Binge eating disorder

Clinic

• BED is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without the compensatory behaviors common to bulimia nervosa, OSFED, or the binge-purge subtype of anorexia nervosa.
• BED is a recently described condition, which was required to distinguish binge eating similar to that seen in bulimia nervosa but without characteristic purging.
• Individuals who are diagnosed with bulimia nervosa and binge eating disorder exhibit similar patterns of compulsive overeating, neurobiological features of dysfunctional cognitive control and food addiction, and biological and environmental risk factors. Some professionals consider BED to be a milder form of bulimia with the two conditions on the same spectrum.
• Binge eating is one of the most prevalent eating disorders among adults, though there tends to be less media coverage and research about the disorder in comparison to anorexia nervosa and bulimia nervosa.

Signs / Symptoms

• Binge eating (Uncontrollable eating) is the core symptom of BED; however, not everyone who binge eats has BED.
• An individual may occasionally binge eat without experiencing many of the negative physical, psychological, or social effects of BED.
• This may be considered disordered eating rather than a clinical disorder.
• Precisely defining binge eating can be problematic, however binge eating episodes in BED are generally described as having the following potential features:
  • Eating much faster than normal, perhaps in a short space of time
  • Eating until feeling uncomfortably full
  • Eating a large amount when not hungry
  • Subjective loss of control over how much or what is eaten
  • Binges may be planned in advance, involving the purchase of special binge foods, and the allocation of specific time for binging, sometimes at night
  • Eating alone or secretly due to embarrassment over the amount of food consumed
  • There may be a dazed mental state during the binge
  • Not being able to remember what was eaten after the binge
  • Feelings of guilt, shame or disgust following a food binge
  • Body image disturbance

BED vs bulimia nervosa

• In contrast to bulimia nervosa, binge eating episodes are not regularly followed by activities intended to compensate for the amount of food consumed, such as self-induced vomiting, laxative or enema misuse, or strenuous exercise.

• BED is characterized more by overeating than dietary restriction.
• Those with BED often have poor body image and frequently diet, but are unsuccessful due to the severity of their binge eating.
• Obesity is common in persons with BED, as is depression, low self-esteem, stress and boredom.
• Those with BED are also at risk of Non-alcoholic fatty liver disease, menstrual irregularities such as amenorrhea, and gastrointestinal problems such as acid reflux and heartburn.

Causes

• BED is an "expressive disorder"—a disorder that is an expression of deeper psychological problems.
• BEDs have higher weight bias internalization, which includes low self-esteem, unhealthy eating patterns, and general body dissatisfaction.
• BED is a side effect of depression, as it is common for people to turn to comfort foods when they are feeling down.