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Binge Eating Disorder (BED)

Binge Eating Disorder (BED) affects millions of Americans. It is sometimes referred to as Compulsive Eating or Compulsive Overeating. Patients with Binge Eating Disorder eat large amounts of food with no ability to control the amount they are eating and a feeling of shame or guilt about overeating. This disorder is not the same as the binge-purge syndrome that characterizes Bulimia Nervosa. Binge Eating Disorder patients typically do not purge after eating or using laxatives. And while everyone may overeat on occasion, BED is not just a case of isolated incidents. We’ve all eaten too much on a holiday or at a backyard barbeque, but patients with binge eating disorder regularly binge in spite of their desire to stop. They eat to cope with challenges and stress, and with feelings of low self-esteem and insecurity, though their overeating causes shame and feelings of disgust.

Patients may use binging to keep others away, maintain an overweight appearance in the belief that no one likes fat people because these patients may feel unworthy of attention or love. As with Bulimia Nervosa, Binge Eating Disorder can be used as self-punishment for being a bad person. Stress often triggers binge eating, and binging will also occur when personal standards are not fulfilled.

There is no known cause for binge eating disorder, but research between brain chemicals and metabolism suggests that genetics may be at play in obesity and in eating disorders, as this disorder often occurs in several members of a family. This research is still preliminary. It should also be noted that half of all people with binge eating disorder suffer from some form of depression. It is unclear whether depression causes BED or if BED causes depression. Patients with BED may abuse alcohol, exhibit impulsive behavior or feel out of control, and they may feel separate and isolated from others in their workplace, family or community.

What are the symptoms?

There are various symptoms associated with BED. Some secondary physical symptoms occur because of the patient’s unhealthy eating habits.

• Consumes unusually large quantities of food in a short period of time (less than 2 hours)
• Difficulty in losing weight and in maintaining a healthy weight
• Eats in secret because of shame or embarrassment
• Eats when under stress or facing emotional challenges
• Eats quickly, unable to control what or how much they are eating
• Feels anxious, lonely or depressed
• Obsesses about food and body image,
  experiments with different diets
• Eats uncontrollably past the point of feeling uncomfortably full
• Above average weight or overweight
• Eating continuously without ever feeling satisfied
• Low self-esteem, suicidal thoughts
• Keeps eating even though it will cause more pain and distress, feels disgusted or guilty after binging, unable to stop binging in spite of repeated attempts
• Patient feels afraid that they can’t binge without help
• Binges at least twice every week over a period of months

Symptoms of complications of BED can include classic obesity-related health problems like diabetes, high blood pressure, high cholesterol, gallbladder problems, heart disease, and even some kinds of cancer.

How is it diagnosed and treated?

Doctors use various techniques to determine whether a patient has a binge eating disorder. Doctors will also perform a full physical examination to rule out other disorders and to identify secondary health problems that may occur with eating disorders. In most cases, they will look for the following signs:

• Frequent episodes of eating abnormally large amounts of food
• Eating much more rapidly than usual.
• Eating large amounts of food, even when not physically hungry.
• Feelings of disgust, depression, or guilt after overeating
• Frequently feeling unable to control what or how much is being eaten
• Eating until uncomfortably full
• Eating alone because of embarrassment at quantity of food the patient is eating

Most people who have a Binge Eating Disorder often hide it from family and friends, and have tried unsuccessfully to control it on their own.

Treatment(s) can include:

• Cognitive Behavioral Therapy
• Medications as appropriate: antidepressants, or topiramate
• Psychotherapy
• Gastrointestinal surgery for weight loss in extreme cases
• Self-Help Groups like Overeaters Anonymous

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