Food isn’t just a daily necessity. Food is also a way of celebrating achievements at work, marking birthdays, and honoring anniversaries. Shared meals bring us together during the holidays, and they help sustain new parents just home from giving birth.
But feeling joy around food isn’t always easy — especially in a culture and media environment that still pressures people to have certain body weights, sizes, and shapes. For this piece, we spoke with mental health professional Julia Preamplume, a licensed clinical social worker at Grow Therapy about the signs, symptoms, and treatment options for those struggling with binge eating disorder.
What is Binge Eating Disorder?
Binge eating disorder (BED) is an eating disorder that’s characterized by consuming large amounts of food, often to the point of discomfort. A binge often happens in a relatively short period of time. The individual usually feels a loss of control and an inability to stop.
BED is the most common eating disorder in the United States. Around 2.2% of American adults suffer from binge eating disorder in their lifetime, according to a 2020 report from Harvard’s School of Public Health.
However, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders only designated it a full-fledged diagnosis in 2013. The key diagnostic features include:
- Recurrent and persistent episodes of binge eating
- Marked distress around binging
- Absence of behaviors to “compensate” for binging (e.g., purging)
A Few Words on the DSM-5 Criteria
Diagnostic criteria are important for getting insurance companies to cover the care that people struggling with BED need. But Preamplume emphasizes that the criteria are just text on a page — it doesn’t have the power to invalidate your experience.
“Even if you don’t fit the criteria, it doesn’t really matter. What’s important is what you’re actually experiencing,” says Preamplume.
Diagnoses also help to inform treatment modalities that may be effective. But they generally are just labels that can sometimes do more harm than good.
Any kind of disordered eating behavior is valid and worthy of care, because it indicates that there’s a struggle in your relationship with food.
What is Considered Binging?
The DSM-V indicates a binge eating episode is associated with three or more of the following characteristics, as recorded in NEDA’s blog post on BED criteria. These include:
- Eating much faster than normal
- Eating until feeling uncomfortably full
- Eating large quantities of food when not feeling physically hungry
- Eating alone due to embarrassment about how much you’re eating
- Feeling self-disgust, guilt, or depression after a binge
As a reminder, what matters is your experience, not whether you fit the exact diagnostic specifications.
Signs and Symptoms of Binge Eating Disorder
Someone dealing with binge eating disorder may try to hide their behaviors, which can make this illness particularly difficult to spot. To help with identifying BED in yourself or a loved one, the National Eating Disorder Association published a thorough list of possible warning signs and symptoms:
Emotional Signs and Symptoms
- Appearing uncomfortable eating around other people
- Fearing eating in public
- Demonstrating extreme concern with body weight and shape
- Feeling disgusted, depressed, or guilty after overeating
- Experiencing low self-esteem
Behavioral Signs and Symptoms
- Leaving evidence of binges, such as large amounts of food disappearing or lots of empty containers and wrappers
- Taking up new food practices or fad diets, such as cutting out food groups
- Stealing or hoarding food in unusual places
- Changing schedules or lifestyles to make time for binges
- Withdrawing from friends and usual activities
- Feeling unable to stop eating
- Developing unusual food rituals, such as eating only a particular food
- Eating alone because of embarrassment
Physical Signs and Symptoms
- Fluctuating body weight, both up and down
- Experiencing stomach cramps and/or other gastrointestinal complaints
- Struggling to concentrate
Struggling with an eating disorder?
Causes of Binge Eating Disorder
Eating something that tastes good activates the dopamine in our brains. Whether or not we binge eat, this reward pathway happens for all of us, and it can feel like a physical high.
“Even the act of knowing ‘I’m going to go to this fridge, I’m going to grab this…’ We can just really feel that excitement,” Preamplume says.
When the binge is over, the brain crashes. All that initial excitement turns into disgust. You may feel physically sick and/or emotionally overwhelmed. Some people feel badly about their bodies afterward or ashamed of their behaviors, though these aren’t their fault.
These emotions are painful. The irony is that many people developed an eating disorder in the first place because they struggled with allowing themselves to experience difficult thoughts or feelings. The disordered eating behaviors were originally a way of coping with life.
How is Binge Eating Disorder Different From Other Eating Disorders?
Preamplume highlighted two more defining characteristics of BED:
- With a purging-type eating disorder, the brain typically experiences a (false) sense of relief. The individual may feel like they are “taking care of it” through unhealthy compensatory behaviors. “With pure binging, you don’t get that sense of satisfaction,” Preamplume says. “It’s just like, ‘Wow, I just ate a bunch of food, and I feel horrible.’” Carrying these emotions and guilt can be especially draining.
- The shame and stigma that people experiencing BED may feel make reaching out especially hard. With some eating disorders, people lose weight and receive affirmation for their appearance. “That’s not something typically someone with binge eating disorder ever really hears,” Preamplume says. “In our society, we look down on people that struggle with their weight or are at a higher weight in any way.”
Binge Eating Disorder vs. Bulimia
Binge eating disorder and bulimia both consist of severe disturbances in eating patterns and weight management. Both also involve some form of binging.
But Preamplume explains that these two conditions tend to have different mindsets. For instance, with BED, binges are consistently accompanied by purging behaviors. “There’s none of that compulsion to expel,” Preamplume says.
Recovery can also look different—although a common misconception is that BED treatment involves losing weight. ED specialist Tamara Pryor, PhD, emphasizes that binge eating disorder recovery is not about weight loss. Instead, her treatment methods involve:
- Identifying the function that binge eating serves in the client’s life
- Developing skills to interrupt binge eating
- Learning how weight stigma contributes to developing BED
- Understanding how internalized weight stigma leads to unhealthy efforts to change body shape, size, or weight, size.
- Creating a healthier, more joyful relationship with food
Binge Eating Disorder vs. Overeating
What distinguishes BED from “simple overeating” is feeling out of control during the binge, according to Eating Disorder Hope’s guidance on binge eating disorder. Preamplume paints the picture: “Have you ever eaten where it feels like you have blinders on, where you can’t see anything except food? Maybe a part of you knows this doesn’t feel good, but it feels like you can’t.”
The mental and emotional experience during a binge can also be a clue. Someone experiencing BED typically feels guilt, shame, or distress — not to mention physical discomfort.
Dangers of Binge Eating Disorder
If you’re living with binge eating disorder, you may start experiencing psychological or physical health problems, according to the Mayo Clinic’s guidance on BED. Potential complications related to binge eating include:
- Poor quality of life
- Difficulty functioning at work, in social settings, or in your personal life
- Social isolation
- Depression and/or anxiety
Recent studies suggest that binge eating disorder often coexists with other mental health conditions. For example, researchers analyzed a large clinical database of almost 12,000 BED patients, both men and women. They found that, among BED patients:
- Nearly one in 10 have a comorbid substance use disorder
- Over half experience a comorbid anxiety disorder
- Nearly half experience a comorbid mood disorder
People with BED may experience medical conditions related to obesity. These include heart disease, gastroesophageal reflux disease (GERD), joint problems, or type 2 diabetes. However, Eating Recovery Center binge eating disorder page carefully notes that weight stigma has shaped how the medical field has defined health consequences of BED and all eating disorders can impact every organ system in your body, especially:
- Cardiovascular system
- Gastrointestinal system
- Nervous system
- Endocrine system
How to Get Help for Binge Eating Disorder
BED is severe and life-threatening. Thankfully, this condition is also treatable. If you are experiencing any level of binge eating disorder symptoms, know that you are worthy of supportive care and clinical attention. Preamplume explains what you can expect in the treatment of binge eating disorder below.
Opening Up for the First Time Can Be the Hardest Part
Sharing your struggles with binge eating disorder can be scary, especially if you’ve opened up before and someone ignored or invalidated your pain. But remember how much the eating disorder costs you every day, and fight to open up.
“The eating disorder takes away so much of your life. It affects your ability to socialize, it affects your ability to enjoy your own company,” Preamplume says. “It makes it hard to have any contentment in your life as long as you have an eating disorder that’s telling you you’re not enough, no matter what you do.”
Take heart that you can regain your life—and thousands of people already have. Find a trusted loved one, someone that you can feel safe simply telling them, “Hey, I’m really struggling here.”
Treatment for Binge Eating Disorder Requires a Team Approach
Self-help is possible but usually not sufficient to recover from any eating disorder, including BED. A treatment team usually includes a registered dietitian who provides nutritional therapy, a primary care provider who evaluates your physical needs, a mental health professional who focuses on the ED symptoms and helps you build healthier coping skills, and possibly a psychiatrist who prescribes necessary medications.
Cognitive behavioral therapy has been shown to be helpful in reducing some of the negative self talk and irrational thoughts that can lead to the shame and difficult emotions – which in turn, can make one less likely to turn to binging to cope with those emotions/thoughts.
Overeaters Anonymous is another treatment option; this 12-step program is catered to helping to address unhealthy eating habits.
Some teams may also include a dentist, who can identify and treat issues caused by the disorder. Ideally, all team members specialize in eating disorders, and together they determine the level of care you need based on the disorder’s severity.
Expect to Make Gradual Changes and Progress Over Time
Your treatment team will likely help you focus on smaller steps toward full recovery. “The goal is to help you absolutely stop the behaviors, but it’s probably not going to be ‘cold turkey,’” Preamplume says.
Here’s an example of recovery in practice: Your registered dietitian’s goal is to help you learn to better nourish your body. A small step toward it could be increasing your intake of a certain food group. However, remember that your treatment goals will depend on how your team assesses your particular needs and health status.
Recovering From Binge Eating Disorder Is Possible
Recovery takes work and dedication, but it is 100% possible, especially when you can work with a mental health provider that you trust.
“I think the big thing is learning about being kind with yourself,” says Preamplume. “That’s really what I hope that anyone struggling with an eating disorder can work on now.”
If you’re looking for support, you can search for a therapist that specializes in eating disorders with Grow Therapy.
