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For most of modern history, people have associated eating disorders with bulimia nervosa and anorexia nervosa, which have been identified in the DSM-5 for decades. However, in 2013 binge eating disorder was finally recognized as a unique and official eating disorder, clearing a path for greater acknowledgment of the disorder and increasing the availability of specialized binge eating disorder treatment.This type of eating disorder is characterized by recurring episodes of consuming very large amounts of food within a short period – often when they’re not hungry and also beyond the point of being full.

People who need binge eating disorder recovery will usually experience feelings of shame, guilt, and disgust after a binge eating episode. The symptoms of binge eating disorder aren’t like those associated with anorexia nervosa or bulimia nervosa, where people restrict food or purge after binging. Instead, this type of eating disorder doesn’t involve any compensatory behaviors after a binge eating episode. Binge eating disorder can be a serious disorder, so if you or a loved one has a binge eating disorder diagnosis, keep reading to learn more about the signs, symptoms, and risks associated with the condition.

1. Binge Eating Disorder Affects All Genders

While many people associate eating disorders with young women and girls (and both anorexia nervosa and bulimia nervosa do happen more frequently in women), both men and women of all ages can develop binge eating disorder. It’s been estimated that 40 percent of all BED cases are actually in men, as compared to only 5 – 15 percent for anorexia nervosa. This is unusual not only because eating disorders tend to affect women much more than men, but also because so many males are diagnosed at all. Stigma against admitting to an eating disorder among males, as well as deep-seated biases in the medical and psychiatric community. The latter is changing, however, largely due to increased awareness about how often males are underrepresented in the eating disorder recovery community.

When discussing gender and eating disorders, it’s impossible to ignore a simple fact; transgender people are more likely to develop an eating disorder. In general, a trans teenager is four times more likely to suffer from anorexia nervosa, bulimia nervosa, or binge eating disorder than their cisgender peers. Trans people often struggle with body dysmorphia and will take extreme steps to alter their body to match their true gender – this can involve restriction or dieting, which influence binge eating episodes. Over time, these can become compulsive. When choosing a comprehensive eating disorder recovery program, it’s worthwhile to look into treatment centers that are prepared to compassionately care for their client’s gender.

2. Binge Eating Disorder Is Very Common

Although anorexia nervosa is arguably more well-known, binge eating disorder is actually the most common eating disorder in the United States today. Almost 5 percent of the adult population is thought to develop it at some point in their lives. Because binge eating disorder is often tied into low self-esteem and negative body image, it’s a risk factor for people who are “on a diet.” A large segment of the population is unsatisfied with their weight and/or trying to lose weight. Spurred on by an aggressive diet industry, many people put themselves at risk for binge eating episodes by restricting food so they always feel hungry.

Despite its frequency, the disorder is often misdiagnosed. One of the reasons it wasn’t totally accepted by the psychiatric community until 2013 is that it was often dismissed as “overeating” – and sometimes dieting was even recommended by doctors! Nowadays, a combination of nutritional education and behavioral therapy, such as Cognitive Behavioral Therapy, are the prime components of treatment.

3. Self-esteem and Shame Can Form a Cycle

Binge eating disorder treatment often revolves around reducing the disordered behavior – and the causes of that behavior must be addressed. Shame and binge eating disorder often go hand-in-hand. A major symptom of binge eating disorder is to tell their friends and family that they are on a diet, circumspectly admitting to a sense of shame about their weight. Body image problems arising from weight dissatisfaction directly affect a person’s self-esteem. Binge eating releases serotonin – a chemical that makes a person feel better and lifts their mood – which alleviates these negative emotions. Unfortunately, this becomes a cycle; a person feels bad about their weight, diets, and binges to feel better, even temporarily.

Shame can also make it harder for a person with binge eating disorder to reach out for help. One of the diagnostic criteria for the disorder lays out that binge eating episodes bring a sense of self-disgust or shame. Because they are ashamed to admit they are binge eating, people are less likely to seek out help or enter eating disorder treatment. Overcoming these feelings is central to binge eating disorder recovery.

4. Emotions Can Trigger a Binge Eating Episode

As mentioned, some people turn to binge eating as a way to cope with low self-esteem or feelings of guilt – and the same chemical process can also alleviate emotional distress or anxiety. In some ways, it’s similar to OCD in that these coping behaviors become compulsive. Binge eating episodes trigger the creation of serotonin, which can act as a way to reduce or get rid of feelings of anxiety and other negative emotions.

Another potent trigger for disordered eating behaviors is the presence of past trauma. PTSD is listed as one of the most notable triggers for a variety of disordered eating behaviors. A 2013 study indicated that 25 percent of participants with binge eating disorder could directly link their binge eating patterns to PTSD. It should be noted that PTSD is not only caused by violent experiences, abuse, or combat; trauma can be caused by emotional experiences as well. Things like being bullied, losing a job, parents divorcing, or even a bad breakup are known to cause trauma and PTSD.

5. Binge Eating Disorder Is Associated with Many Serious Health Risks

While many of those with the condition experience high levels of shame and depression, they also have to worry about several physical health risks as well. Because the foods eaten during a binge are usually junk foods or otherwise unhealthy, and that there is no counteracting purge, long-term BED can lead to obesity and the health risks that come with it. Early intervention is important for a successful binge eating disorder treatment program because many people with binge eating disorder are already dealing with high cholesterol, heart disease, diabetes, obesity, and musculoskeletal issues.

According to Johns Hopkins, binge eating disorder can cause complications from:

  • Overweight or obesity
  • Increased risk for:
    • High cholesterol
    • High blood pressure
    • Diabetes
    • Gallbladder disease
    • Heart disease
    • Some types of cancer
    • Increased risk for psychiatric illnesses, particularly depression

People with binge eating disorder typically eat huge amounts of food at one time — often junk food — to reduce stress and relieve anxiety.

  • Guilt and depression usually follow binge eating.
  • People with binge eating disorder are at higher risk for depressive mood disorders, anxiety, and substance abuse.

The last part may be the most important. Binge eating disorder is very treatable, but its high risk of co-occurring disorders can complicate treatment. When seeking out a therapist or facility to help facilitate recovery, individuals with binge eating disorder should always seek out a program with a full continuum of care.

6. Binge Eating Disorder and Dieting Are Almost Always Linked

Many people who eventually develop binge eating disorder may turn to this type of disordered behavior after attempting to restrict their diets with highly inflexible rules. For example, when a person begins cutting out entire food groups like bread or dairy, they are more likely to feel deprived and hungry. When faced with such restrictive dietary rules, some people may choose to “cheat” on their diet by binging and promising to get back on track again the next day.

A disordered relationship with food, eating, and body weight influences almost every kind of eating disorder. It’s not unusual for a person to alternate between different kinds of disordered eating or change their patterns over time. For example, a person may go from dieting to anorexia nervosa without binge eating episodes, then binging regularly for a period of several months, and then back again. Psychiatrists often require continued displays of a particular type of eating disorder before making a diagnosis, but treatment will require a multifaceted approach so that the individual doesn’t simply change their disordered eating patterns.

Binge Eating Disorder Recovery Isn’t Easy, But Getting Started Can Be

For adolescents who struggle with binge eating disorder, it might seem like recovery is too distant a goal. Recovery is a long process, and usually very emotional. It’s not always an easy journey, but there is good news – it’s easier to get started than you think. The first thing to do is always speak to your parents – or listen if they bring concerns to you. After that, you can reach out to a therapist, psychiatrist, or accredited eating disorder treatment facility. They’ll be able to help you get started on the path to recovery. Don’t hesitate – if you or a loved one is experiencing binge eating disorder, help can be yours sooner than you think.

 

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.