Binge eating disorder: Difference between revisions

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Binge Eating Disorder (BED) is a serious and common eating disorder characterized by recurrent episodes of binge eating without regular compensatory behaviors such as purging, fasting, or excessive exercise. It is distinct from other eating disorders like anorexia nervosa and bulimia nervosa, though it shares some psychological characteristics. BED is officially recognized in the DSM-5 and is associated with physical, emotional, and psychological health consequences.

File:Periwinkle ribbon.svg

Periwinkle ribbon, symbol of eating disorder awareness

History

The term "binge eating disorder" was first introduced by psychiatrist Albert Stunkard in 1959, who initially described the behavior as part of "night eating syndrome". It was later recognized as a separate diagnostic entity in the early 1990s. BED was formally added to the DSM-5 in 2013 as a distinct eating disorder.

Diagnostic Criteria

According to the DSM-5, BED is characterized by:

Recurring episodes of binge eating (at least once a week for three months), defined as:
- Eating, in a discrete period, an amount of food larger than most people would eat under similar circumstances.
- A sense of lack of control during the episode.
Episodes are associated with at least three of the following:
- Eating much more rapidly than normal
- Eating until uncomfortably full
- Eating large amounts of food when not physically hungry
- Eating alone due to embarrassment
- Feeling disgusted, depressed, or guilty afterward
Marked distress regarding binge eating
The behavior is not associated with regular compensatory behaviors (as seen in bulimia nervosa)

Causes and Risk Factors

The exact causes of BED are not fully understood, but a combination of biological, psychological, and environmental factors likely contribute. These include:

Genetics and family history
Hormonal or neurochemical imbalances (e.g., dopamine, serotonin)
Psychological factors such as depression, anxiety disorders, and low self-esteem
History of trauma, abuse, or neglect
Chronic dieting and body image dissatisfaction
Social and cultural pressures around body weight and appearance

Signs and Symptoms

Symptoms may include:

Frequent episodes of consuming large quantities of food
A feeling of loss of control while eating
Eating in secret or alone
Emotional distress before, during, or after binging
Fluctuations in weight
Feelings of shame or guilt related to eating
Avoidance of social activities involving food

Health Complications

BED is often associated with obesity, though individuals with normal weight can also be affected. Potential health risks include:

Type 2 diabetes
Cardiovascular disease
High blood pressure
High cholesterol
Gallbladder disease
Polycystic ovary syndrome (PCOS)
Sleep apnea
Gastrointestinal problems
Menstrual irregularities and fertility issues

BED is also associated with mental health disorders such as:

Diagnosis

Diagnosis involves a clinical assessment by a healthcare professional, often including:

Structured interviews
Self-reported questionnaires
Medical history and physical exam
Psychological evaluation

Treatment

BED is treatable. Treatment options include:

Psychotherapy

Cognitive behavioral therapy (CBT): The most effective evidence-based treatment
Interpersonal therapy (IPT)
Dialectical behavior therapy (DBT)

Medications

Lisdexamfetamine (Vyvanse), the only FDA-approved medication for BED
Antidepressants (SSRIs)
Topiramate and other off-label medications

Nutritional Counseling

Education on balanced eating patterns
Development of structured meal plans
Support for intuitive and mindful eating

Support Groups

Peer-led support (e.g., Overeaters Anonymous)
Community-based recovery programs

BED and Reproductive Health

BED can affect fertility and pregnancy:

Interferes with ovulation
Increases risk of gestational diabetes, preeclampsia, and postpartum depression
Can be triggered or exacerbated by hormonal changes during pregnancy and postpartum

Epidemiology

BED affects approximately 3.5% of women and 2.0% of men in the United States
It is the most common eating disorder across racial and ethnic groups
Onset is typically in late adolescence to early adulthood

Prognosis

With early intervention and comprehensive treatment, recovery is possible. Many individuals recover fully, though some may experience relapses. Long-term follow-up and support improve outcomes.

External Links

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-'''Binge eating disorder''' ('''BED''') is an eating disorder characterized by [[binge eating]] without subsequent purging episodes. The disorder was first described in 1959 by [[psychiatrist]] and [[research]]er Albert Stunkard as "night eating syndrome" (NES), and the term "binge eating disorder" was coined to describe the same binging-type eating behavior without the exclusive [[nocturnal]] component. BED usually leads to [[obesity]] although it can occur in normal weight individuals. There may be a genetic inheritance factor involved in BED independent of other obesity risks and there is also a higher incidence of psychiatric comorbidity, with the percentage of individuals with BED and an [[Axis I]] [[comorbid]] psychiatric disorder being 78.9% and 63.6% for those with subclinical BED.
+'''Binge Eating Disorder''' ('''BED''') is a serious and common [[eating disorder]] characterized by recurrent episodes of [[binge eating]] without regular compensatory behaviors such as [[purging]], [[fasting]], or excessive [[exercise]]. It is distinct from other eating disorders like [[anorexia nervosa]] and [[bulimia nervosa]], though it shares some psychological characteristics. BED is officially recognized in the ''[[Diagnostic and Statistical Manual of Mental Disorders|DSM-5]]'' and is associated with physical, emotional, and psychological health consequences.
-[[File:Periwinkle ribbon.svg|Periwinkle ribbon|thumb]]
-== What is binge eating disorder? ==
-Binge eating disorder is a type of eating disorder. Eating disorders are mental health problems that cause extreme and dangerous eating behaviors. These extreme eating behaviors cause other serious health problems and sometimes death. Some eating disorders also involve extreme exercise.
-According to the American Psychiatric Association, women with binge eating disorder feel out of control and eat too much (binge), at least once a week for at least three months. During binges women with binge eating disorder usually eat faster than normal, eat until they are uncomfortable, eat when they are not physically hungry, and feel embarrassed, disgusted, or depressed because of the binges. Women with this type of eating disorder may be overweight or obese.
+[[File:Periwinkle ribbon.svg|thumb|Periwinkle ribbon, symbol of eating disorder awareness]]
-== What is the difference between binge eating disorder and other eating disorders? ==
+== History ==
-Women with eating disorders, such as binge eating disorder, bulimia, and anorexia, have a mental health condition that affects how they eat, and sometimes how they exercise. These eating disorders threaten their health.
+The term "binge eating disorder" was first introduced by [[psychiatrist]] Albert Stunkard in 1959, who initially described the behavior as part of "[[night eating syndrome]]". It was later recognized as a separate diagnostic entity in the early 1990s. BED was formally added to the DSM-5 in 2013 as a distinct eating disorder.
-Unlike people with anorexia or bulimia, people with binge eating disorder do not throw up their food, exercise a lot, or starve themselves. People with binge eating disorder are often overweight or obese. But not all people with binge eating disorder are overweight, and being overweight does not always mean you have binge eating disorder.
+== Diagnostic Criteria ==
+According to the DSM-5, BED is characterized by:
+* Recurring episodes of binge eating (at least once a week for three months), defined as:
+** Eating, in a discrete period, an amount of food larger than most people would eat under similar circumstances.
+** A sense of lack of control during the episode.
+* Episodes are associated with at least three of the following:
+** Eating much more rapidly than normal
+** Eating until uncomfortably full
+** Eating large amounts of food when not physically hungry
+** Eating alone due to embarrassment
+** Feeling disgusted, depressed, or guilty afterward
+* Marked distress regarding binge eating
+* The behavior is not associated with regular compensatory behaviors (as seen in bulimia nervosa)
-It is possible to have more than one eating disorder in your lifetime. Regardless of what type of eating disorder you may have, you can get better with treatment.
+== Causes and Risk Factors ==
+The exact causes of BED are not fully understood, but a combination of biological, psychological, and environmental factors likely contribute. These include:
+* [[Genetics]] and family history
+* Hormonal or neurochemical imbalances (e.g., [[dopamine]], [[serotonin]])
+* Psychological factors such as [[depression]], [[anxiety disorders]], and [[low self-esteem]]
+* History of [[trauma]], [[abuse]], or [[neglect]]
+* Chronic [[dieting]] and [[body image]] dissatisfaction
+* Social and cultural pressures around body weight and appearance
-== Who is at risk for binge eating disorder? ==
+== Signs and Symptoms ==
-Binge eating disorder affects more than 3% of women in the United States. More than half of people with binge eating disorder are women.1
+Symptoms may include:
+* Frequent episodes of consuming large quantities of food
+* A feeling of loss of control while eating
+* Eating in secret or alone
+* Emotional distress before, during, or after binging
+* Fluctuations in weight
+* Feelings of shame or guilt related to eating
+* Avoidance of social activities involving food
-Binge eating disorder affects women of all races and ethnicities. It is the most common eating disorder among Hispanic, Asian-American, and African-American women.2,3,4
+== Health Complications ==
+BED is often associated with [[obesity]], though individuals with normal weight can also be affected. Potential health risks include:
+* [[Type 2 diabetes]]
+* [[Cardiovascular disease]]
+* [[High blood pressure]]
+* [[High cholesterol]]
+* [[Gallbladder disease]]
+* [[Polycystic ovary syndrome]] (PCOS)
+* [[Sleep apnea]]
+* Gastrointestinal problems
+* [[Menstrual irregularities]] and fertility issues
-Some women may be more at risk for binge eating disorder.
+BED is also associated with mental health disorders such as:
+* [[Major depressive disorder]]
+* [[Generalized anxiety disorder]]
+* [[Post-traumatic stress disorder]] (PTSD)
+* [[Substance use disorders]]
-* Women and girls who diet often are 12 times more likely to binge eat than women and girls who do not diet.5
+== Diagnosis ==
-* Binge eating disorder affects more young and middle-aged women than older women. On average, women develop binge eating disorder in their early to mid-20s.6 But eating disorders are happening more often in older women. In one study, 13% of American women over 50 had signs of an eating disorder.7
+Diagnosis involves a clinical assessment by a healthcare professional, often including:
+* Structured interviews
+* Self-reported questionnaires
+* Medical history and physical exam
+* Psychological evaluation
-== What are the symptoms of binge eating disorder? ==
+== Treatment ==
-It can be difficult to tell whether someone has binge eating disorder. Many women with binge eating disorder hide their behavior because they are embarrassed.
+BED is treatable. Treatment options include:
-You may have binge eating disorder if, for at least once a week over the past three months, you have binged. Binge eating disorder means you have at least three of these symptoms while binging:8
+=== Psychotherapy ===
+* '''[[Cognitive behavioral therapy]] (CBT)''': The most effective evidence-based treatment
+* '''[[Interpersonal therapy]] (IPT)'''
+* '''[[Dialectical behavior therapy]] (DBT)'''
-* Eating faster than normal
+=== Medications ===
-* Eating until uncomfortably full
+* [[Lisdexamfetamine]] (Vyvanse), the only FDA-approved medication for BED
-* Eating large amounts of food when not hungry
+* [[Antidepressants]] (SSRIs)
-* Eating alone because of embarrassment
+* [[Topiramate]] and other off-label medications
-* Feeling disgusted, depressed, or guilty afterward
-People with binge eating disorder may also have other mental health problems, such as depression, anxiety, or substance abuse.
+=== Nutritional Counseling ===
+* Education on balanced eating patterns
+* Development of structured meal plans
+* Support for intuitive and mindful eating
-== What causes binge eating disorder? ==
+=== Support Groups ===
-Researchers are not sure exactly what causes binge eating disorder and other eating disorders. Researchers think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses.
+* Peer-led support (e.g., [[Overeaters Anonymous]])
+* Community-based recovery programs
-Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.9,10
+== BED and Reproductive Health ==
+BED can affect [[fertility]] and [[pregnancy]]:
+* Interferes with ovulation
+* Increases risk of [[gestational diabetes]], [[preeclampsia]], and [[postpartum depression]]
+* Can be triggered or exacerbated by hormonal changes during [[pregnancy]] and postpartum
-Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.11
+== Epidemiology ==
+* BED affects approximately 3.5% of women and 2.0% of men in the United States
+* It is the most common eating disorder across racial and ethnic groups
+* Onset is typically in late adolescence to early adulthood
-Learn more about current research on binge eating disorder.
+== Prognosis ==
+With early intervention and comprehensive treatment, recovery is possible. Many individuals recover fully, though some may experience relapses. Long-term follow-up and support improve outcomes.
-== How does binge eating disorder affect a woman's health? ==
+== See Also ==
-Many, but not all, women with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:12
+* [[Eating disorders]]
+* [[Bulimia nervosa]]
+* [[Anorexia nervosa]]
+* [[Obesity]]
+* [[Body dysmorphic disorder]]
+* [[Mental health]]
+* [[Intuitive eating]]
+* [[Cognitive behavioral therapy]]
-* Type 2 diabetes
+== External Links ==
-* Heart disease
+* [https://www.nimh.nih.gov/health/topics/eating-disorders National Institute of Mental Health - Eating Disorders]
-* High blood pressure
+* [https://www.nationaleatingdisorders.org National Eating Disorders Association (NEDA)]
-* High cholesterol
+* [https://www.womenshealth.gov/mental-health/mental-health-conditions/eating-disorders Office on Women's Health - Eating Disorders]
-* Gallbladder disease
-* Certain types of cancer, including breast, endometrial (a type of uterine cancer), colorectal, kidney, esophageal, pancreatic, thyroid, and gallbladder cancer13
-* Problems with your menstrual cycle, including preventing ovulation, which can make it harder to get pregnant
-People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman's everyday life and can be treated.
-== How is binge eating disorder diagnosed? ==
-Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.
-Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder.
-== How is binge eating disorder treated? ==
-Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better.
-Treatment plans may include one or more of the following:
-* '''Psychotherapy.''' Sometimes called "talk therapy," psychotherapy is counseling to help you change any harmful thoughts or behaviors. This therapy may focus on the importance of talking about your feelings and how they affect what you do. For example, you might talk about how stress triggers a binge. You may work one-on-one with a therapist or in a group with others who have binge eating disorder.
-* '''Nutritional counseling.''' A registered dietitian can help you eat in a healthier way.
-* '''Medicine,''' such as appetite suppressants or antidepressants prescribed by a doctor. Antidepressants may help some girls and women with binge eating disorder who also have anxiety or depression.
-Most girls and women do get better with treatment and are able to eat in healthy ways again.14 Some may get better after the first treatment. Others get well but may relapse and need treatment again.
-== How does binge eating disorder affect pregnancy? ==
-Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder.
-Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control.
-Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for:
-* Gestational hypertension (high blood pressure during pregnancy) and preeclampsia (high blood pressure and kidney problems during pregnancy). If not controlled, both problems can threaten the life of the mother and the baby.
-* Gestational diabetes (diabetes that starts during pregnancy). If not controlled, gestational diabetes can cause you to have a large baby. This raises your risk for a C-section.15
-Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16
-* Worry over pregnancy weight gain. Women may binge because they feel a loss of control over their bodies because of the pregnancy weight.
-* Greater stress during pregnancy
-* Depression
-* History of smoking and alcohol abuse
-* Lack of social support
-After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17
-== If I had an eating disorder in the past, can I still get pregnant? ==
-Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy.
-Tell your doctor if you had an eating disorder in the past and are trying to become pregnant.
-== If I take medicine to treat binge eating disorder, can I breastfeed my baby? ==
-Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding.
-Talk to your doctor to find out what medicine works best for you. Learn more about medicines and breastfeeding in our Breastfeeding section. You can also enter a medicine into the LactMed® database to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby.
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+{{Mental and behavioral disorders}}
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