Binge Eating Disorder
What is it?
The effects of binge eating disorder
What causes binge eating disorder?
Treatment of binge eating disorder
The specific criteria for binge eating disorder are not fully defined and are still being debated (Striegel-Moore and Franko, 2007) However, in general terms, binge eating disorder is characterised by recurrent episodes of overeating or binge eating (at least once a week) without compensatory weight control behaviours as seen in bulimia. Binges may or may not occur in discrete episodes. The characteristics of a binge episode are similar to those in bulimia, i.e. emotional distress prior to a binge, a sense of loss of control over eating, embarrassment or shame over how much is eaten, and negative feelings after eating. People with binge eating disorder also feel concern or distress about the long term effects of binge episodes on their weight or shape, and may judge themselves on weight or shape in the same ways that people with anorexia and bulimia do (Grilo et.al., 2008). People with binge eating disorder may be overweight as a result of their eating patterns (APA, DSM-IV, 1994), but some people with binge eating disorder are a normal weight or may have widely fluctuating weight over time.
In diagnostic terms Binge Eating Disorder is still classified under "Eating Disorder Not Otherwise Specified," reflecting uncertainty about its diagnostic status. NICE Guidelines for Eating Disorders (NCCMH, 2004) classify binge eating disorder as an "atypical" eating disorder, but in fact, binge eating disorder may be at least twice as common as bulimia, has a later age of onset and affects people for longer than bulimia or anorexia (Wonderlich, et.al., 2009).
Binge eating disorder can lead to obesity although this is not always the case. Conversely, not all people with obesity have binge eating disorder. Binge eating disorder may contribute to the development of type 2 diabetes, hypertension, cardiac problems, osteoarthritis, visual impairment and other problems of being overweight (Wonderlich, et.al, 2009). Binge eating is also associated with increased risk of neck, shoulder and lower back pain (Reichborn-Kjennerud, et.al, 2004). It can result in impaired social relations. It can have a profoundly negative effect on a person's self esteem. Individuals with binge eating disorder have higher rates of psychological illness such as depression and anxiety than overweight or obese individuals who do not binge eat (Telch and Agras, 1994; Grucza et.al., 2007)Back to top
There has been insufficient research to determine whether or not genetics play a role in binge eating disorder (Wonderlich, et.al., 2009). Chronic or stringent dieting is implicated in triggering binge eating, primarily because of physiological or psychological deprivation (Fairburn, 1995). A significant proportion of people with binge eating disorder have tried various commercial diet programmes over time without lasting success with controlling weight or eating behaviour, possibly because binge eating has interfered with their efforts to lose weight. Dieting may be related to the pursuit of thinness as a social ideal, or an attempt to improve self-esteem, however, studies have shown that dieting tends to increase distress (Polivy and Herman, 1993). Binge eating may also serve to modulate or distract from emotions such as anxiety or anger. Other psychological causative factors are similar to those for anorexia and bulimia, including dichotomous thinking style or a family history or eating disorder or binge eating. There is a link between adverse childhood experiences such as abuse or bullying and binge eating disorder (Streigel-Moore, et.al., 2002).Back to top
Recommended treatments for binge eating disorder are similar to those for bulimia. Cognitive behaviour therapy for binge eating and interpersonal psychotherapy for binge eating seem to produce equivalent results in the long run in terms of reducing binge eating (NCCMH, 2004).Back to top
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition. Washington, DC, American Psychiatric Association.
Fairburn, C.G. (1995). Overcoming Binge Eating. London: Guilford.
Grilo, C.M., Hrabosky, J.I., White, M.A. Allison, K.C. and Stunkard, A.J. (2008). Overevaluation of shape and weight in binge eating disorder and overweight controls: refinement of BED as a diagnostic construct. Journal of Abnormal Psychology, 117, 414-419.
Grucza, R.A., Przybeck, T.R. and Cloninger, C.R. Prevalence and correlates of binge eating disorders in a community sample. Comprehensive Psychiatry, 48, 124-131.
Marcus, M.M. (1993) Binge eating in obesity. In Fairburn, C.G. and Wilson, G.T. (Eds), Binge Eating: Nature, Assessment and Treatment. New York: Guilford.
National Collaborating Centre for Mental Health (NICE) (2004). Eating Disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders . National Clinical Guideline No. CG9. BPS and Gaskell.
Polivy, J. and Herman, C.P. (1993). Etiology of binge eating: psychological mechanisms. In Fairburn, C.G. and Wilson, G.T. (Eds), Binge Eating: Nature, Assessment and Treatment . New York: Guilford.
Reichborn-Kjennerud, T. Bulik, C.M., Sullivan, P.F., Tambs, K. and Harris, J.R. (2004). Psychiatric and medical symptoms in binge eating in the absence of compensatory behaviours. Obesity Research, 12, 1445-1454.
Striegel-Moore, R.H. Dohm, F., Pike, K.M., Wilfley, D.E., and Fairburn, C.G. (2002). Abuse, bullying, and discrimination as risk factors for binge eating disorder . American Journal of Psychiatry 159:1902-1907.
Striegel-Moore, R.H. and Franco, D.L. (2007). Should binge eating disorder be included in the DSM-IV? A critical review of the state of the evidence. Annual Review of Clinical Psychology, 4, 305-324.
Telch, C.F. and Agras, W.S. (1994). Obesity, binge eating and psychopathology: Are they related? International Journal of Eating Disorders, 15, 53-61.