Binge Eating Disorder

What is Binge Eating Disorder?

Binge eating disorder (BED) is characterised by periods of binge eating or overeating. The person affected by BED may diet frequently, however they will not engage in purging behaviour after a binge. Over time this can, but may not always, result in significant weight gain.
Binges almost always occur in secret, and an appearance of ‘normal’ eating is often maintained in front of others. The food that is eaten is usually filling and high in calories. It tends to be food that people regard as fattening, and which they are attempting to exclude from their diet. The food is usually consumed very quickly, and is seldom tasted or enjoyed.

While in binge eating disorder there is no purging, there may be sporadic fasts or repetitive diets, and often feelings of shame or self-hatred surface after a binge.

A person affected by binge eating disorder may find themselves trapped in a cycle of dieting, binging, self-recrimination and self-loathing. They can feel particularly isolated which can contribute to the prolonging of their experience.

What signs should I look out for?

  • Out-of-control eating
  • Eating more than the body needs at any one time
  • Eating much more quickly than usual during bingeing episodes
  • Eating until uncomfortably full
  • Eating large amounts of food, even when not hungry
  • Eating alone (often due to embarrassment at amount of food being eaten)

What are the emotional and psychological effects of Binge Eating?

  • Feelings of inadequacy and worthlessness
  • Feelings of guilt and shame
  • Depression and related symptoms
  • Low self esteem
  • Dissatisfaction with body image
  • Feeling out of control
  • Anxiety

What are the physical effects of Binge Eating?

  • Significant weight gain
  • Digestive problems
  • Joint and muscular pain
  • Breathlessness
  • Poor skin condition

Is it a serious condition?

Binge Eating disorder is a serious mental health condition. Obesity is a weight classification – a symptom – which may occur as a result of binge eating disorder. While many of the health consequences associated with binge eating disorder are directly related to obesity, it is important to maintain a distinction between this symptom and the disorder itself.
Binge eating disorder has a significant impact on the physical, as well as the emotional, health of the person affected.

Health consequences may include:

  • Digestive problems such as bloating, stomach cramps, constipation or diarrhea;
  • Malnutrition because of the quality of foods consumed (high in fats and sugars, but lacking in vitamins in minerals)
  • Where significant weight gain occurs, related health consequences may include:
    – High blood pressure;
    – High cholesterol levels;
    – Heart disease;
    – Diabetes;
    – Gallbladder disease.

Most physical symptoms can be reversed with weight loss and normalisation of a balanced diet and eating habits.

Can anyone develop Binge Eating Disorder?

Binge eating disorder is almost as common among men as it is among women, and is thought to be more common than other eating disorders such as Anorexia Nervosa and Bulimia Nervosa.

What causes Binge Eating Disorder?

Psychological factors:

  • Low self-esteem, poor body image
  • Depression, anxiety, anger, loneliness
  • Feelings of ineffectiveness and/or a lack of control over life
  • Perfectionist tendencies and thought patterns
  • Difficulty expressing emotions and feelings in daily life

Socio-cultural factors:

  • Narrow definitions of beauty that include only women and men of specific body weights and shapes
  • Cultural norms that value people on the basis of physical appearance, and not inner qualities

Familial factors:

  • Genetic factors
  • Familial disharmony, which can cause insecurity and emotional distress
  • Familial problems around conflict management and negotiation of needs
  • Traumatic experiences such as sexual, physical and/or emotional abuse
  • Loss of a significant family member through death, separation, illness or alcoholism

Dieting

The single most important precipitating factor in binge eating is a period of dieting. Here, a combination of physical and psychological factors might be involved. When your body is in starvation, it will give you strong cravings for food because it is not getting enough nutrition. Psychologically, dieting and preoccupations with food may raise the risk of loss of control. This happens when a minor slip from a person’s stringent diet causes them to abandon the diet completely and to overeat instead.
People with BED are often stuck in a vicious cycle of dieting and bingeing. Underlying this is a profound lack of self-esteem. This leads vulnerable people to be extremely concerned about their shape and weight, about how they are viewed by others, and can drive them to go on strict diets. The dieting then encourages overeating through both physiological and psychological mechanisms. The bingeing causes guilt and to compensate, people diet again. The only way to break this cycle is to stop dieting.

When is Professional Help required?

People often try to control Binge Eating Disorder on their own, and if they fail they may feel demoralised and depressed. This may lead to further episodes, and consequent feelings of social isolation, missing work, school, etc.

More often than not, people who experience BED will need the help and support of a health care professional.

Treatment

  1. Consultation with a General Practitioner is an important first step towards self-care. The GP will look at the physical effects of binge eating and, if necessary, can make a referral to a dietician or to a psychologist or a therapist.
  2. Individual psychotherapy and family therapy can be useful in addressing the psychological and emotional issues that may be underlying the disorder.
  3. Cognitive behavioural therapy (CBT) teaches people to look at their unhealthy patterns of behaviour and how to change them.

For change to occur and to be lasting, a recovery approach which tackles both the physical and psychological aspects of the disorder will be required.