Binge Eating Disorder (BED)
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.
- 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
- 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
- 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
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
Adrien Paczosa is a Registered and Licensed Dietitian practicing in Austin, Texas and the surrounding counties.
She is the owner and founder of I Live Well Nutrition her Dietitian practice which started in 2007 and serves clients in the Austin, Texas area in two locations. Fearless Practitioners, the division of her business that offers training to dietitians and wellness professionals.