Understanding binge eating disorder

Submitted by Jo M from Talk ED

Although clinically recognised as an eating disorder in 2013, binge eating disorder was first noted by a psychiatrist in 1959 and today is one of the most prevalent eating disorders that typically affects young people and adults.  Binge eating disorder is characterised by eating large amounts of food in a short period of time and the person feels unable to control their urge to binge. Although many confuse binge eating disorder with bulimia, the key difference, in simplistic terms, is the absence of purging – that is, the person does not engage in negative compensatory behaviours to eliminate the food or calories, for example through vomiting or excessive exercise.

So is it just over-indulgence?

No!  We all overindulge from time to time. Whether it’s a celebration meal, a party, or a Sunday lunch; we have all had that uncomfortably full feeling at some point, but that does not mean we are suffering from binge eating disorder.

Binge eating disorder is a complex psychological illness and is not simply eating too much at one meal. It is also not a choice or a pleasurable experience.  Specifically, a person will be diagnosed with binge eating disorder if they are:

  • eating large amounts of food in a short period of time at least once a week for a three month period, and without purging or vomiting to eliminate the food. In severe illness, binges may occur 14 times or more per week.
  • eating more rapidly than normal.
  • eating even though uncomfortably full, or not hungry, and feeling a lack of control over stopping.
  • going to extreme lengths to obtain food for a binge. For example, eating food that has been disposed of.
  • eating alone due to feelings of embarrassment or shame.
  • experiencing feelings of self-disgust and guilt after a bingeing episode.

The full criteria used for diagnosis is detailed here.

What causes binge eating disorder?

As with all eating disorders, each person’s experience of the illness will vary and the causes and triggers can be diverse. There are many things we still don’t fully understand about the cause of eating disorders, but we do know that a range of social, environmental, biological and psychological factors interplay in binge eating disorder, including:

  • Genetics – an increased sensitivity to dopamine in the brain which is responsible for feelings of reward and pleasure. There is also scientific evidence pointing to the disorder having an inherited aspect to it.
  • Gender – females more often experience binge eating disorder and it is more common in older teens and adults than younger children.
  • Emotional trauma – difficult life events such as bereavement, family issues, abuse or bullying during childhood.
  • Co-morbid conditions – including post traumatic stress disorder (PTSD), bipolar disorder, depression and anxiety.

How serious is binge eating disorder?

Binge eating disorder can have a very serious impact on a person’s mental and physical health and in severe cases can be life-threatening. It can lead to obesity and associated risks to cardiovascular health such as heart disease, high cholesterol and stroke. It can also be a significant risk factor for type 2 diabetes. Fertility, skin and sleep problems and irritable bowel syndrome are also common amongst sufferers.

From a mental and emotional perspective, those living with binge eating disorder may suffer with anxiety, low confidence and self esteem and whilst these are issues that may contribute to developing the condition in the first place, the experience of having binge eating disorder will likely compound them further.

How is binge eating disorder treated?

Binge eating disorder is very treatable and there is a range of options available.  The treatment options chosen will vary by person depending on their particular needs and severity of the illness. Generally, however, cognitive behavioural therapy (CBT) and other forms of psychotherapy are used.  This involves using therapy to identify the emotional causes and triggers of binge eating in an individual, recognising they may be different for each person, and strategies agreed on how to overcome them. Studies have shown that CBT can be effective in reducing bingeing patterns. One such study concluded that after 20 sessions of CBT, 79% of participants were no longer bingeing and 59% twelve months later.

Other treatment options include anti-depressants which are offered alongside psychological therapies and are designed to help with any associated feelings of depression, anxiety or phobias that are connected to the person’s experience of binge eating disorder.

In summary

Binge eating disorder is a serious health condition that is estimated to affect 3.2% of the UK population aged over 16 years. This makes it the most common eating disorder in the UK, followed by other specified feeding and eating disorders (OSFED), bulimia and anorexia.

In reality, however, it is accepted there is likely a much greater number suffering since many do not come forward for help and treatment. Sadly there is still a great deal of shame, embarrassment and stigma relating to eating disorders of all types, preventing some from reaching out for the help they need. In addition, until a change in NICE guidelines in 2017, many people were not offered specific treatment within the NHS despite its classification as a recognised eating disorder. But please don’t let this put you off – despite a ‘slow start’ to recognise the impact of binge eating disorder there are very effective treatment options now available and accessible to all.

If you are concerned that you, or someone you care for, may have binge eating disorder, we are here to help. Please book a 1:1 support call or take a look at our peer support groups. Our team of staff and volunteers have lived experience of eating disorders. They can listen to your worries and provide practical guidance to help you take positive steps towards recovery.

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