Has this every happened to you? You find yourself home alone after what has been a very draining and taxing day. You enjoy dinner and then a sweet treat. And then a salty treat, followed by an uncontrollable purge of your pantry and refrigerator. It’s only been an hour or two but you’ve already consumed a larger amount of food than what would be considered normal in a similar time frame. You feel out of control. You are eating quickly and beyond satiety. You are uncomfortable and begin to feel disgusted, guilty, or depressed that you’ve eaten so much in the privacy of isolation. Has this happened to you at least once a week over the span of 3 months? If so, you may be surprised to know that these behaviors are characteristic of an eating disorder.
The eating disorder explained above is known as Binge Eating Disorder (BED) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V).
BED is defined as recurrent episodes of binge eating without behaviors aimed at compensating (ie: induced vomiting, laxative use, or excessive exercise). This definition clinically separates it from other eating disorders such as Bulimia Nervosa or Anorexia Nervosa.
Characteristics of BED include1:
- Eating in a discrete period of time (ie: within 2 hours) an amount of food that is significantly larger than what most people would eat during a similar period of time and under similar circumstances
- A sense of lack of control over eating during the episodes (ie: a feeling that one cannot stop eating or control what or how much one is eating)
The binge eating episodes are associated with 3 (or more) of the following1:
- Eating much more rapidly than normal
- 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
- The binge eating occurs, on average, at least once a week for 3 months
What is the prevalence of Binge Eating Disorder (BED)?
The lifetime prevalence of BED is highest in women compared to men (3.5%). This is more common than Anorexia Nervosa (0.6%) and Bulimia Nervosa (1%). Surprisingly, it is overall more common in adult women than amongst adolescents. Individuals of all races, ethnicities, and cultures are affected by BED.
How does our mind and body play a role in BED?
In those with eating disorders such as BED, early research is showing an over-responsiveness to the emotional signals in our brain that respond to “threatening cues” such as food and body weight/shape. In addition, the brain sends large volumes of signals saying; “look, a reward!” when food is presented.
Who is most at risk?
Consider your family. Based on twin studies, there is a 50% vulnerability for eating disorders if it runs in the immediate family.
Risk factors for eating disorders include:
- Being female
- Being overweight as a child
- Heightened concerns over shape and weight
- Sexual abuse
- Mood disorders
- Adolescents exposed to parents overly concerned about eating, shape, and weight
- Weight-related teasing by family members
- Being teased/ bullied, and developing significant stress related to this maltreatment
- Personality traits such as impulsivity and perfectionism have been linked to eating disorders as well.
What are some of the signs or symptoms of having Binge Eating Disorder?
Those with BED are frequently overweight or obese. Their weight is also associated with other diagnoses such as “Metabolic Syndrome” which includes cholesterol / lipid irregularities, high blood pressure, and type 2 Diabetes. For those who have undergone weight loss surgery, it may result in less weight loss (or potentially weight regain).
In general, BED patients report a poorer quality of life that impairs their everyday life at home and their social lives. There tends to be higher incidences of disability, health problems, and impairment in work productivity. Individuals with BED often have major depressive disorder, anxiety, substance use, and disruptive behavioral disorders.
How can BED be treated?
BED is most successfully treated with cognitive behavioral therapy and interpersonal psychotherapy. As a Weight Loss (Bariatric) Surgical Physician Assistant and Specialist in Obesity and Weight Management, I have created a 12 Week Weight Management Program (WMP). The 12 Week WMP is founded on cognitive behavioral therapy and is grounded in scientific studies and the most up to date weight loss literature and guidelines from medical and surgical organizations across the country. I encourage you to join the Facebook Group in order to stay tuned for open enrollment in my 12 Week Weight Management Program (WMP) effective 2019.
Is there a way to prevent BED?
The best way to prevent BED is to reduce some of the risk factors listed above. Developing a healthy relationship with food helps heal internal struggles of body image and negative self-talk.
Easier said than done, right?
With intensive 1:1 coaching, accountability assignments, and support from a small intimate group of patients with similar struggles, the 12 Week WMP is an effective program to help treat and prevent the development of Binge Eating Disorder. If an intensive program is not of interest to you, I still recommend joining a support group like Healthy Habiteers to stay accountable and motivated toward living a healthy, nourishing, and balanced life.
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1 Tanofsky-Kraff M. Eating Disorders. In: Goldman-Cecil Medicine. Vol 219. 2nd ed. Elsevier Inc; :1455-1457.