5 Myths About Binge Eating Disorder
Binge eating disorder is a serious eating disorder in which individuals consume a large amount of food in a short period of time and often feel like they are unable to stop. People with BED often feel distressed, guilty or shameful after engaging in a binge episode. Because of the stigma associated with BED, many people do not reach out for help. However, with proper treatment, recovery is possible.
By: Anya Rosen
Binge eating disorder (BED) is the most common eating disorder among Americans, affecting 2.6% of the population.¹ In fact, this number is likely underreported due to shame and stigma associated with the condition. As a result, BED often goes unrecognized and untreated. In one study involving 22,387 respondents, 344 (1.5%) met the diagnosis criteria for BED.² However, only 11 out of the 344 had ever been diagnosed with BED by a health-care provider.² Below are some common misconceptions about BED, including what it is, who it affects, why it matters, and how it is treated.
Myth #1: BED is Just Overeating
As Ellyn Satter, a Registered Dietitian and Family Therapist, once wrote, “Normal eating is overeating at times, feeling stuffed and uncomfortable.”³ While emotional eating or overeating from time to time is a natural part of the human experience, BED has a defined set of diagnostic criteria and is often accompanied by marked feelings of distress. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) classifies BED accordingly:⁴
(1) Recurrent episodes of binge eating, characterized by both of the following: (1) eating in a discrete period of time, an amount of food larger than most people would eat in a similar amount of time under similar circumstances and (2) a sense of lack of control over eating during the episode.
(2) The binge-eating episodes are associated with three (or more) of the following: eating much more rapidly than normal, eating until uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of feeling embarrassed by how much one is eating, or feeling disgusted with oneself, depressed, or very guilty afterward.
(3) Marked distress regarding binge eating is present.
(4) The binge eating occurs, on average, at least once a week for 3 months.
(5) The binge eating is not associated with use of inappropriate compensatory behaviors and does not occur exclusively during the course of bulimia or anorexia.
If binge eating episodes occur fewer than one time per week or for less than three months, the individual may be diagnosed with atypical BED, a type of Other Specified Feeding or Eating Disorder (OSFED). If you relate to any of the diagnostic criteria for BED, please reach out for support.
Myth #2: BED Only Affects People In Larger Bodies
BED, just like all eating disorders, affects people of every size, shape, color, gender, background and age. Roughly half of people impacted by BED are classified as “normal” weight according to their BMI (another reason why we know that BMI is a poor marker of one’s health).⁵,⁶ Weight is not included in the DSM-5 criteria for BED. Chronic binge eating may lead to weight gain, but that doesn’t happen with every individual due to differences in metabolism, lifestyle, and other factors.
Myth #3: BED Is A Willpower Issue
Like anorexia and bulimia, BED is grounded in restriction. Many people suffering from BED attempt to counteract their binges through dieting. These diets often involve undereating or avoiding certain foods. As a result, individuals are even more driven to binge based on physiological and psychological deprivation. Physically, dieting leads them to seek out food due to alterations in hunger and stress hormones.⁷ Psychologically, forbidden foods are granted more power and become even more crave-worthy. BED patients become trapped in the “binge-restrict cycle,” which perpetuates their behavior even more. That is why “just eat less” or “just don’t eat it” is harmful advice. Instead, it is essential to break the cycle with a non-diet approach to nutrition by stabilizing one’s intake throughout the day, ditching the food labels, and making peace with food.
Myth #4: BED Can Be Cured By Dieting Alone
While nutrition is a key component to BED recovery, eating disorders are serious mental health conditions. Individuals with BED must work with a multi-disciplinary team, including a Registered Dietitian, a licensed psychotherapist, and a medical physician. BED is often related to psychological issues such as depression, anxiety, and substance abuse.⁸ The disorder itself can exacerbate pre-existing mental health conditions or create new ones. Common psychotherapy treatment options include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and dialectical behavioral therapy. Psychotherapy can be used with or without pharmacotherapy, such as selective serotonin reuptake inhibitors (SSRIs). Whether or not pharmacotherapy is used depends on the client.
Myth #5: BED Is Not Dangerous
Just like any other eating disorder, BED can pose great risk to both physical and mental health. Common psychological concerns, such as those listed above, can contribute to loss of motivation, difficulty concentrating, impaired relationships, poor productivity, chronic fatigue and low self-esteem. Physical risks include cardiovascular disease, type 2 diabetes, cholesterol issues, menstrual dysfunction, cortisol disbalances, sleep apnea, non-alcoholic fatty liver disease, gallbladder disease, and more.⁸ The earlier that BED is diagnosed and treated by an interprofessional team, the lower the risk of these complications. It is essential that healthcare providers regularly screen clients for eating disorders.
BED is a serious issue that has been misunderstood by the medical and nutrition community for far too long. It is a highly prevalent problem, affecting a large percentage of the population. It is important to recognize the difference between BED and overeating, to end the unfounded stereotyping, and to acknowledge that binging is rooted in restriction. As with any eating disorder, BED requires a multidisciplinary team to address the nutrition approach, psychological state, and medical complications. With comprehensive care, recovery from BED is possible.
At BALANCE eating disorder treatment center™, our compassionate team of eating disorder professionals specialize in treating the spectrum of eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We offer clients four distinct levels of care to meet their specific treatment needs, including a day program, weeknight program, outpatient groups, and nutrition services with a licensed dietitian. BALANCE also has a binge eating disorder recovery handbook, which can be found here. Click the button below to learn more about our programs and services.
This post was written by BALANCE Intern, Anya Rosen.
Anya is a Dietetic Intern and has completed her Master’s in Clinical Nutrition at New York University. Meanwhile, she is also getting certified as an Integrative Functional Nutrition practitioner, and she is an NASM certified personal trainer. She completed her undergraduate degree in Math & Computer Science at Dartmouth College and worked in tech and consulting for a few years. However, health and wellness has always been her passion. After seeing so many men and women (including herself) struggle with it, she decided to go back to school and make it her career. Her goal is to apply her knowledge, experience and compassion to practice truly individualized, evidence-based patient care.
References
1. Guerdjikova AI, Mori N, Casuto LS, McElroy SL. Update on binge eating disorder. Med Clin North Am. 2019;103(4):669-680. doi: S0025-7125(19)30006-9 [pii].
2. Citrome L. Binge eating disorder revisited: What's new, what's different, what's next. CNS Spectr. 2019;24(S1):4-13. doi: 10.1017/S1092852919001032 [doi].
3. Ellyn Satter. Secrets of feeding a healthy family: How to eat, how to raise good eaters, how to cook.
4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition: DSM-5..
5. Mackenzie J, Harris L. Binge eating symptomatology, BMI, and health. Journal of Eating Disorders. 2015;3:O59. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661756/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661756/. doi: 10.1186/2050-2974-3-S1-O59.
6. de Zwaan M. Binge eating disorder and obesity. Int J Obes Relat Metab Disord. 2001;25 Suppl 1:51. doi: 10.1038/sj.ijo.0801699 [doi].
7. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: A review. Obes Rev. 2007;8(1):21-34. doi: BR270 [pii].
8. Iqbal A, Rehman A. Binge eating disorder. In: StatPearls. Treasure Island (FL): StatPearls Publishing LLC; 2021. NBK551700 [bookaccession].