Binge Eating Disorder

Binge Eating Disorder

Binge Eating Disorder (BED) is an eating disorder where a person often has episodes of consuming large amounts of food in a short period, such as within two hours, and feels like they have no control over their eating during these episodes.

Like other eating disorders, binge eating disorder is about much more than food and eating. Eating disorders are complex mental health conditions characterized by harmful eating patterns and food attitudes. Binge eating disorder is often linked to obesity and other physical and mental health issues, causing significant challenges and reduced quality of life. Still, this disorder usually goes unnoticed and untreated.

Binge Eating Disorder Prevalence

Recent data underscores the urgency of understanding and addressing binge eating disorder, as it reveals that it is the most common eating disorder in the United States. Approximately 2.8% of American adults will experience binge eating disorder at some point in their lifetime. The disorder is more prevalent among women, with about 3.5% of women and 2% of men affected by binge eating disorder.

Research shows that up to 30% of individuals with obesity who are seeking behavioral or surgical weight loss treatment have co-occurring binge eating disorder. This highlights the close association between obesity and binge eating disorder, particularly in those pursuing weight loss interventions.

How is Binge Eating Disorder Diagnosed?

The main feature of binge eating disorder is the uncontrollable consumption of large amounts of food in a short time until it becomes uncomfortably full. Feelings of shame and self-loathing usually follow this lack of control during the episode of binge eating. According to DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) guidelines, to be diagnosed with Binge Eating Disorder, a person must:

• Have binge-eating episodes at least once a week for three months.
• Feel distressed about their binge eating.
• These episodes should include at least three: eating much faster than usual, eating until feeling uncomfortably full, eating when not physically hungry, eating alone due to embarrassment about the amount consumed, or feeling bad about themselves after overeating.

Signs of Binge Eating Disorder

A person with a binge eating disorder might feel like they have no control during a binge eating episode. After a binge-eating episode, they might feel shame, disgust, and guilt.

The most common signs of binge eating involve the following:

• Frequent episodes of eating vast amounts of food in a short period of time
• Eating uncontrollably, even when full or not hungry
• A feeling of loss of control over eating Fear of eating uncontrollably
• Eating rapidly
• Eating alone and in secret
• Obsessively thinking about food
• Strong feelings of embarrassment, guilt, shame, and distress
• Feelings and actions of self-hatred and self-disgust.

Comorbidities with Other Medical and Mental Health Conditions

Binge eating disorder is often accompanied by a variety of physical and mental health issues, which can complicate its treatment and impact a person’s overall well-being.

Physical Comorbidities

Individuals with binge eating disorder frequently experience physical health problems, most commonly obesity, which affects a significant portion of those with the disorder. Obesity, in turn, is closely linked to metabolic syndrome—a cluster of conditions that includes abdominal obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels.

These health issues increase the risk of developing serious diseases, such as Type 2 diabetes, heart disease, and certain types of cancer, including colorectal, breast, and pancreatic cancer. Additionally, people with binge eating disorder often report gastrointestinal problems like acid reflux, bloating, and abdominal pain, as well as respiratory and musculoskeletal issues. Women with binge eating disorder are also more likely to have polycystic ovarian syndrome (PCOS), which can lead to insulin resistance and fertility.

Mental Comorbidities

On the mental health side, binge eating disorder is strongly associated with a range of psychiatric disorders. Almost all individuals with binge eating disorder (94%) have at least one other mental health condition, with common comorbidities including mood disorders (like depression and anxiety), post-traumatic stress disorder (PTSD), and impulse control disorders. Nearly a quarter of people with binge eating disorder have attempted suicide, highlighting the severe emotional toll of the disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) is also prevalent among those with binge eating disorder.

The co-occurrence of these mental health issues often makes binge eating disorder more severe and more challenging to treat, requiring a more comprehensive and tailored approach to therapy.

Emotional Regulation in Binge Eating Disorder

Emotional regulation in binge eating disorder is identified as a critical factor that contributes to the onset and persistence of the disorder. Individuals with binge eating disorder often struggle with managing their emotions effectively, leading them to use maladaptive strategies like rumination (dwelling on negative thoughts) and self-blame.

These strategies worsen emotional distress and can trigger binge-eating episodes as a way to cope. People with binge eating disorder experience significant difficulties in regulating their emotions, such as not accepting their emotional responses, struggling to control impulses, and lacking clarity about their feelings. This impaired emotional regulation is closely linked to higher levels of anxiety, depression, and alexithymia (difficulty in identifying and expressing emotions), which further complicates the disorder.

These findings suggest that it is essential to address these emotional regulation difficulties in treatment, focusing on improving emotional clarity, acceptance, and the use of adaptive coping strategies to reduce binge-eating behaviors.

How We Can Help

Managing binge eating disorder requires a comprehensive approach tailored to each individual’s needs. Here’s how we can assist:

Pharmacological Treatment

Newer medication options currently available for managing obesity and comorbid conditions like diabetes include Ozempic and Wegovy. Although we do not offer those options, we offer oral medications for patients who prefer a less invasive approach and who may have other mood comorbidities that may be treated with psychotropic medications. One option is Vyvanse which is FDA-approved for binge eating disorder, helping to control binge impulses. Additionally, an antidepressant like Wellbutrin can assist with food cravings, appetite reduction, and mood symptoms. Other options that may be used off-label include topiramate to reduce the frequency of binge-eating episodes and promote weight loss by affecting appetite regulation and impulse control.

Psychotherapy

We provide various forms of psychotherapy to address the emotional and behavioral aspects of binge eating disorder. Cognitive Behavioral Therapy (CBT) is highly effective in treating binge eating disorder by helping patients develop healthier eating patterns and coping mechanisms. Dialectical Behavior Therapy (DBT) is another option that focuses on improving emotional regulation, distress tolerance, and interpersonal effectiveness. These therapies are designed to provide long-term strategies for managing the underlying psychological triggers of binge eating.

Bariatric surgery clearance

For patients who are considering bariatric surgery, we provide bariatric surgery clearance assessments recommended by the surgeon to determine eligibility to proceed with bariatric surgery.

Remember, seeking professional help is crucial when experiencing mental health symptoms. Therapists, psychiatrists, counselors, and support groups can offer guidance and support tailored to individual needs. Seeking help is a sign of strength, and prioritizing mental well-being is essential for a healthier and happier future.