Binge Eating Disorder (BED) is now recognised as a specific eating disorder. Eating disorders are serious mental illnesses in which emotions and thinking patterns cause a person to adopt harmful eating habits, such as overeating or starving. Many women and teens I work with dismissed the warning signs for a long time despite feeling like their eating patterns were out of control.
At Institute for Healthy Living we provide effective, personalised eating disorder treatment for all eating disorders, including BED.
What is Binge Eating Disorder?
BED is characterised by recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. A person will be distressed by the episodes. They often have feelings of guilt, embarrassment, or disgust. Binge episodes occur, on average, at least once a week over three months.
People with BED are at risk of developing a variety of different medical conditions including diabetes, high blood pressure and cholesterol levels, gallbladder disease, heart disease and certain types of cancers. Based on international data, the lifetime prevalence in females is between 2.5% and 4.5%, and 1.0% and 3.0% in males.
Warning signs to assist in identifying BED
Physical warning signs
- Rapid weight loss or frequent changes in weight
- Weight is above the healthy weight range (approximately 20% of people with Binge Eating Disorder are overweight).
- Loss of or disturbance of menstrual periods in girls and women
- Fainting or dizziness
- Always feeling tired and not sleeping well
- Swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath which can be signs of vomiting
- Feeling cold most of the time, even in warm weather
Psychological and Emotional warning signs
- Preoccupation with eating, food, body shape and weight.
- Feeling anxious around meal times.
- Feelings of guilt and shame after eating
- Feeling ‘out of control’ around food.
- Having a distorted body image.
- Feeling obsessed with body shape, weight and appearance.
- ‘Black and white’ thinking – rigid thoughts and rules about food
- Changes in emotional and psychological state – depression, stress, anxiety, irritability, low self esteem.
- Using food as a way of coping with emotional discomfort. Binge eating often occurs at times of stress, anger, boredom or distress.
- Using food restriction as self punishment or a way to feel in control.
Behavioural warning signs
- Dieting behaviours.
- Eating in private and avoiding meals with other people.
- Evidence of binge eating (e.g. disappearance of large amounts of food).
- Frequent trips to the bathroom during or shortly after meals.
- Making lists of good or bad foods.
- Suddenly disliking food they have always enjoyed in the past.
- Obsessive rituals around food preparation and eating (e.g. eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time everyday).
- Extreme sensitivity to comments about body shape, weight, eating and exercise habits.
- Secretive behaviour around food such as hiding food in one’s room or hiding evidence of having eaten food.
People with Binge Eating Disorder eat very quickly, eat when they are not physically hungry and continue to eat even when they are full, to the point that they feel uncomfortable.
How is BED treated?
Because most people feel ashamed, they are often hesitant to seek help. Often they are so successful at hiding their binge eating that close family members and friends don’t know about their battle.
Eating disorders require a comprehensive treatment plan that is adjusted to meet the needs of the individual. The goal of treatment for BED is to help the person gain control over his or her eating behavior and to change the function that food has been serving. Treatment most often involves a combination of the following strategies:
- Psychotherapy – Randomised controlled trials have shown large effect sizes for Cognitive Behaviour Therapy (CBT) in the treatment of Binge Eating Disorder. CBT is recommended as a first line treatment for BED and other disordered eating issues.
- Medicine — Randomised controlled trials have shown moderate effect sizes for the use of antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) might be used to help control the anxiety and depression associated with an eating disorder.
- Nutrition counseling — This strategy is designed to teach a healthy approach to food and weight, to help restore normal eating patterns, and to teach the importance of nutrition and a balanced diet.
- Group and/or family therapy — Family support is very important to treatment success. It is important that family members understand the eating disorder and understand how they can help their loved one. People with eating disorders might benefit from group therapy, where they can find support, and openly discuss their feelings and concerns with others who share common experiences and problems.
Vocks, S., et al. (2010). Meta-analysis of the effectiveness of psychological and pharmacological treatments for binge eating disorder. International Journal of Eating Disorders, 43(3), 205.
National Eating Disorders Collaboration. (2010). Eating Disorders Prevention, Treatment and Management: An Evidence Review. http://www.nedc.com.au.
The Australian Longitudinal Study on Women’s Health. (1996). Universities of Newcastle and Queensland.