Binge-eating disorder is an eating disorder that involves recurrent episodes of binge eating, when an individual eats abnormally large quantities of food in a short period of time. Unlike in other eating disorders such as bulimia nervosa, this is not followed by compensatory purging measures to reduce the calorie intake.
While the exact causes of binge-eating disorder are not known, there are several risk factors that are associated with a heightened risk for the condition. These include:
- Family history of eating disorders
- Medical history of depression or anxiety
- Low-self esteem
- History of strict dieting patterns
- Abnormal levels of hunger/satiety hormones
- Abnormal neurotransmitter levels
- History of emotional or sexual abuse
- Highly stressful or emotional situations
In most cases, individuals with binge-eating disorder have several of these risk factors when they present with symptoms of the condition.
A binge-eating episode involves the consumption of an abnormal quantity of food in a short time frame, during which the individual often feels a lack of awareness or control about what they are eating. For example, they may eat 3000-5000 calories of food within 1-2 hours.
Each episode is usually followed by feelings of shame or disgust about their eating habits, and they may try to hide the evidence from family or friends. They do not make any efforts to reduce the calorie intake by purging, however, which is associated with bulimia nervosa.
Instead, there are often reinforcements of strict dieting and increased obsession with body weight and shape. This can then lead to increased cravings for certain foods and continue the binge-eating cycle.
Signs and Symptoms
The signs and symptoms of binge-eating disorder can be separated into two main categories: behavioral, emotional and physical.
Behavioral signs and symptoms refer to the way affected individuals interact with food. They will typically consume large quantities of food in a short timeframe, even if they are already full and with the inability to stop. Often they try to hide unhealthy eating habits from other and eat alone for this reason.
Emotional signs and symptoms refer to the relationship affected individuals have with food. This may include depression, anxiety, shame or embarrassment about eating behavior and desperation to regain control over weight and eating habits.
Physical effects are tied to the eating habits but can vary greatly between patients. Some patients have a normal body weight, but some may become overweight or obese, which can pose additional conditions. In particular, obesity can increase the risk of health conditions such as Type 2 diabetes, cardiovascular disease, osteoarthritis and sleep apnea.
According to the diagnostic and statistical manual of mental disorders, the DSM-5 diagnostic criteria for binge-eating disorder are as follows.
Recurrent binge-eating episodes (eating a large quantity of food within a discrete time period OR feeling lack of control during episode) that occur at least once a week for more than three months. They involve with at least three of:
- Eating more rapidly
- Feeling uncomfortably full
- Eating while alone
- Eating without feeling hungry
- Feeling ashamed or disgusted after episode
Individuals also feel distressed about eating habits and binge eating. However, they do not purge following episodes to reduce calorie intake, which is indicative of bulimia nervosa.
Treatment and Support
It is important for individuals that are affected by binge-eating disorder to have adequate support throughout the recovery process to help them manage struggles in a healthier manner. Family and friends can play an essential role, in addition to eating disorder support groups where patients can discuss struggles with others who are facing similar issues.
Psychotherapy is the primary treatment for binge-eating disorder, in addition to a healthy diet plan. There are various different types of therapy that may be used to identify underlying psychological causes for unhealthy eating habits and introduce coping mechanisms. In some cases, pharmacotherapy with antidepressants may be indicated, although it remains unclear if the benefits outweigh the risks and side effects.