Written by Andrea Clares, ANutr & Talia Cecchele, RD
It is estimated that 1 in 50 people will experience binge eating disorder (BED) in their lifetime. It is the most common eating disorder, but the least understood leaving many people stuck in their illness. Binge eating disorder is not about overindulging, having a lack of willpower or being greedy.
It is a serious illness associated with extreme guilt, shame and distress. Many people suffer alone, too fearful to seek support and embarrassed by what others might think.
What is Binge Eating Disorder?
BED is an eating disorder (ED) characterised by food binges in which a person experiences a loss of control over eating followed by intense feelings of distress, shame and guilt. Currently, BED is the second most prevalent ED after EDNOS (eating disorder not otherwise specified) and affects people of all ages, genders and ethnicities (1).
According to the Diagnostic Statistical Manual for eating disorders (DSM-V) a person must meet the following criteria to be diagnosed with BED:
1. Recurrent and persistent episodes of binge eating
2. Behaviours must be occurring at least weekly, for at least three months, and one must meet at least three of the following criteria:
Eating more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone as a result of feeling embarrassed by how much one has eaten
Experiencing feelings of shame, guilt or disgust after overeating
3. Marked distress regarding binge eating
4. Absence of regular compensatory behaviors (such as purging)
Unlike in people with Bulimia, no compensatory behaviours (e.g. vomiting, laxative misuse, over exercise) are present in individuals with BED.
Is Binge Eating the Same as Overeating?
A food binge has two specific features:
The amount of food consumed is significantly larger than what a person would eat normally in a discrete period of time and,
There is a sense of loss of control over eating during the binging episode.
Overeating is a part of normal eating. It happens on occasion, that feeling of being uncomfortably full and eating a little more than planned. If overeating is something you do on occasion but it doesn't distress you, you don't lose control and you can stop eating, then you probably aren't binging. It’s important to not use the term overeating interchangeably with binge eating as they are in fact different things.
Why do Binges Happen?
As with all EDs, one specific root cause for BED has not been identified. However, evidence shows that the development of any ED can result from a complex interaction between various factors, including biological such as the influence of a person’s genetics, psychological such as an existing history of trauma, and social like in the case of people engaging in dieting or appearance focused sports such as dancing and gymnastics.
Although the clear cause of the binge eating itself is complex to identify, we know that there are some common triggers for it:
A well founded body of research has shown that dieting is the number one predictor of binge eating and weight gain (2). Restriction of any kind, either delaying the time when one starts eating, cutting out foods or reducing the number of calories will lead to food deprivation. This in turn, increases the body’s drive to eat which will increase the risk for binge eating.
Emotional eating is normal. We all eat when we are sad, feel lonely, happy or had a bad day. But if emotional eating becomes one of your main coping mechanisms used to deal with negative emotions or feelings this can increase risk of binge eating.
This has been identified as a trigger for binging episodes, especially as many people with BED binge in secret to avoid being judged, and eat to manage feelings of loneliness.
Although weight and shape concerns are not part of the DSM-V criteria for BED, research suggests that body dissatisfaction is associated with increased levels of binge eating (3).
People with BED are commonly very concerned about either their weight or shape. Unfortunately, engaging in binge eating increases the risk of weight gain as blood sugar levels and hunger and fullness levels become unregulated and many people become insulin resistant. This makes it even harder to manage weight and increases the desire to further restrict, which only increases risk of binging more.
What are the Consequences of Binge Eating?