What is binge eating disorder?
Binge eating disorder (BED) is a behavioral disorder characterized by chronic, compulsive overeating. While occasional overeating is normal, an eating disorder is a condition that you live with every day. It feels like it controls you and interferes with your mental, emotional and physical well-being. Binge eating means consuming large quantities of food in a short period and feeling like you can’t stop.
What are the signs and symptoms of binge eating disorder?
Signs and symptoms of binge eating disorder may include:
- Eating past the point of satisfaction and to the point of discomfort.
- Eating too fast to notice how much you’re eating or how it feels.
- Eating large amounts of food when you’re not hungry or after recently finishing a meal.
- Eating in response to emotional stress (emotional eating).
- Eating alone and in secret and avoiding social eating.
- Organizing your schedule around binge eating sessions.
- Hoarding and stashing food in hidden places to access later.
- Hiding eating from others because you’re embarrassed about how much you’re eating.
- Obsessive thinking about food and specific food cravings.
- Frequent dieting, which may cause weight fluctuations or no weight loss.
- Guilt, remorse, shame and self-esteem issues related to binge eating.
Many people may exhibit signs or symptoms of binge eating occasionally. When they begin to recur regularly (once a week or more), you may have a disorder. Environmental conditions such as stress and relationships can influence your behavior and affect your mental health. These conditions may combine with other causes to push you over the edge from occasional disordered behavior to meeting the criteria for BED.
How do you recover from binge eating disorder?
There’s no quick fix, but with a consistent, long-term treatment plan, you can recover. Psychotherapy is usually the foundation of this treatment plan, and it’s proved effective for most people. Depending on the individual, your plan may also include medications or nutrition advice. You may interact with a variety of healthcare specialists, such as a psychologist, a psychiatrist or registered dietician.
What’s in the treatment plan for binge eating disorder?
Psychotherapy (talk therapy) is the most important part of the treatment plan. You can choose from several different methodologies or approaches. Medications or diet may play supportive roles in your treatment plan. Medications and diet don’t address binge eating disorder directly, but they can help you manage some of the factors that may contribute to your disorder.
Therapy
There are many types of psychotherapy. The most studied and proven methods for treating BED are:
- Cognitive behavioral therapy (CBT): CBT helps you examine your behaviors and the thoughts and feelings behind them. Your therapist then works with you in a structured way to break those patterns and find more constructive ways of responding to those thoughts and feelings.
- Interpersonal therapy (IPT): IPT is a short-term, focused type of individual therapy that addresses the current conflicts and stress factors affecting your life. Rather than dig into childhood issues, your therapist focuses on problem-solving to relieve your most pressing pain points.
Other options include:
Medication
Lisdexamfetamine (Vyvanse®), an ADHD medication, has recently become the first U.S. Food and Drug Administration (FDA)-approved drug to treat binge eating disorder. Research has shown it can help with impulse control in both conditions. It shouldn’t be your only treatment, as impulse control is only one factor involved in BED. It can help suppress BED and keep you from relapsing longer, but it doesn’t address the root of the disorder.
You may also need medication to treat another condition related to your eating disorder, such as antidepressants or anxiety medications. Treating your underlying mental health conditions can help take the edge off your eating disorder. In addition, some providers may prescribe appetite suppressants for some people. These medications have shown short-term benefits for people in treatment for BED.
Diet and nutrition
People of all shapes and sizes can have BED, and they can also have various types of malnutrition. They may be deficient in micronutrients (vitamins and minerals) even if they have an excess of macronutrients (sugar and fat). Nutrient deficiencies can motivate binge eating by producing cravings and a vague sense of not getting enough. Nutritional supplements and nutrition education can help.
Some people find that a structured, nutritionally balanced meal plan can simply reduce some of the decision-making stress related to eating. It can satisfy your physical needs while leaving less room to act impulsively or emotionally. Although weight loss isn’t the main goal of treatment, it can be a side effect, and this can help relieve stress for some people. However, diet may be triggering for others with BED.
How is binge eating disorder diagnosed?
Healthcare providers diagnose eating disorders by asking detailed questions about your behaviors, thoughts and feelings. You might be reluctant to open up about these details, but honesty is important to getting the right diagnosis and the right treatment. You can start by talking to your primary care practitioner or seek out a mental health care practitioner. Either one can make the diagnosis.
Is there a test for binge eating disorder?
There’s no test, though the questions you’ll answer might take the form of a quiz. Your healthcare provider will analyze your answers according to the diagnostic criteria listed in the DSM-5. They may also ask follow-up questions not listed in the manual. If they think you meet the diagnostic criteria, they’ll diagnose binge eating disorder.
Do I need a diagnosis?
You don’t necessarily need a diagnosis to begin treatment. In fact, you may benefit from treatment even if your symptoms are “subclinical” (meaning, they don’t quite meet the criteria for diagnosis). Going through the interview process with a healthcare provider will help you and them to learn more about what type of support may benefit you. Some people feel relieved or validated by receiving a diagnosis and more empowered to seek help. This can be especially important for parents trying to help their children.
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