In this week’s nutrition column I will describe binge eating disorder, how it effects the body and the treatment options available.
What Is Binge Eating Disorder (BED)?
While experts debate on the exact definition of a binge, the term generally refers to a discrete period of time during which an individual overeats to the point of being uncomfortably full without hunger driving eating behaviour. Binges almost always occur in secret and an appearance of ‘normal’ eating is often maintained in front of others. High fat or high carbohydrate foods are usually eaten very quickly at least twice per week and often in a distressed state. The portions sizes consumed are generally at least three times the size of a standard portion e.g. one loaf of bread, five bowls of cereal or one packet of biscuits. Accompanying the excessive caloric consumption that occurs during a binge are often feelings of loss of control and psychological distress, such as guilt, disgust, embarrassment or depression.
Binge eating triggers include exposure to psychological stress, food deprivation or restriction (eg, dieting), patterns of emotional eating, and the restriction or abstinence from followed by the reintroduction of highly palatable foods.
Whilst binge eating disorder is not formally defined as a psychiatric disorder like anorexia nervosa and bulimia nervosa, it is described by health professionals as an “eating disorders not otherwise specified”. The excessive eating is generally not associated with compensatory behaviours e.g. self-induced vomiting or excessive exercise. Binge eating disorder is almost as common among men as it is among women, and is thought to be more common than other eating disorders such as anorexia nervosa and bulimia nervosa.
Binge eating disorder has a significant impact on the physical, as well as the emotional, health of the person affected. Health consequences may include digestive problems such as bloating, stomach cramps, constipation or diarrhoea. Surprisingly malnutrition can arise because of the quality of foods consumed (high in fats and sugars, but lacking in vitamins in minerals).
Where significant weight gain occurs, related health consequences may include: high blood pressure, elevated cholesterol levels, heart disease, diabetes, metabolic syndrome and gallbladder problems. Most of the physical symptoms can be reversed with weight loss and normalisation of a balanced diet and eating habits.
However binge eating disorder is a serious mental health condition. Obesity is a weight classification; a symptom which may occur as a result of binge eating disorder. While many of the health consequences associated with binge eating disorder are directly related to obesity, it is important to maintain a distinction between this symptom and the disorder itself.
The prevalence of these psychological disorders in individuals with binge eating is higher than the general population, with one study reporting that 54% of people exhibited signs of a mood disorder and 37% an anxiety disorder. If you think you may be suffering from
People often try to control BED on their own and if they fail they may feel demoralised and depressed. This may lead to further erratic episodes and consequent feelings of social isolation, missing work, school, etc. More often than not, people who experience BED will need the help and support of a health care professional.
Consultation with a General Practitioner is an important first step towards self-care. The GP will look at the physical effects of binge eating and, if necessary, can make a referral to a dietician or to a psychologist or a therapist. Individual psychotherapy and family therapy can be useful in addressing the psychological and emotional issues that may be underlying the disorder. Cognitive behavioural therapy (CBT) teaches people to look at their unhealthy patterns of behaviour and how to change them. For change to occur and to be lasting, a recovery approach which tackles both the physical and psychological aspects of the disorder will be required.