How do I know if I have binge eating disorder?

Most of us overeat from time to time, and some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean that you have binge eating disorder. Experts generally agree that most people with serious binge eating problems often eat an unusually large amount of food and feel their eating is out of control. People with binge eating disorder also may:

• eat much more quickly than usual during binge episodes



• eat until they are uncomfortably full



• eat large amounts of food even when they are not really hungry



• eat alone because they are embarrassed about the amount of food they eat



• feel disgusted, depressed, or guilty after overeating.

Binge eating also occurs in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.

How common is binge eating disorder, and who is at risk?

Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese,* but normal-weight people also can have the disorder.

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.

Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.

People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.

* The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.

What causes binge eating disorder?

No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder are depressed or have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known.

It is also unclear if dieting and binge eating are related. Some people binge eat after dieting. Dieting here means skipping meals, not eating enough food each day, or avoiding certain kinds of food. These are unhealthy ways to try to change your body shape and weight.

Studies suggest that people with binge eating may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.

Certain behaviors and emotional problems are more common in people with binge eating disorder. These include abusing alcohol, acting quickly without thinking (impulsive behavior), not feeling in charge of themselves, not feeling a part of their communities, and not noticing and talking about their feelings.

Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Other research suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family. This research is still in the early stages.

What are the complications of binge eating disorder?

People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder do. People with binge eating disorder often feel bad about themselves and may miss work, school, or social activities to binge eat.

People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity puts people at risk for many health problems, including

• type 2 diabetes



• high blood pressure



• high blood cholesterol levels



• gallbladder disease



• heart disease



• certain types of cancer.

Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members do not know they binge eat.

Should people with binge eating disorder try to lose weight?

Many people with binge eating disorder are obese and have health problems because of their weight. They should try to lose weight and keep it off; however, research shows that long-term weight loss is more likely when a person has long-term control over his or her binge eating.

People with binge eating disorder who are obese may benefit from a weight-loss program that also offers treatment for eating disorders. However, some people with binge eating disorder may do just as well in a standard weight loss program as people who do not binge eat.

People who are not overweight should avoid trying to lose weight, because it sometimes makes their binge eating worse.

How can people with binge eating disorder be helped?

People with binge eating disorder should get help from a health professional such as a psychiatrist, psychologist, or clinical social worker. There are several different ways to treat binge eating disorder.

• Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It teaches them how to change the way they act in tough situations. It also helps them feel better about their body shape and weight.



• Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas.



• Drug therapy, such as antidepressants, may be helpful for some people.

The methods mentioned here seem to be equally helpful. Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. Other therapies being tried include dialectical behavior therapy, which helps people regulate their emotions; drug therapy with the anti-seizure medication topiramate; weight loss surgery (gastrointestinal surgery); exercise used alone or in combination with cognitive-behavioral therapy; and self-help. Self-help books, videos, and groups have helped some people to control their binge eating.

You are not alone.

If you think you might have binge eating disorder, it is important to know that you are not alone. Most people who have the disorder have tried but failed to control it on their own. You may want to get professional help. Talk to your health care provider about the type of help that may be best for you. The good news is that most people do well in treatment and can overcome binge eating.

For more information

National Eating Disorder Association
Information and Referral Program
603 Stewart Street, Suite 803
Seattle, WA 98101
1-800-931-2237
(206) 382-3587
(206) 829-8501 (fax)
Web: www.nationaleatingdisorders.org
Email: info@nationaleatingdisorders.org

Academy for Eating Disorders
6728 Old McLean Village Drive
McLean, VA 22101
(703) 556-9222
(703) 556-8729 (fax)
Web: http://www.aedweb.org/
Email: aed@degnon.org

Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

sourceLast Editorial Review: 2/21/2008

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