What is binge eating disorder?

Binge eating disorder is a serious eating disorder and mental health illness characterised by the regular and compulsive overeating of food in a short amount of time, being unable to stop until uncomfortably full. 

Even though everyone has overeaten on certan occasions (for example, during a holiday), what defines binge eating disorder is when this behaviour becomes frequent and out of control, driven by an intense need to eat. This can cause people with binge eating disorder to often feel as though they cannot stop eating, even if they are full or are not hungry.

Typically, people with this eating disorder will plan their binges in advance, selecting certain special foods and eating them alone, sometimes in secrecy. Feelings of guilt, shame and loss of control may follow after the bingeing episode.

People with binge eating disorder will often use food as a means of coping with underlying emotions or pressure.

What are the symptoms of binge eating disorder?

The symptoms of binge eating disorder include:

• Eating even if you are not hungry or feel full and feeling you cannot control how much you eat
• Eating very large portions over a short period of time
• Eating very quickly
• Often eating alone or secretly
• Feeling guilty, ashamed or depressed after binge eating
• Struggles with losing weight healthily
• Trying to hide how much food is being eaten
• Stocking supplies of food
• Putting on weight (although not everyone will do so)
• Dieting or eating a small amount of food outside of the bingeing episode

Binge eating disorder is distinct from bulimia, as people with binge eating disorder do not purge the extra calories that are eaten, by either vomiting, abusing laxatives or exercising. 

What causes binge eating disorder?

The causes of binge eating disorder are largely unknown, however, certain risk factors have been identified as increasing susceptibility to binge eating disorder. These risk factors include:

• Age: onset usually starts in late teens or early 20s, however, any age can have binge eating disorder.
• Genetics: susceptibility to binge eating disorder can be greater if a family member has had an eating disorder which suggest that it could be hereditary.
• Emotional and psychological issues: stress, anxiety, poor self-esteem and negative body image have all been linked with contributing to the onset of binge eating disorder.
• Historical relationship with food: those who have dieted a lot in the past can end up suffering from this eating disorder. Also, people who have been obsessive with counting calories or fasting during the day can result in triggering the impulse to binge eat.

How is binge eating disorder diagnosed?

To diagnose binge eating disorder, a doctor may conduct: 

• A psychological evaluation and a discussion of eating habits
• A physical exam to check for high blood pressure, cholesterol levels, heart conditions, diabetes, gastrointestinal reflux disease 
• A sleep disorder analysis
• Blood and urine tests

How does binge eating disorder affect someone's health?

Binge eating disorder can affect several organs in the body and derive in serious complications, including: 

• Insomnia
• Heart symptoms such as high blood pressure, fainting and dizziness from elevated triglyceride levels
• Anxiety, depression, substance abuse disorders
• Jaw that is swollen, acid reflux
• Dehydration
• Obesity
• Type 2 diabetes
• Certain types of cancer such as breast cancer, colorectal cancer, kidney cancer, pancreatic cancer, oesophageal cancer
• Joint and muscle pain as well as lethargy
• Irritable bowel syndrome, gallbladder disease, constant indigestion
• High levels of LDL cholesterol
• Fertility issues like the prevention of ovulation

How can binge eating disorder be prevented?

There is no fool-proof way to prevent binge eating disorder, however, fostering a healthy relationship with food and a positive body image are both helpful in preventing the onset of this eating disorder. In addition, it is really important to recognise the signs of binge eating disorder as early as possible and to start treatment as soon as possible. If left untreated, symptoms may persist for years and even become recurrent. 

What is the treatment for binge eating disorder?

Making the decision to seek treatment for binge eating disorder is the first step in recovery. The main goal for successful binge eating treatment is to learn how to gain control of your eating and to adopt a healthier attitude toward food, body image and your emotions. A mental health professional and sometimes dieticians who are experienced in treating eating disorders will be involved.

Treatment for binge eating disorder can include: 

• Self-help programmes in combination with therapy sessions and/or a support group.
• Cognitive behavioural therapy (CBT): if, after four weeks, self-help programmes have not been helpful, CBT may be offered in group or individual sessions with a therapist. This will usually involve 16 weekly sessions over four months, where the underlying psychological factors of this disorder are addressed as well as ways to lose weight in a healthy and structured manner. Such methods include meal plans, food diaries and regular exercise.
• Prescribed medication: antidepressants may be prescribed in combination with self-help programmes or therapy, to help manage other conditions such as anxiety that may co-exist with binge eating disorder.

The most important fact about treating binge eating disorder is that most people do gradually improve and get better, providing they receive the help and support they need. A small porportion of people will also get help but relapse in the future, needing treatment again.

Binge eating disorder and pregnancy

Many women with binge eating disorder develop obesity as a result of the eating disorder, which increases the level of oestrogen in the body. Elevated levels of oestrogen can then prevent the ovulation or the release of an egg from the ovary, making it more difficult to get pregnant. 

During pregnancy, obesity can increase the risk for several conditions including: gestational hypertension (high blood pressure during pregnancy), pre-eclampsia (which causes high blood pressure and kidney issues) and gestational diabetes (diabetes that develops during pregnancy).

Uncontrolled gestational hypertensiona and pre-eclampsia can become life-threatening for mother and baby, while gestational diabetes can lead to the birth of a baby that is larger than normal. A large baby may require a C-section. 

It is also common for women with binge eating disorder to gain more weight during pregnancy than those women without binge eating disorder. After pregnancy, the weight gain and/or postpartum depression can trigger binge eating disorder in women who have already recovered or are at a high risk for an eating disorder. 

Some medication prescribed for the treatment of binge eating disorder can also pass through a woman's breastmilk. Women with binge eating disorder who wish to breastfeed their baby, should first consult with their doctor which medicines are safe.

Women who have recovered from binge eating disorder and who are at a healthy weight with normal menstrual cycles, can still get pregnant, having a healthy and safe pregnancy.