Binge Eating Disorder

About Binge Eating Disorder

Lots of people find comfort in food. After all, it's often at the heart of our happiest celebrations. Birthdays can mean cake with friends; Thanksgiving often means turkey and stuffing with family. Most people will sometimes eat much more than they normally do (or even want to) on special occasions.

But people with binge eating disorder have a different relationship with food — they feel like they've lost all control over how much they're eating, like they can't stop. They also binge more frequently — at least twice a week for several months.

For people with binge eating disorder, at first food may provide feelings of calm or comfort or stop them feeling other difficult feelings, but if bingeing continues, it can cause anxiety, guilt and distress. A binge usually involves eating unusually large amounts of food quickly and feel completely out of control as they do it. These behaviors can become a habit, and is often alternated with dieting.

Binge eating disorder is more common in people who are obese, but it affects people of healthy weight as well. However, there's little information on how many kids and teens are affected because the condition has only recently been recognized, and some may be too embarrassed to seek help for it.

Also, because most binge eating is done alone, even if their kids may be gaining weight, parents might not be aware that it's due to bingeing.

While most people with other eating disorders (like anorexia and bulimia) are female, an estimated third of those with binge eating disorder are male. Adults in treatment (including 2% of adult Americans — roughly 1 million to 2 million people) often say their problems started in childhood or adolescence.

Signs and Symptoms

Kids and teens who sometimes eat a lot don't necessarily have binge eating disorder. Kids can have huge appetites, especially during growth spurts, when they need more nutrients to fuel their growing bodies. So it can be difficult to determine whether a child has binge eating disorder. But several signs distinguish someone who binge eats from someone with a "healthy appetite."

Parents and other family members may first suspect a problem when they notice large amounts of food missing from the pantry or the refrigerator, though it's hard to imagine one child could have eaten so much.

Other signs include:

• a child eating a lot of food quickly
• a pattern of eating in response to emotional stress, such as family conflict, peer rejection, or poor academic performance
• a child feeling ashamed or disgusted by the amount they have eaten
• finding food containers or wrappers hidden in a child's room
• an increasingly irregular eating pattern, such as skipping meals, eating lots of junk food, and eating at unusual times (like late at night)

People who binge might experience feelings that are common to many eating disorders, such as depression, anxiety, guilt, or shame. They may avoid school, work, or socializing with friends because they're ashamed of their binge eating problem or changes in their body shape and weight.

Causes

The causes of binge eating disorder aren't clear, although the National Institutes of Health (NIH) report that up to half of all people who have it also have a history of depression. It's not known, though, if binge eating brings on depression or if people with depression are prone to the disorder.

Many people who binge eat say that episodes can be triggered by feelings of stress, anger, sadness, boredom, or anxiety. However, even if someone feels better temporarily while eating, it's usually associated with feelings of distress. Most commonly, after a binge a person will feel anxious, guilty, and upset about losing control.

How It Differs From Other Eating Disorders

Binge eating disorder is slightly different from other eating disorders.

People with bulimia nervosa (sometimes called binge-purge syndrome) binge on food and then vomit or use laxatives to avoid gaining weight. They may also fast (stop eating for a while) or compulsively exercise after an eating binge. Like people who suffer from binge eating disorder, those with bulimia nervosa repeatedly eat excessive amounts of food and feel guilty or ashamed about it. Unlike bulimia, however, individuals with binge eating disorder do not or are unable to purge and are, therefore, frequently overweight.

Anorexia nervosa also involves feelings of guilt about eating. Whereas people with binge eating disorder consistently overeat, people with anorexia starve themselves, causing potentially life-threatening damage to their bodies. They also may compulsively exercise to achieve weight loss, a condition known as anorexia athletica.

Diagnosis

Doctors and mental health professionals use the criteria in the Diagnostic and Statistical Manual IV (DSM-IV) when they identify binge eating disorder. These include:

• binge eating more food than most people could consume in short periods of time
• a sense of lack of control over eating
• feelings of distress about eating behaviors
• binge eating that occurs, on average, at least 2 days a week for 6 months
• the binges are not associated with regular purging with laxatives or by vomiting or excessive exercise
• binge episodes associated with:
  • eating more rapidly than usual
  • eating until uncomfortably full
  • eating when not hungry
  • eating alone or in secret
  • feelings of disgust, depression, or guilt

Treatment

A child will be diagnosed with a binge eating disorder only after discussing the medical history, family history, patterns of eating in the family, and emotional issues. The doctor will also perform a complete physical and may order lab tests to assess some complications of obesity and nutritional adequacy.

As with any eating disorder, it's also important for a child to have psychological therapy for support and to help change unhealthy behaviors.

Different types of therapy can help treat binge eating disorder. For example, family therapy and cognitive-behavioral therapy teach people techniques to monitor and change their eating habits and the way they respond to stress. Family therapy includes the whole family in the process of helping the individual.

Cognitive-behavioral therapy combines the approach of helping people change self-defeating thoughts along with changing their behavior. Counseling also helps patients look at relationships they have with others and helps them work on areas that cause them anxiety. In some cases, doctors may prescribe medication to be used with therapy.

But there's no quick fix for any eating disorder. Treatment can take several months or longer while the person learns how to have a healthier approach to food. Although weight-control programs are helpful for some people affected by binge eating disorder, kids and teens should not begin a diet or weight-control program without the advice and supervision of a doctor.

For some parents and family members, the long road to recovery can be frustrating and expensive. Get support for yourself through parents groups or by reading about the disorder so you can help your child and your family get through this.

Risks and Complications

Many children and teens with binge eating disorder become overweight after months of overeating. Their most common health risks are the same ones that accompany obesity, including diabetes, high blood pressure, high cholesterol levels, gallbladder disease, heart disease, some kinds of cancer, and depression and anxiety.

Helping Your Child

If you suspect your child has a problem with binge eating, call your doctor for advice and referrals to qualified mental health professionals who have experience treating eating disorders in kids.

Reassure your child that you're there to help or just to listen. Having an eating disorder can be difficult to admit, and your child may not be ready to acknowledge having a problem. You also can encourage healthier eating habits by modeling your own positive relationship with food and exercise and by not using food as a reward.

With the help of your family, friends, and supportive professionals, your child can start eating healthy amounts of food and learn to manage stress in healthier ways.

Reviewed by: Michelle New, PhD
Date reviewed: September 2011