Calling Binge Eating what it is…a Real Disorder

Understanding the Very Real Dangers of BED

When people hear the terms ‘anorexia’ or ‘bulimia,’ most understand these words to represent complex mental health disorders that result in disordered eating.  For decades now, public awareness of the serious emotional issues that underlie anorexia and bulimia have helped people understand the validity of these dangerous psychiatric conditions.  However, upon hearing the term ‘binge eating disorder,’ many may wrongly associate it with simply a lack of self-control or a character flaw rather than as a bona fide disorder.

On the contrary, binge eating disorder, or BED, was recently added to the revised Diagnostic and Statistical Manual (DSM 5), recognizing it as a valid, diagnosable illness.  By adding BED to the DSM it gives health professionals specific diagnostic criteria that will aid clinicians in identifying and assessing the disorder, leading to effective treatment decisions for those struggling with BED.

What is Binge Eating Disorder?

Because the word “binge” has been used loosely to describe compulsive behaviors such as binge-watching a TV series, or “binging out” on ice cream after a break-up, there is a tendency to dismiss a binge eating disorder as just a reckless overindulgence in food that has resulted in weight gain; just as binge-watching on Netflix results in lost productivity.  It is a misnomer though, as BED usually has co-occurring mental health conditions that drive the disordered eating, which can result in dire health and psychological outcomes.  These comorbid mental health conditions include:

  • Anxiety
  • Bi-polar disorder
  • Depression
  • Substance abuse

Binge eating disorders affect about 2.8 million adults, according to a 2007 national survey by Biological Psychiatry.  Of those who suffer from BED, 5.2% will die from health complications that resulted from the disorder.  Shockingly, BED is more prevalent in adults in the U.S. than both anorexia and bulimia combined.

Those who suffer from BED use food to manage emotions they do not want to experience.  These unwanted emotions include anger, boredom, guilt, stress, sadness, or a sense of being out of control.  Someone with a BED will attempt to offset these emotions with the pleasure they anticipate they’ll feel by consuming vast quantities of comfort food on a recurrent basis.

BED is also accompanied by a fixation on body image, leading to compensatory behaviors after over-indulging in the food, such as vomiting (although purging is not a common trait in BED), using diuretics or laxatives, or over-exercise.  Despite the serious psychological and sociological issues that underlie BED, the disorder is often misdiagnosed as simply an issue with weight.

Diagnostic Criteria for BED

The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder as such:

 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
  • Eating much more rapidly than normal
  • The binge eating episodes are associated with three (or more) of the following:
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward
  • Marked distress regarding binge eating is present
  • The binge eating occurs, on average, at least once a week for 3 months
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

 Signs and Symptoms of BED

Although there are a multitude of variations of BED, there are certain signs and symptoms that someone may be suffering from this serious disorder.   By being aware of these signs, the chance for successful treatment of the disorder is made possible.  Some behaviors are displayed that may be predispositions for developing an eventual BED, but not necessarily.  Regardless, awareness is key in helping a loved one with a mental health condition such as BED.

Emotional characteristics of BED

  • Depression, social isolation, and moodiness
  • Feelings of anger, shame, anxiety and worthlessness preceding the binge
  • Negative or distorted body image
  • Rigid thinking
  • Perfectionist tendencies
  • Need to be in control
  • Conflict avoidance

Behavioral characteristics of BED

  • Eating secretly, hiding, stealing, or hoarding food
  • Disappearance of large amounts of food, empty wrappers or containers indicating large quantities of food consumed
  • Periods of impulsive or continuous eating beyond the point of feeling full, but does not purge. Eating fast, or eating large amounts of food when not hungry
  • Creating rituals allowing for binge sessions
  • Extreme rigidity with food, with periodic dieting/fasting

Effects of BED

A binge eating disorder can put someone at risk for developing several serious health conditions, including heart disease, type 2 diabetes, or high blood pressure, mostly due to obesity or radical weight fluctuations.  Because of the comorbid psychiatric conditions, a BED can also lead to a substance abuse disorder, which in itself can lead to death.

In addition to the physical effects, a BED can cause the sufferer to become disengaged from their normal responsibilities, eventually becoming unable to keep up with their obligations.  A BED can also affect relationships, due to the secretive behaviors and shame that may cause the sufferer to withdraw from loved ones.

Because BED is often a misunderstood condition, it is important to seek help from a provider who is an expert in the field of treating eating disorders.  At Casa Serena, our specialized professionals use evidence-based treatment methods in a caring and supportive environment to effectively treat BED.   Allow our compassionate staff to restore you or your loved one to good health and renewed quality of life.  Call us today (925) 682-8252!

Sources for this page:

http://www.bingeeatingdisorder.com/what-is-BED.aspx

http://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-myths-facts

https://www.nationaleatingdisorders.org/binge-eating-disorder

http://www.huffingtonpost.com/kenneth-l-weiner-md-faed-ceds/binge-eating-disorder_b_3346760.html

http://www.ncbi.nlm.nih.gov/pubmed/16815322