Binge eating disorder
Encyclopedia
Binge eating disorder (BED) is the most common eating disorder in the United States affecting 3.5% of females and 2% of males and is prevalent in up to 30% of those seeking weight loss treatment. Although it is not yet classified as a separate eating disorder, it was first described in 1959 by psychiatrist
and research
er Albert Stunkard as "Night Eating Syndrome" (NES), and the term "Binge Eating Disorder" was coined to describe the same binging-type eating behavior without the exclusive nocturnal component. BED usually leads to obesity although it can occur in normal weight individuals. There may be a genetic inheritance factor involved in BED independent of other obesity risks and there is also a higher incidence of psychiatric comorbidity, with the percentage of individuals with BED and an Axis I comorbid psychiatric disorder being 78.9% and for those with subclinical BED, 63.6%.
. The formal diagnosis criteria differ, however, in that subjects must binge
at least twice per week for a minimum period of three months for bulimia nervosa and a minimum of 6 months for BED. Unlike in bulimia, those with BED do not purge
, fast
or engage in strenuous exercise
after binge eating. Additionally, bulimics are typically of normal weight, are underweight but have been overweight before, or are somewhat overweight. Those with BED are more likely to be obese.
Binge eating disorder is similar to, but distinct from, compulsive overeating. Those with BED do not have a compulsion to overeat and do not spend a great deal of time fantasizing about food. On the contrary, some people with binge eating disorder have very negative feelings about food. As with other eating disorders, binge eating is an "expressive disorder"—a disorder that is an expression of deeper psychological problems. Some researchers believe BED is a milder form or subset of bulimia nervosa, while others argue that it is its own distinct disorder. Currently, the DSM-IV categorizes it under Eating disorder not otherwise specified
(EDNOS), an indication that more research is needed.
and often obese, but people of a healthy weight can also suffer from it.
About two percent of all adults in the United States (as many as four million people) have binge eating disorder. About ten to fifteen percent of people who are moderately obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is almost twice as common among women as among men. The disorder is found in all cultures and ethnicities. People who are obese and have binge eating disorder often became overweight at an earlier age than those without the disorder. They might also lose and gain back weight more often, or be hypervigilant about gaining weight.
causes binge eating disorder, BED causes depression, or the two have a common cause, is not presently known.
The trigger point can be an emotion such as happiness, anger, sadness or boredom. Impulsive behavior and certain other emotional problems can be more common in people with binge eating disorder. However, many people also report that binging occurs regardless of their mood. It is also unclear whether dieting and binge eating are related. Some studies show that about half of all people with BED had episodes before they started to diet.
Researchers also state that binge eating disorder is more common among competitive athletes whose bodies are regularly on display, such as swimmers and gymnasts. Affected athletes in these sports tend to compare their own bodies in a negative way with those of their teammates and competitors. There has been research into how brain chemicals and metabolism
affect binge eating disorder, but this study is in its early stages.
and obesity
. The main health consequences of this type of eating disorder is brought on by the weight gain resulting from the bingeing episodes.
People with binge eating disorder may become ill due to a lack of proper nutrition. Bingeing episodes usually include foods that are high in fat, sugar, and/or salt, but low in vitamins and minerals. Individuals are often upset about their binge eating and may become depressed. Those who are obese and also have BED are at risk for type 2 diabetes, high blood pressure (hypertension), high blood cholesterol levels (hypercholesterolemia), gallbladder disease, heart disease, and certain types of cancer.
Most people with binge eating disorder have tried to control it on their own, but have not been able to for very long. Some people miss work, school, or social activities to binge eat. Obese people with BED often have very low self-esteem and may avoid social gatherings. Those who binge eat, whether obese or not, are aware of their disordered eating patterns, and try to hide their disorder out of shame. Often they become so adept at hiding it that even close friends and family members are unaware that they binge eat.
meetings. Even those who are not overweight are usually upset by their binge eating, and treatment can help them.
Although mental health professionals may be attuned to the signs of binge eating disorders, many physicians do not raise the question, often because they are uninformed about the specifics of the condition. Because it is not a recognized psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders
, it is difficult to obtain insurance reimbursement for treatments.
There are several different ways to treat binge eating disorder. Cognitive-behavioral therapy
teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in difficult situations. Interpersonal psychotherapy
helps people to look at their relationships with friends and family and make changes in problem areas. Drug therapy
, such as antidepressants, may be helpful for some people.
Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. The methods mentioned here seem to be equally helpful. For people who are overweight, a weight-loss program to improve health and to build self-esteem, as well as counselling to pinpoint the root of the psychological problems triggering their binge episodes, may be the best choice.
A clinical trial in Helsinki is investigating the use of intra-nasal naloxone for binge eating disorder, using the same approach as the highly successful Sinclair Method for alcohol addiction. Results of this trial are expected in 2011.
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
and research
Research
Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...
er Albert Stunkard as "Night Eating Syndrome" (NES), and the term "Binge Eating Disorder" was coined to describe the same binging-type eating behavior without the exclusive nocturnal component. BED usually leads to obesity although it can occur in normal weight individuals. There may be a genetic inheritance factor involved in BED independent of other obesity risks and there is also a higher incidence of psychiatric comorbidity, with the percentage of individuals with BED and an Axis I comorbid psychiatric disorder being 78.9% and for those with subclinical BED, 63.6%.
Signs
- Periodically does not exercise control over consumption of food.
- Eats an unusually large amount of food at one time, far more than an average person would eat.
- Eats much more quickly during binge episodes than during normal eating episodes.
- Eats until physically uncomfortable and nauseated due to the amount of food consumed.
- Eats when depressed or bored.
- Eats large amounts of food even when not really hungry.
- Often eats alone during periods of normal eating, owing to feelings of embarrassment about food.
- Feels disgusted, depressedDepression (mood)Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
, or guiltGuiltGuilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...
y after binge eating. - Rapid weight gainWeight gainWeight gain is an increase in body weight. This can be either an increase in muscle mass, fat deposits, or excess fluids such as water.-Description:...
/sudden onset of obesityObesityObesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
. - Severe depression.
- Easily irritated by the simplest things.
Relationship to other eating disorders
Binge eating symptoms are also present in bulimia nervosaBulimia nervosa
Bulimia nervosa is an eating disorder characterized by binge eating and purging or consuming a large amount of food in a short amount of time, followed by an attempt to rid oneself of the food consumed, usually by purging and/or by laxative, diuretics or excessive exercise. Bulimia nervosa is...
. The formal diagnosis criteria differ, however, in that subjects must binge
Binge
-People:* Dagmar Anita Binge, German founder of Binge Discs * Ronald Binge, British composer and arranger of light music-See also:A binge is any behavior indulged to excess...
at least twice per week for a minimum period of three months for bulimia nervosa and a minimum of 6 months for BED. Unlike in bulimia, those with BED do not purge
Purging disorder
Purging disorder is an eating disorder characterized by recurrent purging to control weight or shape in the absence of binge eating episodes that occurs in people with normal or near-normal weight...
, fast
Fasting
Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. An absolute fast is normally defined as abstinence from all food and liquid for a defined period, usually a single day , or several days. Other fasts may be only partially restrictive,...
or engage in strenuous exercise
Exercise bulimia
Exercise bulimia is a subset of the psychological disorder called bulimia in which a person is compelled to exercise in an effort aimed at burning the calories of food energy and fat reserves to an excessive level that negatively affects their health...
after binge eating. Additionally, bulimics are typically of normal weight, are underweight but have been overweight before, or are somewhat overweight. Those with BED are more likely to be obese.
Binge eating disorder is similar to, but distinct from, compulsive overeating. Those with BED do not have a compulsion to overeat and do not spend a great deal of time fantasizing about food. On the contrary, some people with binge eating disorder have very negative feelings about food. As with other eating disorders, binge eating is an "expressive disorder"—a disorder that is an expression of deeper psychological problems. Some researchers believe BED is a milder form or subset of bulimia nervosa, while others argue that it is its own distinct disorder. Currently, the DSM-IV categorizes it under Eating disorder not otherwise specified
Eating disorder not otherwise specified
Eating disorder not otherwise specified involves disordered eating patterns. EDNOS is described in the DSM-IV-TR as a "category [of] disorders of eating that do not meet the criteria for any specific eating disorder".- Characteristics :...
(EDNOS), an indication that more research is needed.
Occurrence and risk factors
Most people with this disorder are overweightOverweight
Overweight is generally defined as having more body fat than is optimally healthy. Being overweight is a common condition, especially where food supplies are plentiful and lifestyles are sedentary...
and often obese, but people of a healthy weight can also suffer from it.
About two percent of all adults in the United States (as many as four million people) have binge eating disorder. About ten to fifteen percent of people who are moderately obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is almost twice as common among women as among men. The disorder is found in all cultures and ethnicities. People who are obese and have binge eating disorder often became overweight at an earlier age than those without the disorder. They might also lose and gain back weight more often, or be hypervigilant about gaining weight.
Causes
No one is certain of what causes binge eating disorder. As many as half of all people with BED have been depressed in the past. Whether depressionClinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
causes binge eating disorder, BED causes depression, or the two have a common cause, is not presently known.
The trigger point can be an emotion such as happiness, anger, sadness or boredom. Impulsive behavior and certain other emotional problems can be more common in people with binge eating disorder. However, many people also report that binging occurs regardless of their mood. It is also unclear whether dieting and binge eating are related. Some studies show that about half of all people with BED had episodes before they started to diet.
Researchers also state that binge eating disorder is more common among competitive athletes whose bodies are regularly on display, such as swimmers and gymnasts. Affected athletes in these sports tend to compare their own bodies in a negative way with those of their teammates and competitors. There has been research into how brain chemicals and metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
affect binge eating disorder, but this study is in its early stages.
Complications
While people of a healthy weight may overeat occasionally, an ongoing habit of consuming large amounts of food in a short period of time ultimately leads to weight gainWeight gain
Weight gain is an increase in body weight. This can be either an increase in muscle mass, fat deposits, or excess fluids such as water.-Description:...
and obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
. The main health consequences of this type of eating disorder is brought on by the weight gain resulting from the bingeing episodes.
People with binge eating disorder may become ill due to a lack of proper nutrition. Bingeing episodes usually include foods that are high in fat, sugar, and/or salt, but low in vitamins and minerals. Individuals are often upset about their binge eating and may become depressed. Those who are obese and also have BED are at risk for type 2 diabetes, high blood pressure (hypertension), high blood cholesterol levels (hypercholesterolemia), gallbladder disease, heart disease, and certain types of cancer.
Most people with binge eating disorder have tried to control it on their own, but have not been able to for very long. Some people miss work, school, or social activities to binge eat. Obese people with BED often have very low self-esteem and may avoid social gatherings. Those who binge eat, whether obese or not, are aware of their disordered eating patterns, and try to hide their disorder out of shame. Often they become so adept at hiding it that even close friends and family members are unaware that they binge eat.
Treatment
People with binge eating disorder, whether or not they want to lose weight, should seek help from health professionals including physicians, nutritionists, psychiatrists, psychologists, clinical social workers or by attending 12-step Overeaters AnonymousOvereaters Anonymous
Overeaters Anonymous is a twelve-step program for people with problems related to food including, but not limited to, compulsive overeaters, those with binge eating disorder, bulimics and anorexics...
meetings. Even those who are not overweight are usually upset by their binge eating, and treatment can help them.
Although mental health professionals may be attuned to the signs of binge eating disorders, many physicians do not raise the question, often because they are uninformed about the specifics of the condition. Because it is not a recognized psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
, it is difficult to obtain insurance reimbursement for treatments.
There are several different ways to treat binge eating disorder. Cognitive-behavioral therapy
Cognitive therapy
Cognitive behavioral therapy is a psychotherapeutic approach: a talking therapy. CBT aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure in the present...
teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in difficult situations. Interpersonal psychotherapy
Interpersonal psychotherapy
Interpersonal Psychotherapy is a time-limited psychotherapy that focuses on the interpersonal context and on building interpersonal skills. IPT is based on the belief that interpersonal factors may contribute heavily to psychological problems. It is commonly distinguished from other forms of...
helps people to look at their relationships with friends and family and make changes in problem areas. Drug therapy
Pharmacotherapy
Pharmacotherapy is the treatment of disease through the administration of drugs. As such, it is considered part of the larger category of therapy....
, such as antidepressants, may be helpful for some people.
Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. The methods mentioned here seem to be equally helpful. For people who are overweight, a weight-loss program to improve health and to build self-esteem, as well as counselling to pinpoint the root of the psychological problems triggering their binge episodes, may be the best choice.
A clinical trial in Helsinki is investigating the use of intra-nasal naloxone for binge eating disorder, using the same approach as the highly successful Sinclair Method for alcohol addiction. Results of this trial are expected in 2011.
External links
- Binge Eating Disorder at Medline Article
- National Institute of Health page on binge eating disorder