Binge Eating

Binge eating is the practice of eating very large quantities of food in a short period of time. The amount of food consumed in a binge is much more than what is required to sustain life or receive adequate nutrition. During a binge session, an individual may feel “out of control,” as if they cannot stop eating no matter how hard they try.

Binge eating is often a symptom of bulimia and binge eating disorder (BED). Like other eating disorder symptoms, binge eating can be treated through therapy.

WHAT IS BINGE EATING?

Binge eating is not the same thing as overeating. Many people have occasions when they eat more than they planned to. Someone may overeat while they are enjoying a party or watching a movie. In other instances, an individual may have a habit of consuming unhealthy amounts of junk food each day.

Binge eating has a stricter definition. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), binge eating involves a large amount of food consumed within a two-hour period. The person feels a lack of control over what they eat or how much they consume. Other potential signs of a binge-eating episode include:

• Eating very quickly
• Consuming lots of food despite not feeling hungry
• Eating past the point of fullness
• Eating alone due to embarrassment over how much one is eating
• Feeling intense disgust, guilt, or depression after the binge

During a typical binge session, an individual may consume anywhere between 1,500 and 11,000 calories in one sitting. As such, people who binge are very likely to gain weight. Even if someone purges immediately afterwards, around half of the calories in a binge may still be absorbed. People who binge regularly have a high chance of developing obesity in the future.

However, it is important to note that most people who are overweight or obese do not engage in binge-eating episodes. Obesity can occur due to many factors, such as diabetes, hypothyroidism, genetic predisposition, and so on. While obesity is fairly common across the globe, bulimia and BED are much rarer conditions.

BINGE EATING DISORDER

According to the DSM-5, an individual with BED needs to have recurrent binge episodes accompanied by significant distress. These episodes occur at least once a week for 3 months or more. Mild BED will involve 1-3 episodes a week, moderate BED will involve 4-7 episodes, and severe BED will involve 8-13 weekly episodes.

Unlike someone with bulimia, a person with BED will not purge their food through vomiting or laxatives. Nor will they try to compensate for binges with fasting or excessive exercise. Although some people with BED do try to diet, people who consistently restrict their food between binges are more likely to have bulimia.

According to the National Institute of Mental Health, 1.2% of Americans will have BED in any given year. It is the most common eating disorder in the United States. BED is twice as prevalent among women as men. However, it seems to be equally prevalent across ethnic groups.

Why Do People Binge Eat?

Binge eating is a mental health issue, not a lack of self-control. It is a complicated issue, often stemming from multiple factors rather than one single cause. Common contributors include:

Trouble regulating emotions

Many people binge eat when they feel unhappy, lonely, bored, or otherwise emotionally distressed. Low self-esteem, stressful events in daily life, or feelings of personal inadequacy can also trigger episodes of binge eating. Someone who already has trouble dealing with negative emotions may become especially reliant on overeating as a coping mechanism.

Social causes

Societal pressure to maintain thinness can contribute to feelings of worthlessness and distress in people whose bodies don’t meet this thin ideal. People who receive negative comments about their bodies may struggle with feelings of shame and low self-worth. These feelings can in turn contribute to binge eating.

Chronic food restriction

Frequent dieting or food restriction can fuel patterns of binge eating. People who diet off and on throughout life or who consistently restrict food may binge eat in response to hunger. Swinging back from extreme food restriction can make it hard to stop eating, even past the point of feeling full.

Family history

According to the DSM-5, binge eating may run in families. Research has found evidence to suggest that people with obesity who binge eat are two times as likely to have a family member who also binge eats.

Low serotonin

Some research suggests that lower levels of serotonin can contribute to binge eating (as well as other eating disorders like bulimia). Low serotonin can contribute to a low mood and feelings of depression. Existing research suggests binge eating may (unconsciously) stem from the desire to improve these feelings of lowness and depression by gaining pleasure from food.

Treatment for Binge Eating

Binge eating, if untreated, can eventually affect physical and emotional health. Getting professional help for binge eating is essential for recovery. It’s absolutely possible to take steps on your own to address binge eating, but without identifying and working through underlying causes of binge eating, any changes you make may not last.

Try to find a counselor who has experience with disordered eating habits. In therapy, your therapist will help you explore triggers of binge eating and learn more helpful ways of coping.

You might learn, for example, how to challenge negative thoughts, such as “I’m worthless”, and replace them with more positive ones, such as “I feel sad because I’m alone.” Reframing your thoughts can help you clarify the situation, acknowledging your circumstances without beating yourself up. This way, you’re more likely to find a way to address problem rather than succumbing to hopelessness.

Therapy may also help you explore the underlying causes of your binge eating. You and your therapist may address emotional dysregulation, troubled relationships with others, traumatic experiences, health issues, or difficulty managing stress. When you can identify these causes and begin working through their effects, you may feel less inclined to binge eat.

Research suggests some medications, including antidepressants, may help people manage binge eating. These medications can have side effects, but they may benefit people who struggle to stop binge eating on their own. Psychiatric medications are generally best used in combination with therapy, since medication doesn’t address the social or emotional issues contributing to binge eating. If you feel medication may help you, your therapist can refer you to a psychiatrist, who can make a recommendation on which medications to try.

Self-Help for Binge Eating

Your therapist can offer guidance on self-help and self-care strategies that can help reduce binge eating episodes. There are plenty to choose from, so choose the ones that work for you.

Consider these to begin with:

• Practice mindful eating. Instead of dieting or cutting specific foods from your diet, focus on consuming more nutritious foods, such as whole fruits and vegetables. Don’t make any foods off-limits. Give yourself permission to enjoy things you like in moderation, savoring them. Reminding yourself there are no “bad” foods can help reduce feelings of guilt and shame associated with eating.
• Make sure to drink enough water. When you stay hydrated, you may have fewer food cravings and feel less like binge eating. Hydration guidelines vary widely based on gender, age, and numerous other factors. Drinking when you feel thirsty is a good guideline. It’s hard to drink too much water, so if in doubt, increasing your intake likely won’t hurt.
• Avoid skipping meals. When you skip meals, you may end up eating more than you intended later in the day. Eating regular meals and snacks throughout the day can help you feel more energized and stay fuller between meals. As a result, you may be less likely to binge eat.
• Write about how you’re feeling. Research suggests writing about your mood when you feel like bingeing can shed light on triggers of binge eating episodes. This knowledge can help you take the first steps toward addressing these stressors. Keeping track of the foods you eat throughout the day can also have benefit, according to one small 2017 study.

Why Dieting Often Backfires

When trying to overcome binge eating, dieting generally isn’t recommended, since most diets don’t work. If you try dieting on your own and don’t succeed, feeling as if you’ve “failed” the diet can trigger feelings of shame and stress. These emotions in turn can trigger more binge eating cycles. If you have a weight-loss goal, it’s best to work with your health care provider and your therapist so you can plan together how you’ll meet your health needs while continuing treatment for binge eating.

Some people turn to other disordered eating behaviors to manage their weight. Severely restricting food may seem helpful in the short term, but it typically leads to habits that may be difficult to address in the future. Disordered eating behaviors can also negatively affect metabolism, especially for people who swing back and forth between bingeing and restricting. These changes are generally hard to remedy.

While dieting typically isn’t helpful, incorporating healthier habits and ideas about food can have a significant benefit on recovery. Your health care provider and trained eating disorder counselors can help you make safe and effective lifestyle changes.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Barakat, S., Maguire, S., Surgenor, L., Donnelly, B., Miceska, B., Fromholtz, L., Russell, J., Hay, P., & Touyz, S. (2017, June 26). The role of regular eating and self-monitoring in the treatment of bulimia nervosa: A pilot study of an online guided self-help CBT program. Behavioral Sciences, 7(3). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28672851
3. Binge-eating disorder. (2018, May 5). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627
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Last Updated: 12-16-2019