Binge Eating Disorder: Identifying Symptoms, Getting Treatment, and More

It’s normal to overeat from time to time. However, if you regularly overeat to the point of feeling ill, you may be experiencing binge eating disorder (BED). BED is a serious illness that can affect your health and negatively impact your quality of life.

Although it can be easy to confuse BED with anorexia nervosa or bulimia, it’s important to understand that they’re each different conditions.

People with anorexia eat very little and do everything they can to lose weight. This sometimes includes excessive exercise, routine vomiting, or the use of laxatives or other substances.

Bulimia is a condition in which people binge and then engage in purging behaviors. For example, after eating a large amount of food, a person may induce vomiting or use laxatives to get rid of the excess calories. The purging behavior may also include excessive exercise.

BED doesn’t involve any form of purging. It’s primarily associated with an unusual and unhealthy approach to eating your food. Keep reading to learn more about the symptoms of BED and how to seek treatment for this condition. 

Many people who have BED eat in secret. Once behind closed doors, you may often eat a large amount of food. And you eat for a certain length of time until you feel overstuffed.

Other behaviors associated with BED include:

• eating a large amount of food even if you’re not hungry
• eating a large amount of food very quickly
• lying about your food habits
• stashing food for later
• rearranging your life around episodes of binge eating
• continuing a cycle of bingeing and trying to gain control over eating

A binge is often followed by feelings of guilt, shame, and embarrassment. Despite not wanting to do it again, the compulsion to binge returns. It’s not unusual for people with BED to also have low self-esteem or experience symptoms of depression. These feelings may contribute to your desire to binge.

If you have BED, you may feel physically tired and have trouble sleeping. Binges can cause a general feeling of ill health, typically characterized by:

• bloating
• constipation
• joint pain
• muscle pain
• menstrual problems
• headaches

People with BED tend to report more mental health issues than people without an eating disorder. Stress, insomnia, and suicidal thoughts are common.

Other psychological effects include:

• difficulty with activities involving food, such as communal meals
• withdrawing from social situations
• sensitivity regarding references to weight or physical appearance
• low self-esteem
• fearing other people’s disapproval
• anxiety
• depression

In some cases, weight gain may also be a sign of BED. But weight gain can occur for many reasons, and not all people who binge are overweight. Weight gain followed by repeated attempts to diet, often called "yo-yo dieting," is often considered a sign of BED.

If you’re experiencing feelings or behaviors tied to BED, you should make an appointment with your doctor. They can help you determine whether what you’re experiencing is typical or if it may be caused by an underlying medical concern, such as BED.

To make a diagnosis, your doctor will likely recommend a psychological evaluation with a mental healthcare professional. This will include a discussion about your eating habits.

In order for a BED diagnosis to be made, you must exhibit the following feelings or behaviors:

• a loss of control over how much you eat
• distress after bingeing
• bingeing at least once per week for at least three months
• bingeing unassociated with purging behaviors

You must also experience three or more of the following:

• eating faster than normal
• frequently eating until you’re too full
• consuming large quantities of food even when you’re not hungry
• eating alone so others don’t see how much you eat
• feelings of disgust, guilt, or depression after bingeing

If a diagnosis is made, your doctor may also perform tests to check for BED-related complications that may include:

• high cholesterol
• high blood pressure
• heart problems
• diabetes
• GERD
• sleep-related breathing disorders

Getting help for your disorder may enable you to feel more in control of your eating habits. Treatment for BED aims to reduce or eliminate unhealthy attitudes and behaviors regarding food. Most treatment plans involve a combination of talk therapy and medication used to manage symptoms. 

Therapy

Psychotherapy, or talk therapy, may help you learn how to manage unhealthy habits and work to eliminate bingeing episodes.

Types of therapy that are helpful in treating BED include the following:

Cognitive behavioral therapy (CBT) focuses on the dysfunctional thoughts and behaviors associated with bingeing. This form of therapy aims to increase your self-awareness and help you to understand how and why you binge. CBT can also teach you how to avoid or combat triggers.

Interpersonal therapy focuses on your relationships with other people. The main goal is to develop or improve the way you relate to others. It can also teach you how to manage triggers involving poor relationships or communication.

Dialectical behavior therapy aims to help you better tolerate stress, monitor your emotions, and develop healthy self-esteem.

Medication

Medication may be used to help manage or reduce episodes of binge eating. Lisdexamfetamine (Vyvanse) is the first drug approved by the U.S. Food and Drug Administration (FDA) to treat moderate to severe BED.

Although it’s typically used to control seizures, topiramate (Topamax) has also been found to reduce episodes of binge eating.

Antidepressant medications are sometimes prescribed for people who binge and also have depression.

If you’re diagnosed with BED, you may be at an increased risk of high blood pressure and high cholesterol. This may make you more likely to develop diabetes, heart disease, and stroke.

Because of this, it’s important that you speak with your doctor if you’re experiencing symptoms of BED. They can work with you to better understand your feelings and behaviors and make a diagnosis if necessary. 

BED is treatable. Your doctor can help you identify what triggers you to binge and help you create coping strategies. Attending a self-help program or support group may also help you gain control over your disorder.

If you have BED, it can be difficult to come to terms with unhealthy habits. Even if you’re committed to seeking treatment, you may fall back into old patterns. It’s important that you have a support system in place, whether that’s individual or group therapy, or a friend or family member to call when you need to talk.

If your loved one has BED, encourage them to seek help. It’s important for you to be supportive and not judge them. Make it clear that you care about their well-being and that you want them to be happy and healthy. You can also set a positive example for your loved one by engaging in healthy eating habits and abstaining from unhealthy episodes of bingeing.