The Truth about Binge Eating Disorder

At some point in our lives, we have all overindulged in a restaurant or at a holiday dinner. But overeating on occasion does not define binge eating.   Binge eating disorder (BED) is the most common eating disorder, affecting up to 3% of the population. However, the incidence is likely a lot higher, because BED is under-reported and under-diagnosed.  This is a very common diagnosis among our patients at New You, so if you suffer from binge eating behavior, you are not alone by any means.  Experiencing binge eating disorder can make you feel embarrassed or isolated, but there is hope, and there is help! 

“What is binge eating disorder?”

The criteria for diagnosis of binge eating disorder according to the DSM-5, (a diagnostic tool for mental disorders) includes the following:

  • Eating an unusually large quantity of food in a short period of time and feeling a loss of control
  • Binging episodes may involve eating rapidly, getting uncomfortably full, eating large quantities without being hungry, eating in secret or hiding your food from others, experiencing intensely negative emotions yet repeating the cycle with regularity

“Why do people binge?”

Binging episodes are usually triggered by an increase in emotional stress, but not always.  Sometimes binge eating behavior develops as a matter of habit. For instance, a person who repeatedly goes all day without eating anything at all may feel driven to eat a very large quantity at the end of the day to feel satisfied.  Since their body cannot use that much food for energy all at once, it will be stored as body fat, and this leads to weight gain over time.  The amount consumed in a binge can be more than a person would normally eat in a whole day, sometimes several days.  

As previously mentioned, binge eating behavior is frequently triggered by stress or anxiety. For instance, at the end of a highly stressful day, a binge may seem to be the only thing that will bring relief. But anyone who experiences binging regularly can attest that the binging does not “fix” the stress, and in fact it often makes things worse.

As many people learned during the isolating months of the COVID-19 pandemic, binging behavior serves as a source of comfort for many people who are feeling lonely and/or depressed.  Many people who live with obesity also may have an underlying psychological condition like major depressive disorder, generalized anxiety disorder, or bipolar disorder to name a few.  If the underlying condition is not properly treated, the binging behavior takes place as a substitute for standard treatments such as medication or mental health counseling.

There are a few people whose binging behavior has a physiologic basis, such as the inability to feel full or satiated by normal portions.  In rare cases, the binging behavior is beyond the patient’s control, and this can be very distressing as the weight gain becomes increasingly severe.

Binge eating disorder can lead to obesity, but there are plenty of people who suffer from binge eating disorder whose BMI may be within the normal range or just slightly above.  Even if the behavior does not lead to obesity, it can be equally upsetting to those individuals.  

Binge eating disorder may also lead to other co-morbid conditions such as diabetes, heart disease, gallbladder disease or gall stones, fatty liver and others.

“How do I know if I have binge eating disorder?

There are no blood or lab tests to diagnose binge eating disorder since it’s based on patient behavior.  Elevated BMI may prompt a provider to discuss food behaviors around mood, but it’s not a common screening in the primary care provider’s office.  If you have experienced a binging episode more than once, it’s important to talk with your provider about this. The providers at New You are highly knowledgeable about BED and always approach this issue without judgement and with action-oriented solutions.  If you feel you may have an eating disorder, please reach out to your provider at New You to talk about your experiences.

“What are the treatments for binge eating disorder?”

Counseling: The primary recommended treatment for BED is mental health counseling, because it addresses underlying psychological triggers and provides support and guidance for developing healthy stress coping strategies that will support and be supported by a healthy new lifestyle for the patient. Depending on the severity of the condition, BED often requires attention from highly specialized providers.   To find individual mental health support, talk to your primary care provider or the staff at New You for a referral to an appropriate provider.  You may also want to reach out to your individual health plan provider for counselors in your plan’s network.  Cost of care can be an additional stressor, so make sure you find a solution that is financially realistic.  By the same token, investment of time, money and energy into supporting mental health has a very worthy pay off in more ways than one in creating a healthy lifestyle.

Support groups:  Joining a support group that meets either online or in person regularly can be very effective in helping patients to manage their emotions, get community support and gain new tools for coping.  New You has online and personal support groups that will help build the kind of healthy support system that each patient needs during their journey.  There are national organizations like Overeaters Anonymous and National Eating Disorders Association (NEDA) that can provide a starting point for finding care and support in your area.

Medical treatment:  Anti-obesity medications can help reduce appetite and provide the patient the opportunity to develop new, appropriately healthy stress coping strategies without feeling like their hunger is out of control.  Having some control can allow the patient to feel more confident and lose some weight while their gaining new skills and strategies for managing life stress.

“Will bariatric surgery cure binge eating disorder?”

In short, No, surgery alone will not cure binge eating disorder.  For a patient to be truly ready for weight loss surgery, it’s necessary to have the binging behavior under control so that the pre- and post-operative diet restrictions can be followed.  If a person were triggered to binge after surgery, this could be uncomfortable at the very least and dangerous at the worst, since consuming large amounts of food would put a lot of pressure on the internal surgical sites.  It’s important to be open and honest about your food behaviors and associated emotions.

New You has solutions that can provide lasting relief from the suffering of BED.  If you have hope, there is help. So, just reach out to New You, and you won’t face it alone.