Binge Eating Disorder: Diagnosis, Treatment, and Resources

Binge eating disorders involve eating large amounts of food, such as an entire large pizza, cake, pie, or family size portions, in a short amount of time, with the sense that you are losing control over the behavior. Initially, this behavior may may provide a sense of comfort, security, and pleasure, but afterwards, it can lead to physical and emotional discomfort, malignant guilt, and torment. Learn about binge eating disorder diagnosis, treatment, and resources below.

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Definition, Symptoms, and Diagnosis

What is binge eating disorder?

Binge eating disorders involve episodes of consuming large quantities of food (binging) to the point of discomfort, most of the time very quickly, without the self-induced vomiting or other compensatory behaviors found in bulimia. To be diagnosed as binge eating disorder, this behavior must occur regularly, at least once a week for three months.

How common is binge eating disorder?

In the United States, about 2.8% of adults experience binge eating disorder during their lifetime, and female have a higher prevalence of binge eating disorder (1.6%) than males (0.8%), according to the National Institute of Mental Health (NIMH). The average age of onset for binge eating disorder is 25 years old.

What are the signs and symptoms of binge eating disorder?

  • Disappearance of large quantities of food
  • Empty wrappers or containers hidden in unexpected places
  • Obvious discomfort when eating in front of others or a fear of eating in front of others
  • Hoarding or stealing food
  • Irregular eating pattern
  • Continual gastrointestinal discomfort (constipation, acid reflux, diarrhea)
  • Increase in weight or fluctuations in weight
  • Feelings of guilt after eating
  • Obsessions with eating and food

How do you diagnose binge eating disorder?

Binge eating disorder is diagnosed according to the criteria outlined in the DSM-V (Diagnostics and Statistics Manual), a manual that therapists and psychiatrists use to diagnose mental health conditions. Binge eating criteria include:

  • Eating a larger than typical quantity of food within a short period of time (2 hours)
  • A lack of control over eating during this discrete period; feeling like one cannot stop eating
  • Binge eating episodes include three or more of the following:
    • Eating much faster than normal
    • Eating until a point that is way past full
    • Eating large amounts of food despite not feeling hungry
    • Eating alone due to shame or embarrassment
    • Feeling guilt or disgust after the binge episode
  • Distress when binge occurs
  • Binge episodes occur at least once a week for 3 months
  • Binge episodes aren't associated with unhealthy compensatory behaviors (purging)

What are medical complications of binge eating disorder?

  • Weight gain
  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Heart disease
  • Trouble sleeping
  • Muscle and joint pain
  • Digestive problems
  • Irregular or infrequent menstrual periods

Treatment for binge eating disorder

What is the best treatment for binge eating disorder?

The best treatment for binge eating disorder can involve both psychotherapy and medication. Cognitive Behavioral Therapy (CBT) is used to help the patient identify negative thinking patterns and unhelpful behaviors that have contributed to the disorder. Behavioral therapy is used to help make the behavioral changes necessary to helping the patient stop the binges. Support groups and family therapy help the patient to deal with the effects the disorder has on relationships and self image.

What are the commonly prescribed medications for binge eating disorder?

The most commonly prescribed medications for binge eating disorder include selective serotonin reuptake inhibitors (SSRIs), as serotonin may be involved in appetite. Stimulants such as Vyvanse are also prescribed secondary to the side effect profile, which includes appetite suppression and evidence that this medication reduces the number of binge episodes. Topiramate, an anticonvulsant, is also utilized in clinical practice.  


Help a friend with binge eating disorder

How can you help someone with binge eating disorder?

Helping someone with binge eating disorder involves being compassionate and understanding, even if you may not be able to fully understand what the individual is experiencing. Let the person know that you are there to listen and that you won’t judge them. Avoid making comments about what they eat or how, or telling them to try a certain diet or exercise program. Avoid advising; rather, think more about listening and validating feelings. Researching the disorder to understand it better can be helpful, too. Ask if they are in treatment and what you can do as their friend or loved one to help support their treatment.

Here are some things to keep in mind when helping someone with binge eating disorder.

Do

  • Do be empathetic and express your love and support.
  • Do be honest about your own struggles to understand.
  • Do recognize there is no a quick and easy solution or cure.
  • Do listen and validate their feelings.
  • Do be patient and at the same time know your own limits.

Don’t

  • Don’t try to be a therapist.
  • Don’t tell them to just eat something and to stop obsessing.
  • Don’t use shame or guilt to convince them to eat or change their behavior.
  • Don’t gossip to other people about what they are going through.
  • Don’t make critical or mean comments about their eating.

Learn more on how to help a friend >>
Learn how to help a friend struggling with anorexia nervosa >>
Learn how to help a friend struggling with bulimia nervosa >>



Additional resources

What are some national advocacy organizations for binge eating disorder?

National Eating Disorders Association: The National Eating Disorders Association (NEDA) is a nonprofit organization dedicated to supporting individuals and families affected by eating disorders. NEDA offers our programs and services to raise awareness, build communities of support and recovery, and fund research.

National Association of Anorexia Nervosa and Associated Disorders (ANAD): The National Association of Anorexia Nervosa and Associated Disorders (ANAD) is a non-profit organization headquartered in Illinois, providing support, awareness, advocacy, referral, education, and prevention work for people struggling with eating disorders.

Project HEAL: Project HEAL is a non-profit organization that advocates for everyone who is seeking treatment for eating disorders, regardless of their race, income, insurance plan, age, education level, sex, or sexual orientation. They provide financial assistance in accessing treatment for highly motivated applicants who want to recover from an eating disorder but cannot afford to pay for treatment. They also have a peer mentorship program called Communities for HEALing, in which they offer one-on-one support and local weekly support groups. Communities for HEALing is undergoing a research study that will demonstrate whether different kinds of mentorship can help people recover from an eating disorder, whether that is through peer mentorship or social support mentorship.

International Association of Eating Disorders Professionals (IAEDP): The International Association of Eating Disorders Professionals (IAEDP) provides ethical and professional standards for therapists, nutritionists, and other medical and mental health professionals  that treat eating disorders. They provide educational classes, and trainings in order to promote a standard of excellence in the field of eating disorders. They also certify that professionals have met prescribed requirements, help raise public and professional awareness for eating disorders, and assist in prevention efforts.




Sources

  • The lifetime prevalence of binge eating disorder was 2.8%.
    • https://www.nimh.nih.gov/health/statistics/eating-disorders.shtml
  • What are the key diagnostic features of BED according to the DSM-5? They are...
    • Garner, D. (n.d.). Binge Eating Disorder and the DSM-5: What the Changes Mean. Retrieved August 18, 2018, from https://www.eatingdisorderhope.com/information/binge-eating-disorder/binge-eating-disorder-and-the-dsm-5-what-the-changes-mean
  • For adults with BED, cognitive-behavioral therapy (CBT) is the most well-established psychological treatment, as reflected in systematic reviews, meta-analysis, and clinical guidelines, although superiority to other bona fide treatments has not been demonstrated clearly. 
    • Hilbert, A. (2013, September 25). Cognitive-behavioral therapy for binge eating disorder in adolescents: Study protocol for a randomized controlled trial. Retrieved August 18, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850645/

About the contributors

Dr. Marianna Kessimian, MD

Dr. Marianna Kessimian is a child, adolescent, and adult psychiatrist in Providence, RI. She received her MD from Boston University where she was also selected for the Gold Humanism in Medicine society as well as the Ruth J Hunter Johnson Prize for excellence in psychiatry. Dr. Kessimian completed her adult psychiatry training and child psychiatry fellowship at Brown University, where she served as chief resident. Previously, she was a staff psychiatrist at the Young Adult Behavioral Health clinic, and in this role was afforded the opportunity to work on campus at the Rhode Island School of Design providing psychiatric care to their students.

 

Hannah Goodman, LMHC

Hannah Goodman is a Licensed Mental Health Counselor in Barrington, RI. She specializes in anxiety, including panic disorder, Obsessive Compulsive Disorder and worry. She also has expertise in depression, adolescent issues, life transitions, couples counseling, and family counseling. Outside of her counseling practice, Hannah works as a writing coach and college counselor, drawing on her years of experience in the school system to help individuals of all ages with writing projects and prospective college and graduate students with their applications.