What are the other Names for this Condition? (Also known as/Synonyms)

• Compulsive Overeating Disorder
• Emotional Eating Disorder
• BED (Binge-Eating Disorder)

What is Binge-Eating Disorder? (Definition/Background Information)

• Binge-Eating Disorder (BED) is an eating disorder, which involves recurrent episodes of eating large portions of food even when one is not hungry. It may be described as a form of compulsive behavior
• The eating episodes occur at least once a week and spans over a period of 3 months. It is not accompanied by compensatory episodes of purging (via fasting or vomiting) or laxative abuse, which is often the case in bulimia nervosa (another eating disorder that can be potentially life-threatening)
• This disorder has been often shown to run in families. Both genetic and environmental factors may play a contributory role towards the development of Binge-Eating Disorder
• Individuals with Binge-Eating Disorder often experience feelings of guilt and embarrassment, and might binge eat alone. Those diagnosed with this disorder may most likely have coexisting mood and anxiety disorders, or indulge in harmful practices such as substance abuse
• Binge-Eating Disorder is diagnosed with a combination of psychological examination, as well as physical examination. The American Psychiatric Association published Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists certain criteria for evaluating and diagnosing individuals with BED
• The complications of Binge-Eating Disorder include obesity and obesity-associated medical conditions including cardiac and respiratory related conditions. In general, the affected individuals are known to have a poorer quality of life
• Most individuals with BED benefit from a combination treatment of psychotherapy and medication. The prognosis for Binge-Eating Disorder depends on multiple factors. However, with ample medical treatment and good family support, most individuals are able to lead a healthy life with an absence of serious complications

Who gets Binge-Eating Disorder? (Age and Sex Distribution)

• Binge-Eating Disorder has a slight female predominance. Studies indicate that up to 3.5% of the female population and about 2% of the male population may be affected
• The disorder most often affects the adolescent age group in females; in males, middle-aged men are affected the most
• This disorder is observed across all racial and ethnic groups

What are the Risk Factors for Binge-Eating Disorder? (Predisposing Factors)

The risk factors for the development of Binge-Eating Disorder are as follows:

• An individual is more likely to develop Binge-Eating Disorder, if a close family member has been affected by the condition. This seem to indicate that inherited genes play a major role in the development of BED
• Dieting has been associated with the disorder: In individuals with depression, dieting can trigger the development of BED
• Most individuals, who indulge in binge eating, often have low self-esteem and poor body self-image; these are known to act as trigger points for the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Binge-Eating Disorder? (Etiology)

• The causes of Binge-Eating Disorder are unknown
• It has been proven that genetics, psychosocial factors, and long-term dieting increase an individual’s risk for developing this disorder

What are the Signs and Symptoms of Binge-Eating Disorder?

Generally, individuals with Binge-Eating Disorder are overweight or obese. The following emotional and behavioral signs and symptoms may be observed:

• Eating abnormally large portions of food in a specific amount of time, such as a two-hour period.
• Individuals may exhibit secretive food behaviors including stealing or hoarding food
• The affected individual has uncontrolled and impulsive episodes of eating beyond the point of feeling uncomfortably full, without vomiting
• Individuals with BED often experience feelings of anger and shame. Initiating the binge is a means of relieving stress and numbing one’s negative thoughts
• Depression may be present in a majority of individuals affected by this condition. They also experience social isolation and irritability
• Individuals with BED often have poor body self-image; they generally dislike their appearance

Additionally, the physical and physiological manifestation of BED may include obesity and related conditions such as diabetes, high cholesterol levels, and cardiovascular health conditions.

Note: Individuals, who binge eats, may not always be overweight or obese.

How is Binge-Eating Disorder Diagnosed?

A diagnosis of Binge-Eating Disorder may involve the following tests and exams:

• A thorough psychological evaluation, including discussing one’s eating habits
• A complete physical examination to check for the health consequences of Binge-Eating Disorder, such as high cholesterol, tested using fasting lipid profile, gastroesophageal reflux disease (GERD), which is diagnosed using upper gastrointestinal endoscopy and diabetes tested by measuring the fasting blood sugars and hbA1c levels

For a diagnosis of Binge-Eating Disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA), lists the following parameters:

• Recurrent episodes of binge eating
• Binge eating once a week for at least 3 months
• A sense of losing control during the bingeing/binging episodes (feeling that one cannot stop eating, or being unable to control the amount of food intake)
• Binge eating that is associated with at least 3 of the following factors:
  • Eating large portions of food when one is not hungry
  • Eating alone, out of embarrassment
  • Eating much more rapidly than normal, until there is a feeling of being uncontrollably full
  • Feeling guilty or distressed after a binge episode
• Binge eating not associated with purging or other compensatory behaviors to lose weight

(Source: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), American Psychiatric Association)

Note: The APA-published, DSM-5 has included Binge-Eating Disorder as a separate category of eating disorder. The DSM-5 is the standard classification of mental disorders used by mental health professionals in the United States.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Binge-Eating Disorder?

Complications of Binge-Eating Disorder may include:

• Poor quality of life: Individuals with BED often have a poorer quality of life. They also regularly harbor feelings of guilt and embarrassment
• Social isolation: These individuals have poor social and work relationships. They may also perform poorly at school and office
• Feeling guilty and distressed due to the overeating condition
• Obesity and obesity-associated medical complications, such as gastroesophageal reflux disease, diabetes, heart disease, high cholesterol, and sleep-related breathing disorders (apnea)
• Psychiatric disorders that are often linked with Binge-Eating Disorder include depression, bipolar disorder, and anxiety
• Individuals with the condition are more at risk for substance abuse

How is Binge-Eating Disorder Treated?

The treatment options for Binge-Eating Disorder may have to be considered based on the affected individual’s signs and symptoms and clinical history. The treatment options can be classified into psychotherapy and medications and may include the following:

• Psychotherapy: It can be either individual-based or group therapy. The techniques may include the following:
  • Cognitive behavioral therapy (CBT): It is a form of psychotherapy that focuses on changing harmful thinking patterns, feelings, and behavior
  • Dialectic behavior therapy: This form of psychotherapy is for individuals with severe personality disturbances. It is designed to help change one’s patterns of behavior that are not helpful, such as self-harm, suicidal thinking, and substance abuse
  • Interpersonal psychotherapy (IPT): This form of psychotherapy focuses on interpersonal issues. The targets of IPT include improving interpersonal communication and increased social support
• Administration of medications such as anticonvulsants and antidepressants
• Behavioral weight loss program may be considered on a case-by-case basis
• Treatment involves not only the affected individuals, but can also involve the support of one’s close friends and family members
• Close monitoring of the individual after the symptoms subside is very important in preventing a relapse. Any early signs of relapse should be treated immediately
• Generally, outpatient treatment is sufficient for most individuals. In some individuals with severe signs and symptoms, inpatient hospitalization may be required

How can Binge-Eating Disorders be Prevented?

It is typically difficult to prevent Binge-Eating Disorder, although future episodes of binge eating may be controlled. Individuals, who have been diagnosed with BED, can be helped through the following measures to prevent future episodes or recurrences.

Such preventative measures may include the following:

• Support groups: Support groups can be established to help cope with the symptoms and improve the quality of one’s life
• Stress management: Stress plays an important role in binge eating.  Stress management can help deal with binge eating episodes and reduce its frequency
• Family members and close friends can provide non-judgmental support and encourage their loved ones to seek early treatment for this potentially serious condition

What is the Prognosis of Binge-Eating Disorder? (Outcomes/Resolutions)

The prognosis for Binge-Eating Disorder depends on various factors.

• With ample treatment and familial support, most individuals with this disorder can expect to see a significant decrease in their symptoms. They often lead healthy lives with no serious medical complications being noticed
• A greater public awareness about Binge-Eating Disorder is mandatory to ensure that every individual with this disorder has the opportunity to access resources, adequate treatment, and support for their road to recovery. A better understanding of the condition helps in better outcomes and prognosis

Additional and Relevant Useful Information for Binge-Eating Disorder:

• Binge-Eating Disorder is the most prevalent eating disorder in the United States
• Individuals with Binge-Eating Disorder are often reported to be stigmatized. BED is a frequently misunderstood disease often confused with occasional over-eating