Binge Eating2018-09-27T13:38:59+00:00

Binge Eating Disorder

Binge Eating Disorder

Binge Eating Disorder

Binge-eating disorder is a serious eating disorder in which you frequently consume unusually large amounts of food and feel unable to stop eating.

Almost everyone overeats on occasion, such as having seconds or thirds of a holiday meal. But for some people, excessive overeating that feels out of control and becomes a regular occurrence crosses the line to binge-eating disorder.

When you have binge-eating disorder, you may be embarrassed about overeating and vow to stop. But you feel such a compulsion that you can’t resist the urges and continue binge eating. If you have binge-eating disorder, treatment can help.

Symptoms of Binge Eating Disorder:

Most people with binge-eating disorder are overweight or obese, but you may be at a normal weight.

Behavioral and emotional signs and symptoms of binge-eating disorder include:

  • Eating unusually large amounts of food in a specific amount of time, such as over a 2-hour period
  • Feeling that your eating behavior is out of control
  • Eating even when you’re full or not hungry
  • Eating rapidly during binge episodes
  • Eating until you’re uncomfortably full
  • Frequently eating alone or in secret
  • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
  • Frequently dieting, possibly without weight loss

Unlike a person with bulimia, after a binge, you don’t regularly compensate for extra calories eaten by vomiting, using laxatives or exercising excessively. You may even try to diet or eat normal meals. But restricting your diet may simply lead to more binge eating.

The severity of binge-eating disorder is determined by how often episodes of bingeing occur during a week.

Causes of Binge Eating Disorder:

The causes of binge-eating disorder are unknown. But genetics, biological factors, long-term dieting and psychological issues increase your risk.

Risks factors for Binge Eating Disorder:

Factors that can increase your risk of developing binge-eating disorder include:

  • Family history. You’re much more likely to have an eating disorder if your parents or siblings have (or had) an eating disorder. This may indicate that inherited genes increase the risk of developing an eating disorder
  • Psychological issues. Most people who have binge-eating disorder feel negatively about themselves and their skills and accomplishments. Triggers for bingeing can include stress, poor body self-image, food and boredom
  • Dieting. Many people with binge-eating disorder have a history of dieting — some have dieted to excess dating back to childhood. Dieting or restricting calories during the day may trigger an urge to binge eat, especially if you have low self-esteem and symptoms of depression
  • Your age. Although people of any age can have binge-eating disorder, it often begins in the late teens or early 20s

Binge Eating Disorder complications:

You may develop psychological and physical problems related to binge eating.

Complications that may be caused by binge-eating disorder include:

  • Feeling bad about yourself or your life
  • Poor quality of life
  • Problems functioning at work, with your personal life or in social situations
  • Social isolation
  • Obesity
  • Medical conditions related to obesity, such as joint problems, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD) and some sleep-related breathing disorders

Psychiatric disorders that are often linked with binge-eating disorder include:

  • Depression
  • Bipolar disorder
  • Anxiety
  • Substance use disorders

Diagnosing Binge Eating Disorder:

To diagnose binge-eating disorder, your doctor may recommend a psychological evaluation, including discussion of your eating habits.

Your doctor also may want you to have other tests to check for health consequences of binge-eating disorder, such as high cholesterol, high blood pressure, heart problems, diabetes, GERD, and some sleep-related breathing disorders.

These tests may include:

  • A physical exam
  • Blood and urine tests
  • A sleep disorder center consultation

Criteria for diagnosis

For a diagnosis of binge-eating disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:

  • Recurrent episodes of eating an abnormally large amount of food
  • Feeling a lack of control during bingeing, such as how much you’re eating and whether you can stop eating
  • Binge eating that’s associated with at least three of these factors: eating rapidly; eating until you’re uncomfortably full; eating large amounts when you’re not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating
  • Concern about your binge eating
  • Binge eating at least once a week for at least three months
  • Binge eating that’s not associated with purging, such as self-induced vomiting, or other compensating behaviors to lose weight, such as excessive exercise or laxative use

Treatment of Binge Eating Disorder:

The goals for treatment of binge-eating disorder are to reduce eating binges, and, when necessary, to lose weight. Because binge eating is so entwined with shame, poor self-image and other negative emotions, treatment also may address these and other psychological issues.

By getting help for binge eating, you can learn how to feel more in control of your eating.

Psychotherapy

Whether in individual or group sessions, psychotherapy (also called talk therapy) can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes.

Examples of psychotherapy include:

  • Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns
  • Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and co-workers. This may help reduce binge eating that’s triggered by poor relationships and unhealthy communication skills
  • Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat

Binge Eating Disorder medications can include:

  • Lisdexamfetamine dimesylate (Vyvanse), a drug that’s used to treat attention-deficit hyperactivity disorder, is now approved to treat binge-eating disorder in adults. This drug is the first FDA-approved medication to treat moderate to severe binge-eating disorder. Vyvanse is a stimulant and can be habit-forming and abused. Common side effects include dry mouth and insomnia, but more serious side effects can occur

Several other types of medication may help reduce symptoms. Examples include:

  • The anticonvulsant topiramate (Topamax). Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, there are side effects, such as dizziness and kidney stones, so discuss the risks and benefits with your doctor
  • Antidepressants. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may be helpful. It’s not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood

Behavioral weight-loss programs

Many people with binge-eating disorder have a history of failed attempts to lose weight on their own. However, weight-loss programs typically aren’t recommended until the binge-eating disorder is treated because dieting may trigger more binge-eating episodes, making weight loss less successful.

When appropriate, weight-loss programs are generally done under medical supervision to ensure that your nutritional requirements are met. Weight-loss programs that address binge triggers can be especially helpful when you’re also getting cognitive behavioral therapy.

Symptoms of Binge Eating Disorder:

Most people with binge-eating disorder are overweight or obese, but you may be at a normal weight.

Behavioral and emotional signs and symptoms of binge-eating disorder include:

  • Eating unusually large amounts of food in a specific amount of time, such as over a 2-hour period
  • Feeling that your eating behavior is out of control
  • Eating even when you’re full or not hungry
  • Eating rapidly during binge episodes
  • Eating until you’re uncomfortably full
  • Frequently eating alone or in secret
  • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
  • Frequently dieting, possibly without weight loss

Unlike a person with bulimia, after a binge, you don’t regularly compensate for extra calories eaten by vomiting, using laxatives or exercising excessively. You may even try to diet or eat normal meals. But restricting your diet may simply lead to more binge eating.

The severity of binge-eating disorder is determined by how often episodes of bingeing occur during a week.

Causes of Binge Eating Disorder:

The causes of binge-eating disorder are unknown. But genetics, biological factors, long-term dieting and psychological issues increase your risk.

Risks factors for Binge Eating Disorder:

Factors that can increase your risk of developing binge-eating disorder include:

  • Family history. You’re much more likely to have an eating disorder if your parents or siblings have (or had) an eating disorder. This may indicate that inherited genes increase the risk of developing an eating disorder
  • Psychological issues. Most people who have binge-eating disorder feel negatively about themselves and their skills and accomplishments. Triggers for bingeing can include stress, poor body self-image, food and boredom
  • Dieting. Many people with binge-eating disorder have a history of dieting — some have dieted to excess dating back to childhood. Dieting or restricting calories during the day may trigger an urge to binge eat, especially if you have low self-esteem and symptoms of depression
  • Your age. Although people of any age can have binge-eating disorder, it often begins in the late teens or early 20s

Binge Eating Disorder complications:

You may develop psychological and physical problems related to binge eating.

Complications that may be caused by binge-eating disorder include:

  • Feeling bad about yourself or your life
  • Poor quality of life
  • Problems functioning at work, with your personal life or in social situations
  • Social isolation
  • Obesity
  • Medical conditions related to obesity, such as joint problems, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD) and some sleep-related breathing disorders

Psychiatric disorders that are often linked with binge-eating disorder include:

  • Depression
  • Bipolar disorder
  • Anxiety
  • Substance use disorders

Diagnosing Binge Eating Disorder:

To diagnose binge-eating disorder, your doctor may recommend a psychological evaluation, including discussion of your eating habits.

Your doctor also may want you to have other tests to check for health consequences of binge-eating disorder, such as high cholesterol, high blood pressure, heart problems, diabetes, GERD, and some sleep-related breathing disorders.

These tests may include:

  • A physical exam
  • Blood and urine tests
  • A sleep disorder center consultation

Criteria for diagnosis

For a diagnosis of binge-eating disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:

  • Recurrent episodes of eating an abnormally large amount of food
  • Feeling a lack of control during bingeing, such as how much you’re eating and whether you can stop eating
  • Binge eating that’s associated with at least three of these factors: eating rapidly; eating until you’re uncomfortably full; eating large amounts when you’re not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating
  • Concern about your binge eating
  • Binge eating at least once a week for at least three months
  • Binge eating that’s not associated with purging, such as self-induced vomiting, or other compensating behaviors to lose weight, such as excessive exercise or laxative use

Treatment of Binge Eating Disorder:

The goals for treatment of binge-eating disorder are to reduce eating binges, and, when necessary, to lose weight. Because binge eating is so entwined with shame, poor self-image and other negative emotions, treatment also may address these and other psychological issues.

By getting help for binge eating, you can learn how to feel more in control of your eating.

Psychotherapy

Whether in individual or group sessions, psychotherapy (also called talk therapy) can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes.

Examples of psychotherapy include:

  • Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns
  • Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and co-workers. This may help reduce binge eating that’s triggered by poor relationships and unhealthy communication skills
  • Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat

Binge Eating Disorder medications can include:

  • Lisdexamfetamine dimesylate (Vyvanse), a drug that’s used to treat attention-deficit hyperactivity disorder, is now approved to treat binge-eating disorder in adults. This drug is the first FDA-approved medication to treat moderate to severe binge-eating disorder. Vyvanse is a stimulant and can be habit-forming and abused. Common side effects include dry mouth and insomnia, but more serious side effects can occur

Several other types of medication may help reduce symptoms. Examples include:

  • The anticonvulsant topiramate (Topamax). Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, there are side effects, such as dizziness and kidney stones, so discuss the risks and benefits with your doctor
  • Antidepressants. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may be helpful. It’s not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood

Behavioral weight-loss programs

Many people with binge-eating disorder have a history of failed attempts to lose weight on their own. However, weight-loss programs typically aren’t recommended until the binge-eating disorder is treated because dieting may trigger more binge-eating episodes, making weight loss less successful.

When appropriate, weight-loss programs are generally done under medical supervision to ensure that your nutritional requirements are met. Weight-loss programs that address binge triggers can be especially helpful when you’re also getting cognitive behavioral therapy.