What is Binge Eating Disorder? 19 Signs & Symptoms For This Dangerous Condition

Adequate nutrition is necessary for survival. Food is ingrained into every facet of life. It’s present during celebrations, it bonds families, and helps express culture. However, some individuals feel out of control as they indulge in their favorite delicacies. They eat more than normal or when they are not physically hungry. These are indicators of binge eating disorder—a mental disorder manifesting with episodes of excessive eating. The psychological, behavioral, and physical effects of binge eating disorder impact the entire body.

What is Binge Eating Disorder?

Binge eating disorder is a type of eating disorder characterized by the compulsive consumption of large quantities of food without engaging in compensatory behaviors like purging, exercise, laxative abuse, or fasting. Binge eating exceeds occasionally overeating at dinnertime or snacking at a party. An individual with binge eating disorder cannot control the intense urge to excessively eat. Their eating binges, which occur at least once per week for three or more months, trigger emotional, physical, and psychological distress.

Periods of binge eating are almost always in response to stress. Food is used as a coping mechanism because they develop an emotional connection to eating. Due to this, binge eating tends to occur in cycles starting with a trigger like negative emotions (i.e. guilt, shame, anxiety, fear) or poor body image, and the binge eating cycle continues.

5 Psychological Symptoms of Binge Eating Disorder

Since binge eating disorder is a mental health condition, the main symptoms are primarily psychological and emotional. Someone with binge eating disorder has an intense emotional connection to food. Their eating habits have a devastating impact on their mental health.

• Negative emotions—The hallmark signs of binge eating are negative emotions and a sense of a loss of control. Emotions of shame, guilt, anxiety, fear, and disgust surround food.
• Low self-esteem—Although someone with binge eating disorder can be a normal weight, many do have rapid weight fluctuations. The changes in physical appearance, combined with the emotional dysregulation, leaves one prone to low confidence and self-esteem.
• Mood swings—Mood becomes erratic. Irritability is common.
• Other mental illness—Anxiety, depression, and other mental disorders can potentially develop along with binge eating.
• Unhealthy personality traits—Expression of perfectionism, impulsivity, and a compulsive need to be in control manifest in binge eating disorder.

6 Behavioral Signs of Binge Eating Disorder

Binge eating disorder is undoubtedly associated with psychological symptoms, but the disorder also influences behavior. An individual with binge eating disorder may display erratic behaviors before and after binge eating episodes.

• Hoarding food—Those who binge eat stockpile food to eat later.  
• Eating in secret—Mealtimes are normally spent with others, but those with binge eating disorder prefer to eat alone in secret because they are embarrassed over their eating binges.
• Buying lots of food—Binge eaters purchase large quantities of food, more than what the typical grocery shopper would buy.
• Social withdraw—Food bonds friends and family. The preference to eat alone, as well as the stress of the disorder, leads to social withdraw and isolation.
• Frequent dieting—Frequent dieting can precede or follow an episode of binge eating. However, dieting does not always result in weight loss.
• Abnormal eating habits—Eating might appear strange. For example, engaging in food rituals, excluding certain food groups, or skip meals between binges.

8 Physical Symptoms of Binge Eating Disorder

While binge eating disorder is a mental health condition, it has a profound impact on the physical body. A wide variety of symptoms arise from excessively overeating, as well as the psychological consequences like anxiety and depression.

• Frequent weight fluctuations—Episodes of overeating and dieting causes weight gain followed by yo-yo-ing weight loss.
• Obesity—Massive weight gain beyond what is healthy and increases the risk of medical conditions (i.e. diabetes, high cholesterol, etc.)
• Heart complications—Weight fluctuations and malnutrition damage the heart. Someone with binge eating disorder might experience heart disease, arrhythmias, a fast heart rate, dizziness, and fainting.
• Sleep apnea—A sleep disorder marked by repeated pauses in breathing while asleep
• Dry skin and hair—Skin, hair, and nails weaken, especially when binging on junk foods. The skin is prone to acne.
• Hormonal imbalances—Attempting to overcome the physical stress of binge eating, the body cannot properly regulate hormones. This causes a lack of sex drive and irregular menstruation.
• Gastrointestinal ailments—Overeating leads to abdominal pain, bloating, nausea, reflux, and changes in bowel habits like diarrhea and/or constipation
• Fatigue—Improper nutrition leaves someone with binge eating disorder feeling exhausted or sluggish throughout the day.

Diagnosing Binge Eating Disorder

No laboratory tests can confirm the diagnosis of binge eating disorder. However, a thorough physical and psychological evaluation is warranted if a physician suspects their patient of having the disorder. The evaluation includes blood, urine, and cardiovascular tests to determine whether someone suffers from vitamin deficiencies, electrolyte imbalances, liver disorders, and malnutrition as a result of the eating disorder. The patient will likely be referred to a psychologist or mental health professional who are experts in mental disorders.

To receive a diagnosis of binge eating disorder, the DSM-5 outlines a set diagnostic criteria (Bulik et al., 2007):

1. Persistent episodes of binge eating accompanied by a loss of sense of control
2. Binge eating episodes include three or more of the following:
   • Eating rapidly
   • Eating until uncomfortably full
   • Eating when not physically hungry
   • Feeling depressed, guilty, or disgusted after overeating
   • Eating alone out of embarrassment by the large quantities of food consumed
3. Distress after eating
4. Absence of compensatory behaviors (i.e. purging, laxative abuse, etc.)

Causes of Binge Eating Disorder

Experts are not entirely sure the causes of binge eating disorder, but both environmental and genetic factors play a role. The risk of developing the disorder is higher amongst families. There is evidence that binge eating disorder is hereditable due to genetic mutations. These genes affect appetite and mood because they alter chemical messages in the brain.

An environmental upbringing is also a component. Binge eating often follows periods of stress. It is not uncommon for binge eating disorder to develop from poor body image and traumatic events such as abuse. The attitudes regarding food and physical appearance can influence the disorder too.  

How Binge Eating Disorder Impacts the Nervous System

Appetite stimulation and hunger are two processes controlled by a part of the brain known as the hypothalamus. The hypothalamus regulates the release of vital hormones like leptin, ghrelin, and ortexin that regulate appetite and other bodily processes. The effects of binge eating disorder go on to affect cognitive functioning. Those with binge eating disorder are suspected to have decreased sensitivity to the reward and motivation receptors, which underlies their compulsion to over eat. Instead, they find it difficult to refrain from the impulsivity compelling them to binge eat.

Binge Eating Disorder Versus Anorexia Nervosa

Binge eating disorder is the most common eating disorder in the United States. Despite its frequency in the general population, many confuse the disorder with anorexia nervosa or bulimia nervosa.

Anorexia nervosa is a form of eating disorder characterized by an obsessive fear of gaining weight accompanied by a distorted body image and weight loss. The desired weight loss is obtained by starvation or exercise. In contrast to the excessive food consumption of binge eating disorder, an individual with anorexia is so fearful of gaining weight that they refuse to eat. Additionally, those with anorexia nervosa are underweight, while those with binge eating disorder are overweight and some even have a healthy body mass index (BMI).

Perhaps the biggest difference between anorexia nervosa and binge eating disorder are compensatory behaviors. Binge eating disorder does not include behaviors to offset overeating, but behaviors such as over-exercising and laxative abuse are typical of an anorexia nervosa diagnosis.

Binge Eating Disorder Versus Bulimia Nervosa

Bulimia nervosa is a type of eating disorder recognized by episodes of binge eating followed by compensatory behaviors to avoid gaining weight. Like anorexia, bulimia has the irrational fear of weight gain. The disorder is similar to binge eating disorder, but includes the presence of purging, fasting, laxative abuse, or excessive exercise after a binge eating episode.

Psychiatric Diagnoses Common In Binge Eating Disorder

Binge eating disorder is associated with other psychiatric comorbidities. In some cases, the mental disorder  is pre-existing before the binge eating disorder diagnosis. Other times, individuals with binge eating disorder develop additional mental illness later. Depression, anxiety, bipolar disorder, and substance abuse disorder are the most prevalent.

Depression and Anxiety

Depression is a mood disorder marked by persistent, unexplained sadness lasting 2 or more months. The disorder causes low mood, a loss of interest in activities, apathy, and feelings of hopelessness. Anxiety is also a mental health disorder in which fear and worry disproportionate to the situation interferes with daily life. Both disorders are the most common mental health conditions seen along with binge eating disorder. Depression and anxiety increases the chance of binge eating to cope with emotional stress, while binge eating disorder increases the likelihood of anxiety and depression triggered by feelings of guilt and shame, negative body image, and social isolation.

Bipolar Disorder

Bipolar disorder is a mood disorder characterized by extreme fluctuations in mood ranging from depressive lows to manic highs. Bipolar disorder and binge eating disorder are commonly seen together. For example, research by University of Minnesota indicates that “bipolar patients who binge eat are more likely to have other mental health issues such as suicidal thoughts, psychosis, anxiety disorders and substance abuse” (2013). Symptoms of either condition influence the other, as patients are more likely to experience an episode of binge eating when symptoms of their bipolar disorder are flaring.

Substance Abuse Disorder

Substance abuse disorder is the abuse of substances (i.e. alcohol, nicotine, marijuana, and illegal substances) that interferes with  health, relationships, and/or work. Studies show that those with both disorders share similar personality traits, as participants published in the Journal of Behavioral Addictions (2013) show equally high measures of impulsivity, sensation seeking, and emotional dysregulation. Binge eaters turn to food for comfort, which leaves them prone to abusing substances in much the same way.

Binge Eating Disorder Treatment

Binge eating disorder treatment is multi-faceted. Treatment targets the underlying behaviors of binge eating. It also seeks to assist patients in reestablishing healthy lifestyle habits and managing emotional dysregulation through programs and medications. Support from loved ones is crucial during treatment for binge eating disorder.

Psychotherapy

Psychotherapy is the first line treatment for binge eating disorder—specifically cognitive behavioral therapy (CBT). Cognitive behavioral therapy is a form of psychotherapy, or talk therapy, that addresses the unproductive cognitive distortions that underlie the unwanted behavior (i.e. binging). A therapist works with the individual and applies strategies to identify thoughts, feelings, and beliefs underlying binge eating disorder. Therapy also focuses on past trauma that triggers the emotional dysregulation seen in the condition.

Medications

In some cases, medications are used to manage symptoms of binge eating disorder. Pharmaceutical options are most successful when combined with other therapies and programs.

• Stimulants—Stimulants prescribed for attention deficit hyperactivity disorder (ADHD) also have benefits for binge eating disorder because they act as appetite suppressants. Trials of lisdexamfetamine, the first medication approved for binge eating disorder resulted in weight loss by reducing binge eating episodes along with impulsivity.
• Selective serotonin reuptake inhibitors (SSRIs)—Depression and anxiety are common comorbidities of binge eating. Those conditions respond to SSRIs, which are antidepressants that increase the amount of the neurotransmitter, serotonin. Studies (Stefano et al., 2008) reveal that binge eaters taking an SSRI medication are more likely to remain in remission during treatment.
• Anti-convulsants—Anticonvulsants are also called antiepileptics or seizure medications. While there is little research in anticonvulsants for binge eating, scientists have tested the drugs on patients with bulimia nervosa, which has many similarities to binge eating disorder. Anticonvulsants like Topiramate decrease impulsive behaviors in those with eating disorders and that reduces binge eating episodes.

Nutrition and Weight Loss Programs

Nutrition and weight loss programs for binge eating disorder focus on normalizing eating patterns. They train patients on a proper balanced diet, while overseeing that they establish healthy weight loss goals. Components to the programs may include a therapeutic meal, meal planning, as well as advocating for “intuitive eating”—meaning patients are taught to recognize the signs their bodies are giving them in regards to food—and they must eat when hungry and stop when full. These programs implement exercise regimens that are enjoyable to the individual.

Coping Techniques For Binge Eating Disorder

• Have a strong support system—Overcoming binge eating disorder is a process that requires a strong support system from family and loved ones. They help provide support, recognize unhealthy patterns, and ensure the management plan stays on track!
• Keep a meal diary—Logging meals along with the moods that surround them is helpful to identify when and why binges occur.
• Organize the kitchen—Remove foods that are frequently consumed during binges. This makes overeating less likely.  
• Avoid triggers—Episodes of binge eating are typically triggered by negative emotions and stress. The key is to avoid those triggers.
• Reduce stress—Practice mindfulness, do yoga, and receive plenty of rest.  
• Physical activity—Incorporating physical activity is known to reduce stress. However, it is important to only exercise in a healthy manner and to do so without the mentality of dieting.

References

Bulik, C. M., Brownley, K. A., & Shapiro, J. R. (2007). Diagnosis and management of binge eating disorder. World psychiatry : official journal of the World Psychiatric Association (WPA), 6(3), 142–148.

Schreiber, L. R., Odlaug, B. L., & Grant, J. E. (2013). The overlap between binge eating disorder and substance use disorders: Diagnosis and neurobiology. Journal of behavioral addictions, 2(4), 191–198. https://doi.org/10.1556/JBA.2.2013.015

Cheyanne Perry

Cheyanne is currently studying psychology at North Greenville University. As an avid patient advocate living with Ehlers Danlos Syndrome, she is interested in the biological processes that connect physical illness and mental health. In her spare time, she enjoys immersing herself in a good book, creating for her Etsy shop, or writing for her own blog.