Binge-eating disorder symptoms are physical but arise from psychological causes. BEDS-7 helps diagnosis leading to treatment of binge-eating disorder.

Binge Eating Disorder (BED)

Online Consultation

Ismail Munir

Overview

Binge eating disorder is a life-threatening and severe eating disorder. Although treatable, it is characterized by continuous episodes of eating large quantities of food, loss of control while binge eating, shame, and guilt afterwards. It is the most common eating disorder in the US<a href="#accordion">[1]</a>. Moreover, it is one of the newest recognized disorders under the DSM-5 criteria.

The common misconception about eating disorders is that it is a lifestyle choice. Eating disorders can be fatal and serious, and are associated with disturbances in eating behaviours and emotional instability. Body dysmorphia and unhealthy eating habits also signal eating disorders. The most common eating disorders are <a href="https://merisehat.pk/disease/bulimia-nervosa">bulimia nervosa</a>, anorexia nervosa, and binge-eating disorder. 
&nbsp;

<h5><a href="https://merisehat.pk/disease/anorexia-nervosa">Anorexia Nervosa</a></h5>

Anorexia nervosa is a condition in which people avoid eating food and restrict themselves to eating very small quantities. They also become habitual in weighing themselves repeatedly. Moreover, even when their weight is less than normal, they see themselves as fat.

Anorexia nervosa has two subtypes:

<ul>
	<li>Restrictive subtype</li>
	<li>Binge-purge subtype&nbsp; 
	&nbsp;</li>
</ul>

Anorexia nervosa has a high mortality rate compared to other eating disorders. Those affected are at a higher risk of dying from health complications associated with starvation. People with anorexia can also be suicidal (the second leading cause of death in anorexic patients). 
&nbsp;

<h5><a href="https://merisehat.pk/disease/bulimia-nervosa">Bulimia Nervosa</a></h5>

People have frequent episodes of eating unusually large servings of food in bulimia nervosa. They lack control over these episodes, which are followed by forced vomiting to compensate for the overeating. Also, there is a tendency to use laxatives and diuretics excessively. Dangerous habits, like prolonged and repeated fasting and excessive exercise, are also noted. Furthermore, people with bulimia can be underweight, overweight, or of a normal weight. 
&nbsp;

<h5>Avoidant Restrictive Food Intake Disorder (ARFID)</h5>

ARFID was known as a selective eating disorder, wherein people limit the type or amount of food they eat. Unlike anorexic patients, people do not have a distorted body image in ARFID. Moreover, they don&rsquo;t even fear losing weight.

It is very common in middle childhood and has an earlier onset as compared to other eating disorders. Children go through phases of picky eating and do not have enough calories to grow properly. Moreover, an adult with ARFID doesn&rsquo;t eat enough calories for the healthy functioning of their body.&nbsp; 
&nbsp;

<h5>Binge Eating Disorder</h5>

People lose control when they eat with a binge eating disorder. Moreover, they have recurring episodes of eating large quantities of food. Binge eating is not followed by purging, unlike bulimia nervosa. People with this eating disorder do not even fast or exercise excessively and, hence, are usually overweight or obese.&nbsp;

Binge eating disorder is a severe disorder where people consume large quantities of food and cannot stop themselves from eating.&nbsp;

Overeating during special occasions or a holiday is common, but excessive eating that a person cannot control is a sign of a binge eating disorder. Especially if the occurrence is recurrent.

People with binge eating disorder feel a sense of embarrassment when they overeat and try to stop themselves. However, the compulsion is so severe that resisting these urges becomes next to impossible. Treatment can help overcome binge eating disorders. 
&nbsp;

<h5>Compulsive Overeating</h5>

The term compulsive overeating is commonly used for binge eating disorder and while they sound the same, there is a difference in severity. People with compulsive overeating may binge eat frequently, however, they don&rsquo;t meet the criteria of binge eating disorder. Based on the diagnosis, compulsive overeating is classified as other specified feeding disorders (OSFED). However, this does not signify that the behavior is less concerning. 
&nbsp;

<h5>Night Eating Syndrome&nbsp;</h5>

People with night eating syndrome have recurrent eating episodes that are manifested by eating right after waking up from their sleep. It is also characterized by excessive consumption of food after evening meals.&nbsp;

According to the DSM-5 criteria, recall and awareness for eating and eating at night are explained through external influences, such as the sleep-wake cycle and local norms. Night-eating syndrome is specified in DSM-5 under the category of OSFED. However, it is different from binge eating syndrome individuals in that people with night eating syndrome are less concerned about weight. They also have less severe depression and disinhibition.

People with night eating syndrome eat less during the day compared to those with binge eating syndrome. 
&nbsp;

Signs And Symptoms

Most people who have binge eating disorders are either overweight or obese. However, some of them can also be of normal weight.&nbsp;

The emotional and behavioral signs and symptoms of binge eating disorder include the following: 
&nbsp;

<ul>
	<li>People with binge eating syndrome eat large quantities of food in a specific period, for example, more than usual food in two hours</li>
	<li>Their eating behavior is out of control</li>
	<li>Eating behavior gets out of control</li>
	<li>Even when people are full, they eat food despite the discomfort</li>
	<li>Eating alone or in secret because of embarrassment</li>
	<li>Feeling disgusted, depressed, ashamed upset, or guilty about eating food</li>
	<li>Frequent dieting and weight loss 
	&nbsp;</li>
</ul>

Unlike bulimia, people who binge do not compensate for the extra calories by inducing vomiting or excessive exercise. They try to diet and eat normal meals, but restricting calories in this way provokes their binge eating behavior.

The determining factor of the severity is how often the episodes occur throughout the week.&nbsp;People should seek help for binge eating disorder as soon as possible. The problems vary and can be recurrent if not treated. However, if they are treated, they can be short-lived.&nbsp;Patients can talk to their healthcare provider about what they are feeling and seek treatment accordingly. 
&nbsp;

Causes

Although biological factors, genetics, long-term dieting, and psychological issues increase the risk of binge eating disorder, the definitive causes are unknown. 
&nbsp;

Binge Eating Disorder Screener-7 (BEDS-7)

The patient reported screener helps in quickly screening adults who may have binge eating disorders. However, the purpose of this tool is screening only and it should not be used as a diagnostic tool.

Multiple questions are asked and if the answer to the first question is yes, then the health care provider continues to the next one. There are a total of 7 questions and if a patient says no to question 2, but checks one box from questions 3 to 7, it is a cause for concern.&nbsp;&nbsp;

The last step is to evaluate the patient based on the DSM-5 diagnostic criteria for BED<a href="#accordion">[2]</a>. 
&nbsp;

Diagnosis

<ul>
	<li>It is characterized by recurrent episodes of binge eating.</li>
	<li>During discrete&nbsp;periods, which can be within two hours, the quantity of food the person with a BED consumes is greater than what other people would normally eat during a similar time and under the same circumstances.</li>
	<li>A person with BED exhibits a lack of control over eating during the episodes. They cannot stop eating or are unable to control how much they eat.&nbsp;</li>
</ul>

The episodes are associated with: 
&nbsp;

<ul>
	<li>Abnormal, rapid eating</li>
	<li>Continuous eating till the fullness makes them uncomfortable</li>
	<li>Eating large quantities of food, despite not feeling hungry</li>
	<li>The embarrassment of overeating provokes them to eat alone</li>
	<li>Feeling guilty and disgusted after eating 
	&nbsp;</li>
</ul>

Moreover, people with binge eating disorders feel distressed after eating. Binge eating occurs once a week for three months on average.&nbsp;

Binge eating is not like anorexia nervosa because it is not accompanied by inappropriate compensatory behaviors (purging). 
&nbsp;

Treatment

With the right support and treatment, people can recover from binge eating disorders. However, it can take time. People can get treated through guided self-help programs and cognitive behavioral therapy, which is a type of talk therapy. It consists of group sessions and individual sessions. 
&nbsp;

Some people develop psychological symptoms because of binge eating. The complications include the following:&nbsp; 
&nbsp;

<ul>
	<li>Poor quality of life&nbsp;</li>
	<li>Unable to function properly at work because of personal and social disruptions</li>
	<li>Social isolation</li>
	<li><a href="https://merisehat.pk/disease/obesity">Obesity</a></li>
	<li>Medical conditions that are linked with obesity, for example, joint problems, diabetes type 2, heart disease, sleep-related disorders, and gastroesophageal reflux disease<a href="#accordion">[4]</a></li>
</ul>

&nbsp;

The following psychiatric disorders are linked with binge-eating disorders: 
&nbsp;

<ul>
	<li><a href="https://merisehat.pk/disease/bipolar-disorder">Bipolar disorder</a></li>
	<li><a href="https://merisehat.pk/disease/depression">Depression</a></li>
	<li>Substance abuse</li>
	<li><a href="https://merisehat.pk/disease/anxiety">Anxiety</a> 
	&nbsp;</li>
</ul>

Binge eating disorder is more prevalent in women than men<a href="#accrodion">[2]</a>. But people of any age can have it and it usually starts in the late teens or early twenties.&nbsp;

The risk factors include: 
&nbsp;

<ul>
	<li>
	<h5>Family History&nbsp;</h5>
	</li>
</ul>

Eating disorders run in the family. People whose siblings or parents have had eating disorders are more likely to have it.

<ul>
	<li>
	<h5>Dieting</h5>
	</li>
</ul>

People who have a history of dieting may develop binge eating disorder at some point in the future. Restriction of calories and dieting can trigger the urge to binge eat, especially in people with symptoms of depression.

<ul>
	<li>
	<h5>Psychological Issues</h5>
	</li>
</ul>

Those who suffer from binge eating disorder feel negatively about their self. The triggers include stress and poor self-image. 
&nbsp;

There is no definitive way to prevent binge eating disorder, but it&#39;s better to speak to a healthcare provider if symptoms arise.&nbsp;

If a loved one is suffering from a binge-eating disorder, try to convince them to see a healthcare provider without being offensive or further disrupting their mental health.&nbsp;

As a caregiver to a child with a binge-eating disorder:

<ul>
	<li>Reinforce a healthy body image regardless of size and shape.</li>
	<li>Consult their pediatrician&nbsp;and discuss the early indicating factors to prevent the development of the disorder. 
	&nbsp;</li>
</ul>

A study that followed 1300 women, who were dissatisfied with their bodies, for three years revealed that emotional stress and impaire interpersonal functioning induces the onset of eating disorders in women. Hence, the study aimed towards building targeted programs of prevention to reduce the risks<a href="#accordion">[3]</a>.

&nbsp;

Key Points

<ul>
	<li>Binge eating disorder is also called compulsive eating disorder and this, along with other eating disorders, is a serious mental illness.</li>
	<li>Binge eating disorder leads to uncontrollable eating habits, which cause weight gain.</li>
	<li>People with binge eating disorders often lose control over their eating habits.</li>
	<li>There are no preventive measures, but if someone has BED, they should consult a healthcare provider right away.</li>
	<li>Binge eating disorder is one of the most common eating disorders and treatment includes support programs and self-help. 
	&nbsp;</li>
</ul>

[1] Iqbal, A. and Rehman, A., 2019. Binge eating disorder.

[2] Herman, B.K., Deal, L.S., DiBenedetti, D.B., Nelson, L., Fehnel, S.E. and Brown, T.M., 2016. Development of the 7-item binge-eating disorder screener (BEDS-7). The primary care companion for CNS disorders, 18(2), p.25291.

[3] Stice, E., Gau, J.M., Rohde, P. and Shaw, H., 2017. Risk factors that predict future onset of each DSM–5 eating disorder: Predictive specificity in high-risk adolescent females. Journal of abnormal psychology, 126(1), p.38.

[4] Brownley, K.A., Berkman, N.D., Peat, C.M., Lohr, K.N., Cullen, K.E., Bann, C.M. and Bulik, C.M., 2016. Binge-eating disorder in adults: a systematic review and meta-analysis. Annals of internal medicine, 165(6), pp.409-420.

[5] Amianto, F., Ottone, L., Abbate Daga, G. and Fassino, S., 2015. Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC psychiatry, 15(1), pp.1-22.