Binge eating disorder is one type of eating disorder that is characterized by consuming a very large amount of food in a relatively short period of time, often eating so fast that one is not aware of what they’re eating and/or how it tastes. While binging, a person feels out of control and unable to stop eating, even though they likely want to stop. After the binge, a person often feels ashamed and guilty, wishing that they had not binged and thinking that next time they will be better able to resist the urge. People affected by binge eating disorder will usually eat even when you are not hungry, and often eat to the point of feeling uncomfortably full, nauseous, and/or sick. People who binge usually feel very ashamed of their behavior, recognizing that it is not typical or healthy, thus most binge episodes occur in a private setting with no one around, such as a bedroom, car, or office. To be officially diagnosed as Binge Eating Disorder, a person must experience binge episodes, on average, at least once a week for three consecutive months.

For many, binge eating is one part of a larger overeat-diet-overeat-diet cycle. What begins as an innocent diet to lose a few pounds, can quickly turn into a rigid, restrictive way of eating that leaves a person feeling deprived and miserable. Eventually, this artificial way of eating sets the dieter up to “give in” to the non-diet foods, fueling a black-and-white thought process of, “I’ve already blown my diet; I might as well eat as much as I can.” For many, this ignites a series of binges, followed by feelings of shame, guilt, disgust, and depression. Eventually, whether a day, a month, or a year later, the person may feel desperate to get their eating “under control” and develop a new diet plan that will once again limit their eating and set them up for bingeing, trapping them in this vicious, self-defeating cycle with food.

Who is Affected by Binge Eating Disorder?

Binge eating disorder is the most common type of eating disorder, outnumbering anorexia and bulimia. Current research suggests that about 3.5% of all women in the US and 2% of all men are affected by binge eating disorder. This disorder affects people of all races, ethnicities, and socioeconomic levels.

Emotional eating is just that — eating for emotional reasons, rather than physical hunger. Emotional “hunger” often comes on suddenly in the form of a specific craving, compelling you to get that food as soon as possible. Emotional eaters tend to eat past the point of fullness, hoping for some emotional relief from the food. Unfortunately, after eating the comfort food(s), feelings of guilt and shame may develop.

 

Foods that are considered comforting vary from person to person, although there tend to be common foods that are considered more comforting than others. Ice cream tends to be one of the most common foods used for comfort during times of sadness or distress, followed by other desserts (e.g., chocolate, cookies), pizza, steak, casseroles, and potato chips. Interestingly, the specific food that is craved is often dependent on a person’s mood, such that boredom may compel you to eat chips, whereas happiness may get you reaching for pizza.

The Difference between Binge Eating and Emotional Eating

You may be wondering how emotional eating is different from binge eating. There are many similarities, including eating that is fueled by emotions, eating past the point of feeling full, and feeling guilty and ashamed after eating. The main differences between emotional eating and binge eating are:

  • Emotional eating is not defined by the quantity of food consumed; binge eating is defined by eating a relatively large amount of food in one sitting.
  • Emotional eating may occur at a fast, normal, or slow speed; binge eating occurs at a rapid pace.
  • Emotional eating may occur in the company of others — grazing on snacks at work to stave off boredom, or eating an extra piece of cake at a birthday party; binge eating is almost always done in secrecy when no one is around.
  • Emotional eating is not a diagnosable eating disorder, despite the fact that it can have devastating effects on one’s physical and emotional well-being.

Binge and emotional eating can lead to a wide variety of mental and physical health risks.

Emotional and Psychological Health Risks

  • Depression
  • Anxiety
  • Suicidal thoughts
  • Body dysmorphia
  • Substance use, addiction
  • Loneliness, isolation
  • Low self-esteem

Physical and Medical Health Risks

  • Weight gain, obesity
  • Insomnia, sleep apnea
  • Type 2 diabetes, insulin resistance
  • Gallbladder disease
  • High cholesterol
  • High blood pressure
  • Cardiovascular disease
  • Cancer
  • Osteoarthritis
  • Joint and muscle pain
  • Gastrointestinal problems
  • Kidney disease
  • Stroke
  • Fertility problems

The tendency to inappropriately use food is caused by a number of factors, including genetic/biological, emotional, and environmental.

Genetic/Biological Causes

  • Family history of eating disorders, depression, anxiety, substance use
  • Abnormalities within the hypothalamus, in which your brain does not send correct hunger and fullness signals
  • Decreased levels of serotonin, leading to a bigger appetite and stronger cravings

Emotional Causes

  • Depression
  • Anxiety
  • Substance use
  • Difficult managing distressing emotions
  • Stress
  • History of trauma/abuse (especially body-focused trauma, such as physical or sexual abuse)
  • Dissatisfying relationships with loved ones
  • Intense desire to please others
  • Tendency to avoid conflict or confrontation
  • Low social support, loneliness, isolation
  • Difficulty managing impulses
  • Body dissatisfaction

Environmental Causes

  • Social pressure to be thin, look a certain way
  • Addictive qualities of processed foods
  • Critical comments about your body and weight from others (especially family and friends)
  • Hyperfocus on food and body image in your family of origin

Behavioral and Physical Signs of Emotional and Binge Eating

  • Eating large amounts of food in a short period of time
  • Eating more quickly than normal
  • Unable to stop eating when you want to
  • Eating when you’re not hungry or already full, sometimes to the point of being physically uncomfortable
  • Hiding food for the purposes of secretly eating it later
  • Eating smaller portions when in the presence of others, and then overeating or bingeing when alone
  • Eating in places where you may be distracted (e.g., in the car, in bed, on the couch)
  • Planning your day around food and eating
  • Noticeable fluctuations in weight as a result of overeat-undereat cycle

Emotional and Psychological Signs of Emotional and Binge Eating

  • Feeling out of control while eating
  • Needing food to relieve stress, tension, or distress
  • Feeling embarrassed by the amount and type of food eaten
  • Feeling disconnected from mind and/or body while eating
  • Spending large amounts of time each day thinking about food, eating, and your body
  • Feeling ashamed, guilty, and/or depressed after eating
  • Believing that a diet and strong willpower will resolve this issue
  • Feeling uncomfortable in your own body; wishing you could better control your weight

A common cause of death worldwide, obesity is now one of the most serious international public health problems in the 21st century. In 2013, the American Medical Association classified obesity as a medical disease, shining the spotlight on the necessity of preventing and treating this devastating illness.

Causes of Obesity

There are many pathways to obesity, one of which is overeating or bingeing coupled with minimal or no exercise. Often, a person affected by binge eating disorder will consume several thousand calories (or tens of thousands of calories) in one sitting, which far exceeds the daily calories needed to maintain a healthy body weight. Over time, these eating episodes can result in unwanted weight gain, making a person overweight, obese, or morbidly obese. (It is important to note, however, that not all people affected by emotional eating and binge eating are obese, and not all obese people are emotional or binge eaters).

Obesity and weight gain can also be caused by genetic and/or medical conditions, such as hypothyroidism, insulin resistance, diabetes, polycystic ovarian syndrome (PCOS), low testosterone, and Cushing’s syndrome. Additionally, certain medications can cause weight gain, including steroids, some antidepressants, high blood pressure medication, and seizure medication. It is important to have a thorough medical exam to rule out any physical conditions that may be affecting your weight.

Mental and Physical Health Risks

Obesity can lead to a wide variety of mental and physical health risks.

Emotional and Psychological Health Risks

  • Depression
  • Anxiety
  • Suicidal thoughts
  • Body dysmorphia
  • Substance use, addiction
  • Loneliness, isolation
  • Low self-esteem
  • Social stigma, stereotyping, bullying
  • Passed up for job promotion or new job

Physical and Medical Health Risks

  • Insomnia, sleep apnea
  • Type 2 diabetes, insulin resistance
  • Gallbladder disease
  • High cholesterol
  • High blood pressure
  • Cardiovascular disease
  • Cancer
  • Osteoarthritis
  • Joint and muscle pain
  • Gastrointestinal problems
  • Reduced life expectancy

Signs and Symptoms of Obesity

  • Becoming overweight or obese is often a gradual process, occurring in small increments that may make it difficult to notice. The following signs may indicate an unhealthy, excessive body weight:
  • Consistent weight gain
  • Clothes feeling too small and tight
  • Easily winded after walking, going up stairs, or carrying something
  • Feeling tired and lethargic throughout the day, even after sleeping or drinking caffeine
  • Feeling achy throughout your body, especially in your joints and muscles
  • Not fitting in to spaces you used to be able to fit into, such as armchairs, restaurant booths, and airplane seats

Severity Levels and BMI

Currently, the terms ‘overweight’ and ‘obese’ are defined by the medical community using body mass index (BMI) and waist:hip ratio of fat distribution.

BMI is a widely used tool to measure body shape and physical health based on a person’s weight and height. Calculate your BMI now.

According to the World Health Organization, there are six classifications of health based on a person’s BMI:

  • Underweight < 18.5 BMI
  • Normal weight 18.5 – 24.9 BMI
  • Overweight 25.0 – 29.9 BMI
  • Class I Obesity 30.0 – 34.9 BMI
  • Class II Obesity 35.0 – 39.9 BMI
  • Class III Obesity ≥ 40.0 BMI

“Severe obesity” is often defined as a BMI ≥ 35.0, which is equivalent to Class II or III obesity.

“Morbid obesity” is often defined as either: (1) a BMI ≥ 35.0 and obesity-related health issues; or (2) a BMI ≥ 40.0-44.9.

“Super obesity” is often defined as a BMI ≥ 45.

It is important to note that BMI is not used with children and adolescents because their bodies are still growing and so there is no absolute weight they should maintain. Thus, childhood obesity is defined by a weight that is greater than the 95th percentile for their age, gender, and height.

Websites

  • Academy for Eating Disorders: AED is a professional organization that conducts rigorous research and provides state-of-the-art professional training/education on eating disorders.
  • www.EDReferral.com: This website provides a comprehensive directory of eating disorder professionals throughout the country, including therapists, dietitians, and in-patient treatment facilities.
  • Gurze Books: This publication company specializes in books on eating disorders, healthy weight management, and related topics (e.g., body image, obesity). On this website, you can purchase books at discounted prices; read various articles and newsletters about eating disorders; and find links to treatment centers, organizations, and other websites.
  • National Eating Disorders Association (NEDA): NEDA is the largest non-profit eating disorder organization in the country. They host a variety of events around the country (e.g. conferences, NEDAwareness Week events) and their website provides a wealth of information about eating disorders, treatment, and upcoming events.

Smart Phone Apps

  • Recovery Record: This app helps users by consistently assessing throughout the day what and how much they are eating, and how they are feeling.
  • No More Diets: This app helps you identify emotional issues that drive your eating behaviors, while also helping you identify your own body’s hunger and fullness cues.
  • Self Esteem Daily Affirmations: This app provides affirmations, with the option of creating a list of favorites.
  • Optimism: This app provides a mood chart that helps users develop strategies to manage depression, bipolar, or other physical and mental health conditions.
  • Positive Thinking: This app helps users adopt positive thinking through the use of motivational and inspirational quotes.

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