3.5% of women and 2% of men in the UK suffer from BED (6)
Symptoms of Binge Eating Disorder
Symptoms of binge eating disorder can include (7):
- Eating Large Amounts of Food in a Short Period with a lack of control over eating
- Eating more rapidly than usual
- Eating in secret
- Eating When Not Hungry
- Recurrent binge episodes (at least once a week in the period of 3 months)
- Feelings of distress, guilt, shame or disgust after the binge
- Feeling a Lack of Control around food
- Preoccupation with Body Weight and Shape
- Feeling in a state of physical discomfort after bingeing such as feeling bloated or feeling uncomfortably full
Binge eating disorder and other eating disorders
BED is closely related to other eating disorders. Research has shown that many individuals with BED also exhibit symptoms of other eating disorders at different times in their lives. For example, a person with a history of anorexia nervosa or bulimia nervosa might develop BED later in life, especially if the initial disorder was not effectively treated. People also with a history of yo-yo dieting or being on very restrictive diets may go on to struggle with BED. In addition, the co-occurrence of BED and other eating disorders can exacerbate the severity of each condition, as individuals may oscillate between periods of binge eating and restrictive behaviours.
Individuals with BED may often experience similar psychological issues to those with bulimia nervosa and anorexia nervosa, such as body dissatisfaction, low self-esteem, and severe distress about their eating behaviours. However, the emotional and psychological profiles of individuals with these disorders can vary (8)
Binge eating disorder and mental health
The fluidity between eating disorders suggests that they share common psychological issues, such as such as body dissatisfaction, low self-esteem, and severe distress, which may have its roots in trauma, anxiety, and depression (9)
Many individuals with BED may have experienced traumatic events in their lives, and/ or suffer from depression or anxiety. These experiences, depressive symptoms and feelings of anxiety could trigger binge eating episodes, and in many cases use binge eating as an unhealthy coping mechanism as a way to deal with emotional pain and stress (10, 11)
Causes and Risk of Binge Eating Disorder
Causes of Binge Eating Disorder
Binge eating disorder (BED) is a multifaceted condition with origins that stem from a combination of factors. Biological, psychological, and environmental factors can all contribute to the development of BED.
Biological Factors
Genetic predisposition, neurotransmitter imbalances, and early-life experiences can increase susceptibility to BED. Research has suggested that genetics play a significant role in the development of BED. Individuals with a family history of eating disorders are more likely to be affected themselves. (12). Large-scale genetic studies, such as those conducted by the Eating Disorders Genetics Initiative, have identified specific genetic markers associated with BED (13). Structural and functional changes in brain regions were found to be associated with reward processing, emotional regulation, and decision-making, which may contribute to the compulsive overeating and loss of control characteristic of BED (14)
Psychological Factors
Emotional eating, or eating as a way to cope with negative emotions, including stress, sadness, or boredom, are common triggers during binge eating episodes. Like with other eating disorders, individuals with BED often exhibit higher levels of stress, anxiety, and depression compared to those without the disorder. They may often use binge eating as a way to cope with their emotions.
Societal pressures to conform to certain body ideals, experiencing weight or obesity stigma, following restrictive eating and rigid dietary rules, could lead to body dissatisfaction and unhealthy eating behaviours. Additionally, exposure to traumatic events, such as abuse or neglect, has been linked to an increased risk of developing BED. These traumatic experiences can create emotional turmoil, which some individuals attempt to soothe through binge eating. Family dynamics and early life experiences also play a crucial role. For instance, growing up in a household where food is used as a reward or punishment, or where there is a significant focus on dieting and weight, can predispose individuals to disordered eating behaviours later in life.
Risk of Binge Eating Disorder
BED is associated with significant emotional distress, including feelings of shame, guilt, and self-hatred. Many individuals with BED also experience depression, anxiety, and low self-esteem. The disorder can also affect relationships, work or academic performance, and overall quality of life. Social isolation and withdrawal are common among individuals struggling with the disorder.
Apart from the emotional effects, individuals with BED are at a higher risk of developing type 2 diabetes, heart disease, gastrointestinal problems, and other associated conditions such as an increased risk of obesity (15).
Frequent consumption of large quantities of food, often high in sugars and fats, can increase the risk for metabolic syndrome and obesity. In addition, these binge eating episodes can also overwhelm the digestive system, and in extreme cases, even cause a stomach rupture due to the rapid consumption of large amounts of food. Despite the large amount of food consumed, the nutritional quality of individuals with BED are often poor. Many binge episodes involve foods high in carbohydrates and fats, but low in essential vitamins and minerals, increasing the risk of nutrition deficiencies and even malnutrition.
Getting help
Like other eating disorders, seeking early and effective treatment for BED is the first crucial step toward addressing the disorder. Utilising a multidisciplinary approach that addresses both the psychological and physical aspects of BED can significantly accelerate recovery. This can include a combination of therapy and counselling, medication, nutrition guidance, and lifestyle changes.
Therapy and Counselling
Therapeutic interventions are essential in treating BED, with Cognitive Behavioural Therapy (CBT) being one of the most effective methods. CBT helps individuals identify and change negative thought patterns and behaviours related to eating.Other useful therapies include Interpersonal Therapy, which focuses on improving relationships and social skills, and Dialectical Behavior Therapy, which helps with managing emotions and being mindful.
Nutrition Guidance
Proper nutrition guidance is vital for those recovering from BED. Registered dietitians can help individuals develop a more peaceful relationship with food, but also educate individuals to understand the importance of a balanced diet and how to make food choices that are right for you. This helps to shift focus away from restrictive behaviours and towards a more intuitive and positive relationship with food.
A supportive environment
Having a supportive environment can be critical to recovery. Having family and friends can provide extra emotional support.
Individuals with BED frequently encounter invalidation, which undermines the seriousness and life-limiting impact of this disorder and its underlying causes. Being around people who understand what you’re going through can be really empowering and make you feel less alone. Likewise, working with a team of the right healthcare professionals and support groups can provide an emotional safety net through recovery.
Conclusion
Binge Eating Disorder is a complex and challenging condition that can impact both physical and emotional health profoundly. Recognizing the symptoms, understanding the underlying causes, and seeking appropriate treatment promptly are crucial steps toward recovery. Remember every step forward, no matter how small, is a significant achievement and part of your journey to recovery.
Take the first steps towards recovery today.
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