Binge Eating Disorder

Binge eating disorder is when you eat large quantities of food in a short time. It can make you eat quickly, and until you’re uncomfortable or sick to your stomach. You might feel disgusted or ashamed afterward.

While everyone overeats occasionally, binge eating happens often — usually at least once a week for three months. It often starts as a way to cope with stress, painful emotions or trauma. Unlike anorexia or bulimia, people who binge eat don’t throw up the food or exercise to burn it off.

Binge eating disorder can affect anyone at any size, but it’s most common in women who are in their early to mid-20s. Eating disorders are mental health conditions. It’s not your fault or a sign you don’t have any self-control. You deserve to feel healthy and safe. Healthcare providers can help.

Symptoms of binge eating disorder

Signs and symptoms of binge eating disorder may include:

• Eating to the point of discomfort
• Eating very quickly
• Eating when you’re not hungry
• Eating in response to stress or trauma
• Eating alone due to embarrassment
• Feeling guilt, shame and out of control

Some people with binge eating disorders are frequent dieters. They severely limit calories and then binge eat. Or they may start a diet after a binge to make up for it.

Binge eating disorder causes

Many things can affect how and why you eat. There isn’t one single reason why someone develops binge eating disorder. Your emotions, biology and habits all play a role. What triggers you to binge eat might be different from what triggers someone else. Scientists know that eating can release pleasure hormones in your brain (serotonin and dopamine). This can make it hard to stop eating. Eating can also be a way of coping with stress or numbing your emotions. It can make you feel good when life feels hard.

Risk factors

You may be more likely to develop binge eating disorder if you have:

• Obesity
• Depression or anxiety
• A family history of eating disorders
• A personal history of trauma or abuse
• Substance use disorder (SUD)

Complications of binge eating disorder

Binge eating has physical and emotional effects on your body.

It can cause:

• Weight gain (from eating large amounts of food)
• Bloating, nausea or stomach discomfort
• Heartburn, indigestion or other digestive problems
• Blood sugar spikes
• Metabolic issues, like not knowing when you’re hungry or full

Binge eating also worsens depression and anxiety. Many people feel shame and guilt about their eating habits, which affects their self-esteem. This can impact almost all areas of your life. You may avoid social events or distance yourself from family and friends. Untreated mental health conditions can increase your risk of harmful thoughts and behaviors or self-harm. If you’re having suicidal thoughts, call the Suicide and Crisis Lifeline at 988.

How doctors diagnose binge eating disorders

Healthcare providers diagnose eating disorders by asking questions about your behaviors, thoughts and feelings. You might be hesitant to open up, but honesty is important in getting a diagnosis.

Your provider will analyze your answers according to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The criteria to diagnose binge eating disorder include:

• Eating large amounts of food in a short time (compared to what most people would eat in a similar time)
• Feeling like you can’t stop eating
• Binging occurring at least once a week and going on for three months

You must also have at least three of the following symptoms:

• Eating to the point of physical discomfort
• Feeling disgusted or guilty afterward
• Eating alone
• Eating quickly
• Eating when you’re not hungry

You don’t necessarily need an official diagnosis to begin treatment, either. Your provider is there to understand what’s going on so they can best help you, even if you don’t meet the exact criteria.

How is binge eating treated?

There’s no quick fix. But with the right treatment plan, you can build a healthier, more balanced relationship with food and eating. Psychotherapy is usually the main part of treatment. In some cases, your plan may also include medications or nutrition advice. You may work with a variety of healthcare specialists — like a psychologist, psychiatrist or registered dietitian.

Therapy

Psychotherapy (talk therapy) is the most important part of the treatment plan. There are different approaches to therapy:

• Cognitive behavioral therapy (CBT): CBT helps you look at the reasons behind your thoughts and actions. Your therapist will work with you to break unhealthy behavior patterns and find healthier coping strategies.
• Interpersonal psychotherapy (IPT): IPT is a short-term, focused type of therapy that addresses immediate conflicts and stressors.

Medication

Medications may play a supporting role in your treatment. Medications may include:

• Lisdexamfetamine (Vyvanse^®): This medication can help with impulse control. It can suppress the desire to binge eat.
• Medications for other mental health conditions: You may need medications to treat another condition related to your eating disorder, like antidepressants or anxiety medications.
• Appetite suppressants: Some healthcare providers may prescribe appetite suppressants for some people. These medications can help to break the cycle of binge eating.

Diet and nutrition

What you eat can play a role in your recovery, too. A registered dietitian can help you build a healthy and balanced relationship with food. They can suggest well-rounded meals that leave you satisfied while also making sure you get the right nutrients. Recovery focuses on consistency and getting nutrients, not dieting or food rules.

When should I see my healthcare provider?

If you think you or someone you care for has an eating disorder, it’s always a good idea to contact a healthcare provider. People who have eating disorders often don’t recognize that anything is wrong. Loved ones can play an important role in bringing attention to the matter. A healthcare provider can advise you on what to do next to help yourself or your loved one.

Will I always have binge eating disorder?

Recovery from binge eating disorder is possible with the right care. Most mental health conditions carry a risk of relapse. But it can go into remission, and that remission can last months or years. This is what recovery means for binge eating disorder. The road to recovery may not be short or straight, but most people do achieve it. Remember, it’s not a matter of willpower. It’s about recognition, support, skills and healing.

What are some tips for living with binge eating disorder?

Being mindful of your urges and triggers is one of the best things you can do. You can also learn to recognize when your body is hungry or full. Here are some specific tips:

• Practice mindful eating. Slow down before you eat. Take a deep, slow breath. Then, just notice, without judgment, what’s happening in your mind and body. You can also stop and do this while you’re eating.
• Learn to recognize hunger. Physical hunger symptoms include stomach pangs or grumbles and light-headedness. Ask yourself what you’re feeling — boredom, anxiety or actual hunger.
• Eat when you’re hungry. If you’re hungry, eat right away. Don’t wait until you’re starving, or you’ll be more likely to lose control and binge eat.
• Stop before you’re full. Eating too fast can lead to eating too much, simply because you haven’t had time to notice that you’re full. Aim to feel about 80% full after each meal.
• Keep a journal. Journaling is one of the most tried-and-true methods for becoming more conscious of your thoughts, feelings and behaviors. Take note of what you eat each day and what you’re thinking and feeling. You’ll start to recognize patterns and triggers.
• Tackle your triggers. If you’ve noticed that certain foods or situations tend to lead to binge eating, look for ways to remove them from your life.

Why is it hard to stop binge eating?

Binge eating isn’t about willpower or control. It’s very complex and involves brain chemicals, emotions and habits. All these factors can work against you when you have binge eating disorder. That’s also what makes recovery challenging. But with support, compassion and the right treatment, you can recover from this condition. Binge eating disorder is a real health condition, and it’s more common than you might think.