by Joe Borders, MFT
Therapist in Roseville, Ca

July 23, 2018

What is Binge Eating Disorder?

Binge eating disorder is the most common eating disorder in the US, and yet many people have never heard of it! Most people are aware of eating disorders, and many may have even heard of anorexia, bulimia, and body image issues, but there are many other disorders relating to food and body image. Binge eating disorder specifically involves over eating, often to a level of discomfort (binging).

How is Binge Eating Disorder Different from Other Eating Disorders?

Unlike those with anorexia, people with BED eat excessively when they binge, and unlike those who struggle with bulimia, they do not purge after binging. Because of this, people with BED end up taking in very high volumes of food/calories. This means that they may be more likely to encounter health problems with obesity, joint pain, and heart and kidney problems. It also means they may need a different sort of treatment when trying to take on this problem.

How is Treatment of BED Different?

Because BED involves high caloric intake, contributing to obesity and other health problems, treatment for BED can look very different than it does for other eating disorders. Along with helping the person to have a better relationship with food and eat healthier, there may be a very real need for medication and medical treatment of other health issues. The big difference though is that people with BED are more likely to need treatment that involves working towards weight loss.

How is Treatment Similar?

Although there may be major differences in how BED and other eating disorders are treated, the root cause is often addressed in the same way. This is because just like with anorexia or bulimia, the problem is psychological (though this is not the case with all eating disorders! Another disorder with dietary problems that few know of is Prader-Willi Syndrome for example).

Of course exact therapeutic approaches will vary, but with any eating disorder, some specific goals or points of focus would be:

• Better Coping Skills–helping the client find better ways to cope with stress or other triggers that lead them to binge
• Recognizing Triggers–figuring out what leads to the binging behavior. Is it stress, grief, boredom? And again, working to find better ways to work through those feelings
• Personalized Therapy–processing original emotional/psychological problems. This might mean working through early trauma or relationship difficulties, self esteem or depression. The focus here would really depend on the needs and past of the client.

What Causes BED?

There is no one cause of eating disorders, but there has been a lot of research that shows a few common factors that make someone much more likely to develop an eating disorder:

1. Genetics–people who have family members who have had eating disorders are much more likely to develop them themselves.
2. Upbringing– this relates to factor number 1: if someone grows up around a family member who exhibits unhealthy behaviors around food, that can affect them too.
3. Trauma–whether it be due to pressure to perform physically in an intense sport, to look a certain way, or sexual abuse, experiencing trauma, especially in youth, is another common contributor to developing an eating disorder.
4. Psychological Problems–there has been a strong correlation between depression and eating disorders.

Feelings of shame, lack of self-esteem, and low sense of self control are common among those who struggle with BED. The following video depicts one man’s experience with those psychological difficulties.

What are the Symptoms/Warning Signs?

If you are concerned that you or someone you know might suffer from BED, consider the DSM 5’s definition of what constitutes BED and check to see if these symptoms are present.

Binging (overeating to the point of discomfort), accompanied by the following:

1. 1. Eating When Not Hungry
   2. Eating Quickly
   3. Feelings of Guilt/Shame After Eating
   4. Frequent* Eating Binges. (*The DSM defines this as at least one binge per week for three months)

Why Knowing All This Matters

Too many people struggle with stigma around getting help for many psychological issues. Because this one is connected so fiercely with feelings of shame and guilt, many people may not seek out help, or be willing to face the severity of their problem. Spreading awareness and information about this disorder can help to reduce that stigma as people realize just how common a problem this is. Also, hopefully it will help those who suffer with this and any other mental disorder to seek out help.

Below is a very insightful video we found by Kati Morton, a licensed therapist with lots of great videos on YouTube, that gives a great breakdown of what BED is and how she treats it. Her breakdown at the end where she offers specific strategies and gives the viewer “homework” is especially helpful.

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