Binge-eating disorder is a form of compulsive overeating that is affecting a growing number of people globally. Sufferers feel a compulsion to consume large quantities of food on a regular basis. They will not feel able to control their desire to binge and may eat even if they are not hungry. Binges are usually planned and can involve specially purchased 'bingeing' foods.
Episodes of binge-eating typically take place in private and can last for a number of hours. Some sufferers however may binge all day long, feeling powerless to stop no matter how full they become.
Unlike bulimia, binge-eating does not involve any attempt to 'make up' or purge when they overeat - sufferers do not typically vomit, fast, take laxatives or over-exercise following a binge. In some cases however, episodes will alternate with periods of dieting. This can make the problem worse, and can exacerbate the impact it has on mental and physical health.
Often binge eaters will feel extremely distressed and upset - consumed with guilt over their lack of control. This shame can prevent sufferers from seeking help, but may also be a sign of underlying psychological issues.
This page will look into binge-eating disorder in more depth, including the treatments available to help sufferers develop a healthier relationship with food and themselves.
On this page
- Who is affected by binge-eating disorder?
- Causes of binge-eating disorder
- Symptoms of binge-eating disorder
- Side effects of binge-eating disorder
Who is affected by binge-eating disorder?
Although only recently recognised as a standalone condition, binge-eating disorder is considered the most common eating disorder. Unlike other eating disorders such as anorexia, it equally affects men and women of all ages. It does however, tend to be more common in adults than young people, and a particularly high percentage of adults in their 40s and 50s have the disorder. Among these sufferers, the majority are usually overweight.
Causes of binge-eating disorder
Like anorexia and bulimia, there is no definite cause of binge-eating disorder. There are however various factors that are thought to influence the development of the condition, including a person's emotions, experiences and genetics. Generally it is due to a combination of these things that people fall into the binge-eating cycle.
Extensive research has shown that mood triggers our impulse to eat. In regards to binge-eating disorder, stress and anxiety are considered among the most common triggers. Typically, a number of sufferers will resort to overeating as a short-term release from the ups and downs of life - particularly distressing experiences and personal difficulties that put great strain on their mental well-being. Food provides a soothing and comforting escape, although binge-eating is a far more destructive form of comfort eating.
Stress can also derive from overwhelming emotions such as unhappiness, loneliness and low self-esteem. People - especially those who have never learned to deal effectively with stress - will binge eat to cope with these uncomfortable feelings. Unfortunately, the shame, upset and guilt they experience following a binge can exacerbate the stress, which fuels the cycle. Sufferers will also find it very stressful trying to hide their binge-eating disorder from others, and may feel that their lack of control around food mirrors the lack of control they have over their personal life.
Depression and binge-eating disorder are strongly linked. According to the NHS, nearly 50% of all binge-eating disorder sufferers have had depression at one point in their life. However depression can also be an effect of binge-eating disorder as well as a cause. One particular study highlighting the link was published in the Journal of Adolescent Health. Researchers found that teenage girls who feel depressed are twice as likely to develop binge-eating disorder as other girls, whilst regular binge eaters have double the normal risk developing depression.
Investigations into whether biological factors can cause the illness have been undertaken, but nothing is yet conclusive. It is thought that specific abnormalities, such as imbalances of chemicals in the brain could play a role in the development of compulsive overeating habits, but genetics may also be a factor. Eating disorders - particularly binge-eating disorder - tend to run in families, so some people may be more biologically vulnerable to developing eating disorders than others.
Pressure to diet
People who spend their whole lives dieting, obsessing over their bodies and developing unnatural eating patterns can sometimes be more prone to the disorder. Although there is very little evidence to explain this link, it is common for people to binge after resorting to unhealthy methods to lose weight, such as limiting their food intake during the day by skipping meals and avoiding certain foods.
Social pressure to be thin can also add to the shame and inadequacy sufferers feel, and this can fuel their emotional eating - especially if they are unable to achieve their desired body shape. Poor body image will also trigger more intense feelings of guilt following a binge, which will further exacerbate the problem.
In some cases, the stage can be set for binge-eating during childhood - especially if parents unwittingly use food to comfort, dismiss or reward their children. Children who are exposed to critical comments about their bodies and/or weight may also be more susceptible to developing the illness.
Symptoms of binge-eating disorder
Identifying the symptoms of binge-eating disorder is crucial to determining the difference between someone who frequently eats more than they should and someone who has a problem with compulsive overeating. Binge-eating symptoms usually begin in late adolescence or early adulthood, yet there may not be any obvious physical signs - especially as many sufferers will be of normal weight. Fluctuations in weight may occur, as can loss of sexual desire, but on the whole, it is very likely that symptoms will fester as emotional and behavioural problems.
Behavioural symptoms of binge-eating disorder:
- Inability to stop eating during a binge or control what is being eaten.
- Eating large amounts of food in a short space of time.
- Eating when not hungry and to the point of discomfort.
- Hiding or stockpiling food to be eaten later in secret.
- Eating normally around others, but gorging alone.
- Eating continuously throughout the day with no structured eating times.
Emotional symptoms of binge-eating disorder:
- Embarrassment, disgust, guilt and shame after overeating.
- Feeling numb while bingeing - sufferers tend to be on auto-pilot.
- Never feeling satisfied even when uncomfortably full.
- Desperation to stop binge-eating and control eating habits.
- Feeling relief from stress and tension when bingeing.
Side effects of binge-eating disorder
Binge-eating disorder can have a number of negative side effects on physical and emotional well-being, and may even lead to several social problems. People with the illness tend to report more health issues than those without an eating disorder.
One of the most prominent side effects of binge-eating - particularly over a long period - is weight gain, and this in turn can lead to a number of health problems and medical complications. These include:
- type 2 diabetes
- high cholesterol
- high blood pressure
- heart disease
- joint and muscle pain
- sleep apnea
- gastrointestinal problems
- gallbladder disease
- mild breathing difficulties
- liver and kidney problems.
There are several emotional consequences of binge-eating and, as established, these are primarily stress, depression and low self-esteem. Many sufferers will also experience intense self-blame and feelings of despair over their lack of discipline and failure to control their compulsiveness to eat. Panic attacks and lack of focus are also linked to the condition.
Often it is the emotional impact that leads to social issues, and many sufferers will feel increasingly isolated from others and may therefore be experiencing problems in their relationships. The disorder can also leave sufferers feeling abnormally tired and lacking in energy, and many will experience stomach pains and may even have more frequent headaches. These too can negatively impact emotional state and sociability.
Binge-eating disorder treatment
It is very rare for people with binge-eating disorder to seek help. This is sometimes because they are unaware of the illness or do not realise they have a problem. Furthermore, even if a sufferer does recognise they have binge-eating symptoms, often the intense feelings of shame and guilt that characterise the disorder will put them off seeking help. This is because it would mean coming clean about their habits.
There are however a variety of treatments available for this disorder. Often medication such as antidepressants will be prescribed to sufferers to help ease their emotional pain. These will be offered as part of a comprehensive treatment programme that includes therapy, support groups led by trained volunteers and health professionals and self-help techniques. Therapy is particularly valuable for helping to relieve the shame that consumes many sufferers, as well as other uncomfortable emotions such as stress, anger, sadness and worry that can compel sufferers to binge eat.
A guiding belief of counselling for binge-eating disorder is that if sufferers can learn other ways of dealing with their emotions, it may help them to concentrate on something other than eating. They can also learn skills that will help them to deal more effectively and assertively with other people, which will be valuable in helping to heal any relationship problems that may have resulted from their compulsive overeating habits.
In therapy, counsellors will also take into account the addictive nature of binge-eating and how difficult it can be for sufferers to break the binge-eating cycle. Helping clients to develop a healthier relationship with food - one that is based on meeting nutritional needs rather than emotional needs - is a key focus. They will also pay great attention to the root causes of the disorder - the emotional triggers that lead to binge-eating - as well as the symptoms and destructive eating habits.
What to expect in counselling
Typically, counselling for binge-eating disorder will involve cognitive behavioural therapy techniques, and it can take place in one-on-one sessions or as part of group therapy. Many sufferers may prefer to meet with their counsellor alone, but joining a group can be beneficial for helping to reduce the stigma and loneliness associated with the disorder.
The ultimate aim of counselling is to teach sufferers how to fight the compulsion to binge, turn unhealthy habits into healthy ones, and develop effective mood-boosting skills. Cognitive behavioural therapy will involve focusing on dysfunctional thoughts and behaviours, whilst helping sufferers to become self-aware of their compulsive overeating and how it is linked to their emotions. This will lead on to setting new goals for future eating habits, and improved physical and mental well-being. Therapy may also involve nutritional advice, weight-loss support and mindfulness techniques - the latter of which can help sufferers learn to better accept themselves and regulate their emotions more effectively.
What should I be looking for in a counsellor or psychotherapist?
Whilst there is no law in place specifying the level of training a counsellor must have in order to treat individuals with binge-eating disorder, the National Institute for Health and Care Excellence have developed a set of clinical guidelines that issue advice on types of psychological treatment, medication and available services.
Key recommendations include the following:
- Cognitive behaviour therapy for binge-eating disorder (CBT-BED), a specifically adapted form of CBT, should be offered to adults with binge-eating disorder.
- Other psychological treatments (interpersonal psychotherapy for binge-eating disorder and modified dialectical behaviour therapy) may be offered to adults with persistent binge-eating disorder.
- Patients should be informed that all psychological treatments for binge-eating disorder have a limited effect on body weight.
- When providing psychological treatments for patients with binge-eating disorder, consideration should be given to the provision of concurrent or consecutive interventions focusing on the management of any comorbid obesity.
For more information, please visit the full NICE guidelines:
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