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Binge Eating Disorder

Topic Overview

What is binge eating disorder?

Binge eating means eating larger amounts of food than most people would in a similar situation, in a short period of time. A person with this eating disorder binge eats regularly for several months. When you binge eat, you may feel like you can't control your eating, and you may you feel unhappy about it afterward.

Binge eating disorder is not the same thing as bulimia. Unlike bulimia, if you have binge eating disorder, you don't vomit or try other ways to get rid of calories. But you might try to limit how much food you eat between eating binges. Binge eating disorder is sometimes called compulsive overeating.

Some people who binge eat have a normal weight. But over time, many people who have binge eating disorder gain weight and have problems from being obese. People with binge eating disorder also often have depression, anxiety, or other emotional problems.

Having an eating disorder isn't a sign of weakness or a character flaw. And it is not something you can overcome with just willpower. Many people struggle with eating disorders for a long time. Some people try to keep it a secret or deny that they have a problem. In most cases, you will need treatment to get better. If you have binge eating disorder, treatment can prevent health problems, help you feel better about yourself, and improve the quality of your life.

What causes binge eating disorder?

Experts are not sure what causes binge eating disorder, but it seems to run in families. Cultural attitudes about body shape and weight might also play a role. Anxiety, depression, or stress can cause some people to binge eat.

What are the symptoms?

From time to time, most of us feel like we have eaten more than we should. But eating too much every now and then does not mean that you have binge eating disorder. If you have binge eating disorder, you may:

  • Eat way too much in a short period of time (less than 2 hours) on a regular basis.
  • Eat when you are not hungry.
  • Eat for emotional reasons, such as being sad, angry, lonely, or bored.
  • Feel like you can't stop eating.
  • Eat faster than normal when you binge eat.
  • Eat so much that you feel painfully full.
  • Feel unhappy, upset, guilty, or depressed after you binge eat.
  • Eat alone because you are embarrassed about how much you eat.

Even if you don't have all the symptoms of binge eating disorder, having even a few symptoms can be a sign of a problem that needs treatment. It is important to get help right away if you or someone you know has any of these symptoms.

How is binge eating disorder diagnosed?

A doctor can find out if you have binge eating disorder by asking questions about your eating habits and past health. Your doctor may also ask questions about your mental health and how you feel about food and the shape of your body. If you are overweight, your doctor may also do a physical exam to rule out problems caused by obesity.

How is it treated?

Treatment for binge eating disorder includes getting counseling and taking medicine. You may need treatment for a long time to fully recover. You also may need treatment for other problems that often occur with binge eating disorder. These can include bipolar disorder, depression, anxiety disorders, obesity, or problems with being overweight.

Who gets binge eating disorder?

Binge eating disorder most often starts in the late teens or the young-adult years, but it can begin in later adulthood too. It is more common in women than men.

Binge eating disorder can be triggered by dieting, depression, or anxiety. It can even start because of boredom or stress, which is then relieved by binging. Your risk for binge eating increases if:

  • You or your parents are overweight.
  • You or your parents have had depression or symptoms of depression.
  • You have a poor body image, which means that you don't like the way your body looks.
  • You were often told negative things about your weight, eating habits, or how your body looks.

Symptoms

If you have binge eating disorder, you:

  • Eat an extremely large amount of food within a 2-hour period (a binge) at least once a week on average for at least 3 months.
  • Feel unable to control how much you eat during a binge.
  • Feel very unhappy about binging.

If you have binge eating disorder, you also have three (or more) of the following symptoms:

  • You eat more quickly than normal during a binge.
  • You eat until you are painfully full.
  • You binge eat when you are not hungry, to reduce stress or to comfort yourself.
  • You eat alone because you are embarrassed about how much food you eat.
  • You feel upset, guilty, or depressed after binge eating.

Common personality traits found in those who have binge eating disorder and other eating disorders include low self-esteem and excessive concern about body size and shape.

Binge eating disorder is different from bulimia, because people with binge eating disorder do not regularly vomit or use other ways to get rid of calories. For more information on bulimia, see the topic Bulimia Nervosa.

Some people eat very little during the day but eat very large amounts of food in the evening and at night. This is called night eating syndrome.

Many people who have an eating disorder also struggle with depression or anxiety disorders. It can be difficult to treat binge eating disorder if these other conditions are not also treated.

Frequent binge eating can cause you to gain a large amount of weight, even though you might try to restrict your food intake between binges. People with binge eating disorder often try to follow strict diets. But dieting does not stop binge eating in the long term and might actually make the problem worse.

You might feel so discouraged at times that you stop trying to control your eating disorder altogether. One binge might merge into the next, with no period of normal eating in between.

Although you might not have all of the symptoms of binge eating disorder, even a few symptoms can be a sign of a problem that needs treatment. If you have any of these symptoms, or someone you know does, talk to a doctor, friend, or family member about your concerns right away.

Exams and Tests

Doctors diagnose binge eating disorder by asking questions about your medical history and eating habits. Your doctor also might do a mental health assessment, which is an evaluation of your emotions and how well you think, reason, and remember. If you are overweight, your doctor may also do a physical exam to rule out problems caused by obesity.

Binge eating disorder often is associated with being overweight. Your doctor might use a tool called the body mass index (BMI) to look at how much you weigh compared with your height.

Treatment Overview

Treatment for binge eating disorder includes counseling and medicine. Goals in treating binge eating often include:

Most people with binge eating disorder need treatment, but many people who have an eating disorder try to keep it secret or deny that they have a problem. Some might join weight management programs to lose weight but do not seek treatment for binge eating or for mental health problems related to the condition. It often is a family member or friend who convinces the person to seek treatment.

If you think that you or someone you know might have an eating disorder, talk to your doctor. Signs of an eating disorder that needs treatment include binge eating, concern or embarrassment about eating behaviors, secretive eating habits, preoccupation with weight or body image, or an unhealthy body weight because of eating problems.

Counseling

Several types of counseling can be useful in treating eating disorders.

  • Cognitive-behavioral therapy (CBT) . This type of therapy can help you control the urge to binge eat, especially when combined with nutritional counseling and a weight-reduction program.footnote 1 CBT often deals with learning how to eat a balanced diet, because this is important to recovery. Forming more regular eating habits can help reduce binge eating.
  • Interpersonal therapy . This type of therapy can help you examine any connection between your relationships, your emotional reactions to those relationships, and your symptoms of binge eating.
  • Dialectical behavior therapy . This approach focuses on helping you manage emotions. By coping better with life's challenges and your emotions, binge eating behaviors may decrease. This type of therapy helps reduce binge eating that is related to stress.

Medicine

Medicines can be used to reduce the urge to binge eat. Examples include:

  • Antidepressants, medicines typically used for depression or anxiety.
  • Topiramate (Topamax), a medicine typically used to treat seizures or chronic pain.
  • Lisdexamfetamine dimesylate (Vyvanse), a medicine typically used for ADHD.

What to think about

Medicines and counseling may help you quit binge eating and lose excess weight. But this will take some time and patience. Some people find that they still have trouble losing excess weight, even after they stop binge eating. Talk to your doctor about what results are realistic to expect from treatment.

Unfortunately, many people don't seek treatment for mental health problems. You may not seek treatment because you are embarrassed about your eating, you think the symptoms are not bad enough, or that you can work things out on your own. But getting treatment is important.

If you need help deciding whether to see your doctor, read about some reasons why people don't get helpand how to overcome them.

Home Treatment

Continuing healthy habits at home can improve binge eating disorder.

It is helpful when family members are supportive of their loved one who has binge eating disorder. Learning about the disorder will be useful for the entire family.

In many cases, eating disorders are associated with poor body image and low self-esteem. Parents can help reduce the chances that their children will develop an eating disorder by teaching them to have:

For more information, see the topic Healthy Eating for Children.

Other treatment

Other treatments can help reduce binge eating.

Self-care programs. These are organized programs that provide self-help materials such as manuals or computer-based activities that can be useful in treating eating disorders. But most people who have an eating disorder also need counseling and possibly medicine.

Stress management techniques. Many people report that their binging episodes are triggered by feelings of anxiety or tension. Although not part of the treatment of binge eating disorder, relieving stress can help during recovery and can improve quality of life. Techniques to reduce stress include:

  • Exercising. Regular physical activity is one of the most effective stress-management techniques.
  • Writing. Research shows that expressing yourself in writing can be a very effective way to reduce your stress level.
  • Expressing your feelings.Talking, laughing, crying, and expressing anger are normal parts of the emotional healing process.
  • Doing something you enjoy. A hobby or other healthy leisure activity that is meaningful to you can help you relax. Volunteer work or work that helps others can be a powerful stress-buster.
  • Body-centered relaxation. This includes breathing exercises, muscle relaxation exercises, massage, aromatherapy, yoga, and traditional Chinese relaxation exercises such as tai chi and qi gong.
  • Stress-reducing activities. These include learning how to relax your body through mindfulness-based stress reduction, meditation, or imagery exercises or by listening to relaxing music or using humor to reduce stress.

For more information on stress reduction, see the topic Stress Management.

References

Citations

  1. Agras WS (2008). The eating disorders. In DC Dale, DD Federman, eds., ACP Medicine, section 13, chap. 9. Hamilton, ON: BC Decker.

Other Works Consulted

  • American Psychiatric Association (2013). Feeding and eating disorders. In Diagnostic and Statistical Manual of Mental Disorders, 5th ed., pp. 329-354. Washington, DC: American Psychiatric Association.
  • Anderson AE, Yager J (2009). Eating disorders. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 2128-2149. Philadelphia: Lippincott Williams and Wilkins.
  • Brownley KA, et al. (2016). Binge-eating disorder in adults: A systematic review and meta-analysis. Annals of Internal Medicine, published online June 28, 2016. DOI: 10.7326/M15-2455. Accessed August 26, 2016.
  • Gwirtsman HE, et al., (2008). Eating disorders. In MH Ebert et al., eds., Current Diagnosis and Treatment in Psychiatry, 2nd ed., pp. 456-469. New York: McGraw-Hill.
  • Hay PPJ, et al. (2009). Psychological treatments for bulimia nervosa and binging. Cochrane Database of Systematic Reviews (4).
  • National Eating Disorders Association (accessed April 2013). Binge eating disorder. Available online: http://www.nationaleatingdisorders.org/binge-eating-disorder.
  • National Eating Disorders Association (accessed April 2013). General information about EDs. Available online: http://www.nationaleatingdisorders.org/general-information.
  • Palmer CA, Boyd LD (2009). Nutrition, diet, and associated oral conditions. In NO Harris et al., eds., Primary Preventative Dentistry, 7th ed., pp. 305-314. Upper Saddle River, NJ: Pearson.
  • Sadock BJ, Sadock VA (2010). Eating disorders. In Kaplan and Sadock's Pocket Handbook of Clinical Psychiatry, 5th ed., pp. 259-268. Philadelphia: Lippincott Williams and Wilkins.
  • Yager J, et al. (August 2012). Guideline Watch: Practice Guideline for the Treatment of Patients With Eating Disorders, 3rd ed. Arlington, VA: American Psychiatric Association. Also available online: http://psychiatryonline.org/content.aspx?bookid=28&sectionid=39113853.

Credits

ByHealthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
W. Stewart Agras, MD, FRCPC - Psychiatry

Current as ofDecember 7, 2017

Current as of: December 7, 2017

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & W. Stewart Agras, MD, FRCPC - Psychiatry