Binge eating disorder (BED) is a treatable condition.
Types of Eating Disorders
There are many types of eating disorders classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and recognized by the National Institute of Mental Health. Eating disorders cause “serious disturbances to your everyday diet”, and can include a range of behaviors between overeating and eating too little. This type of illness is often combined with “severe distress or concern about body weight or shape”. The most common eating disorders are “anorexia nervosa, bulimia nervosa, and binge-eating disorder”. In anorexia, patients are emaciated, unwilling to maintain a healthy weight, and have a distorted body image that leads to severely restricted eating. Many medical factors can result, such as lack of menstruation, osteoporosis, brittle nails and hair, anemia, organ failure, and more. In the case of bulimia, patients ingest very large amounts of food, followed by “forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination”. Bulimics may even have a healthy weight or be overweight, but they share the desire to lose weight and are unhappy with their bodies, much like anorexics. As a result, those with bulimia can have inflamed throats, worn enamel on the teeth, acid reflux, intestinal issues, dehydration, and the potential for heart attacks, due to the electrolyte imbalance. Binge-eating disorder is discussed below. There are many factors involved with the causes of these illnesses, including genetic, behavioral, biological, social, and psychological factors. Scientists are working to determine if there is a link to “DNA variations”. Brain activity is also studied by researchers in order to better understand and potentially treat these issues. Other studies examine types of psychotherapeutic treatment. For example, it was found that “more adolescents with bulimia…recovered after receiving Maudsley model family-based treatment” vs. “psychotherapy that did not specifically address the eating disorder”.1
What is Binge Eating Disorder?
Unlike bulimia, where binging is followed by purging, binge eating disorder (BED) is characterized by just the binging episodes. Historically, it was called “night eating syndrome”, but now BED is not classified by just nocturnal eating. While anorexia nervosa and bulimia are more well-known, BED is “one of the most prevalent eating disorders among adults”, gaining its own recognition in the DSM-5. In order to be diagnosed, patients need to have “recurrent episodes of binge eating”. Binging is defined as eating a larger amount of food than most people would eat within a certain time period (such as a two-hour window), as well as “lack of control over eating”. Binge eating must include at least three of the following features: eating rapidly, feeling overly full, eating large amounts of food despite lack of hunger, eating alone out of embarrassment, and a feeling of guilt or disgust afterward. Patients with BED are distressed over their binges, which occur “at least once a week for 3 months”. Binge eating may occur without the presence of a disorder, such as when people occasionally engage in binging without experiencing the social, psychological, or physical effects of BED. It is possible that binge eating is a result of people who recover from rigid eating or dieting practices. Trauma and environmental factors may also contribute to BED. Stressors such as physical abuse, body criticism, sexual abuse, depression, low self-esteem, and childhood obesity may also contribute to the development of this disorder. There could also be a genetic relationship.2
BED vs. Other Disorders and Prevalence
Binge eating disorder is “more common than anorexia nervosa or bulimia nervosa”. Even though eating disorders generally have impacted women twice as often, BED is “an ‘equal opportunity disorder’”, and it also “does not discriminate with regard to race”. While there are similarities between BED and bulimia, patients with binge eating disorder do not purge, and the illness does not coexist with bulimia or anorexia. There is also a difference, according to professionals, between binge eating and overeating. BED also differs from emotional eating, having a craving, holiday overeating, and compulsive eating. This disorder is treatable, with the goals including a decrease or stop to the binge episodes, maintaining a healthy weight, treatment of any other psychiatric disorders, and the correction of “self-defeating thoughts…that trigger a binge”.3 The prevalence of BED is about “1-3%” in the “general population”, but in those with obesity, it is about “25% or more”. Being obese, however, does not necessarily mean that the person has binge eating disorder.4
Treatment Options for BED
There are many professionals who treat BED, including nutritionists, psychiatrists, psychologists, physicians, and social workers. There are even group therapies and 12-step programs. The main treatment for binge eating disorder is cognitive behavioral therapy (CBT), and “psychotherapy and behavioral interventions are more effective than pharmacological interventions”. In terms of medication, however, Vyvanse (lisdexamfetamine), has been FDA-approved for BED. Some patients are prescribed anticonvulsants, antidepressants, or anti-obesity medications. Medications often carry risks and side-effects.5 Patients with BED experience anxiety, worthlessness, shame, or anger before binges, with the initiation of a binge meant to numb these feelings. Body size disgust is typical, and depression may co-occur in patients. In addition, the person affected may have rigid, inflexible thinking, a need for control, trouble expressing feelings, perfectionism, a strong need to please others, and may try to avoid conflict. Their weight may range from normal to obese. It is important to treat BED, and resources may be found through the National Eating Disorders Association (NEDA). Without treatment, obesity, high cholesterol, heart disease, diabetes, gallbladder disease, high blood pressure, and musculoskeletal problems can result.6 Other conditions that may develop from obesity include certain cancers, osteoarthritis, gastrointestinal problems, and sleep apnea.7 There is also a “social stigma of BED”, but it is “a real diagnosis” and is not the same as occasionally overeating. Aside from CBT, patients may also benefit from “ interpersonal therapy (IPT), dialectical behavioral therapy (DBT), and pharmacotherapy”. Before seeking treatment, it is crucial to consult a healthcare professional, especially one specializing in eating disorders.8 Some alternative treatment options for BED are exercise, yoga, meditation, massage therapy, and chiropractic care. These can be useful in reducing the stress which tends to trigger binges. In terms of self-care, patients should learn about how to eat more healthily, perhaps from a nutritionist. Healthcare professionals might need to treat co-occurring high cholesterol, diabetes, or other medical conditions. Patients may have to lose weight or limit certain foods. In the process, they need to learn how to do so without triggering binges. Their relationship with food has to change, with the goal of the patients becoming healthier. The cycle of binge eating can be overcome, and it is important that those with BED have patience with themselves during recovery instead of engaging in self-blame.9 Another organization that provides information to patients is the Binge Eating Disorder Association (BEDA). BEDA notes that patients, in additional to psychotherapy, nutrition counseling, and medication options, may benefit from support groups, family or couples therapy, and education and support for family members. Some of the additional alternative therapies are movement classes, psychodrama, art therapies, and equine therapy. BEDA indicates that “treatment providers must also be trained…if applicable…in the neurology of trauma and…trauma resolution”, in addition to psychotherapy. Treatment that is “evidence-based” includes “cognitive behavioral therapy, mindfulness based interventions, Internal Family Systems therapy, and psychodynamic psychotherapy”.10
Learn more about chiropractic care and eating disorders.