Definition

Binge eating disorder (BED) is a severe, life-threatening eating disorder characterized by recurrent episodes of eating large quantities of food, a feeling of a loss of control during the binge; experiencing shame or distress afterwards, and not regularly using compensatory measures (e.g., purging) to counter the binge eating.

About BED

• Recently recognized as a diagnosable eating disorder in the DSM-5, released in May 2013.
• Most common eating disorder in the United States, affecting 1-5% of the general population.
• Affects 3.5% of women, 2% of men, and up to 1.6% of adolescents.
• About 60% of people struggling with binge eating disorder are female and 40% are male.
• Body weight varies from normal to mild, moderate, or severe obesity.

Symptoms and Diagnostic Criteria

• Recurrent episodes of binge eating defined as both:
  • Eating, in a set period of time, a definitely larger amount of food than what most people would eat in a similar period of time.
  • A sense of lack of control over quantity and type of food eaten during the episode.
• At least three of the following binge eating episodes that involve eating…
  • Much more rapidly than normal.
  • Until feeling uncomfortably full.
  • Large amounts of food when not feeling physically hungry.
  • Alone due to feeling embarrassed by how much one is eating.
  • Feeling disgusted with oneself, depressed, or very guilty afterward.
• Marked distress regarding binge eating.
• 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)

Characteristics of BED

Behavioral

• Evidence of binge eating, (e.g. disappearance of large amounts of food in short periods of time, lots of empty wrappers and containers)
• Secretive food behaviors, including eating secretly and stealing, hiding, or hoarding food.
• Disruption in normal eating behaviors (e.g. eating throughout the day with no planned mealtimes; skipping meals; sporadic fasting or repetitive dieting; developing food rituals).
• Can involve extreme restriction and rigidity with food and periodic dieting and/or fasting.
• Has periods of uncontrolled, impulsive, or continuous eating beyond the point of uncomfortable fullness, (does not purge).
• Creating lifestyle schedules or rituals to make time for binge sessions

Emotional/ Mental

• Experiencing feelings of anger, anxiety, worthlessness, or shame preceding binges.
• May have co-occurring conditions like depression, also social isolation, moodiness, and irritability.
• Feeling disgust about one’s body size.
• Thought patterns and personality types associated with BED:
  • Rigid and inflexible “all or nothing” thinking
  • A strong need to be in control
  • Difficulty expressing feelings and needs
  • Perfectionistic tendencies
  • Working hard to please others

Health Consequences

The reliance on binge eating to relieve negative feelings can be detrimental to both physical and mental health, including:

• Obesity, which can lead to potential health consequences like high blood pressure and cholesterol, heart disease, type II diabetes, and sleep apnea.
• Lower quality of life.
• Lifetime major depression.
• High levels of anxiety.

How Friends and Family Can Help

• Set aside a time for a private meeting with your friend to discuss your concerns openly and honestly in a caring, supportive way.
• Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional.
• Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes and avoid giving simple solutions.
• Remind your friend that you care and want your friend to be healthy and happy and express your continued support.

Information provided by the National Eating Disorder Association