Binge Eating Disorder

Binge Eating Disorder (BED) is marked by recurrent episodes of consuming excessively large amounts of food within a short time frame, more than what most individuals would eat under similar circumstances. Unlike typical overeating, these binge episodes are often accompanied by feelings of distress and a lack of control over eating behaviors. Though BED was officially classified as a distinct eating disorder in 2013, it is currently the most common eating disorder in the United States, impacting about 2% to 5% of adults and 1% to 3% of adolescents and children. While BED can develop at any age, it typically begins during adolescence or early adulthood and is more common among women. However, BED can affect individuals of any gender. It is also a misconception that eating disorders, including BED, are predominantly witnessed in young, white women, as they equally affect people of color. Furthermore, BED can occur in individuals of all body sizes, with only about half of those affected being classified as having obesity based on Body Mass Index (BMI).

Causes

Binge Eating Disorder does not stem from a single, identifiable cause. Rather, it is often a product of a combination of genetic, psychological, and social factors. Some common risk factors include:

• Physical and Genetic Risk Factors:

• Having a close family member, such as a parent, with an eating disorder.

• A family background of mental health issues.

• Experiencing anxiety disorders.

• A history of dieting or attempts to control weight.

• Possessing specific genes linked to BED.

• Having Type 1 diabetes, which may lead to unhealthy behaviors like skipping insulin to control weight, known as diabulimia.

• Psychological Risk Factors:

• Perfectionism with self-imposed high standards.

• Dissatisfaction with body image.

• Difficulty adapting behaviors.

• Social Risk Factors:

• Feelings of loneliness and isolation.

• Weight stigma, involving discrimination based on weight.

• Past experiences of teasing or bullying, especially related to weight.

• Traumatic life events or significant stress.

Symptoms

Individuals with Binge Eating Disorder experience symptomatic episodes of consuming unusually large amounts of food over a short period. Symptoms include:

• Eating significantly more than most people would under similar conditions.

• A perceived lack of control over eating behavior during episodes.

For a diagnosis, such binge episodes must occur at least once weekly over a minimum span of three months. These episodes often involve at least three of the following:

• Eating much faster than normal.

• Continuing to eat until feeling uncomfortably full.

• Eating large quantities even when not physically hungry.

• Eating alone due to embarrassment.

• Experiencing depression, guilt, or disgust after overeating.

Additional indicators may include hiding food wrappers, significant weight fluctuations, an excessive focus on weight and body image, irregular eating patterns, and using food to handle stress or cravings.

Diagnosis

If you suspect Binge Eating Disorder, consult a healthcare provider. The provider will evaluate your eating patterns, emotional state, and behavior related to food. A physical exam and tests may be conducted to exclude other conditions. The diagnosis may use criteria from the DSM-5, a key reference for mental health disorders, including BED. Multiple visits might be necessary to confirm the diagnosis, so patience is essential. Open, honest communication about eating habits is crucial, and any concerns regarding weight bias should be voiced to ensure a fair assessment.

Treatments

Managing BED typically involves therapy and possibly medications, facilitated by healthcare professionals like primary care providers, psychiatrists, and nutritionists, to reduce binge episodes. Cognitive Behavioral Therapy (CBT) is a cornerstone treatment strategy, helping individuals recognize and modify negative patterns. Interpersonal Psychotherapy focuses on managing interpersonal issues and relationships. Dialectical Behavior Therapy aids in self-acceptance and emotion management. For those unable to access in-person therapy, online therapy offers an effective alternative.

Medications

Medications may complement psychotherapy to help manage BED by reducing binge episodes or addressing obesity when related to BED. Research on new treatments is ongoing.

• Lisdexamfetamine (Vyvanse) is the FDA-approved medication for BED, acting by enhancing the release of brain chemicals dopamine and norepinephrine to decrease binge urges.

• Topiramate (Topamax), used for seizures and migraines, can aid in reducing binge eating and weight loss in BED patients. It is used "off-label" for this disorder.

• Selective serotonin reuptake inhibitors (SSRIs), like citalopram (Celexa) and sertraline (Zoloft), are antidepressants also used "off-label" to alleviate BED symptoms.