BINGE EATING DISORDER

Binge eating disorder (BED) is a type of feeding and eating

disorder that’s now recognized as an official diagnosis. It
affects almost 2% of people worldwide and can cause
additional health issues linked to diet, such as high cholesterol
levels and diabetes.

Feeding and eating disorders are not about food alone, which
is why they’re recognized as psychiatric disorders. People
typically develop them as a way of dealing with a deeper issue
or another psychological condition, such as anxiety or
depression.
People with BED may eat a lot of food in a short
amount of time, even if they aren’t hungry. Emotional
stress or de-stress often plays a role and might trigger
a period of binge eating.

A person might feel a sense of release or relief during

a binge but experience feelings of shame or loss of
control afterward.

People with BED often experience feelings of

extreme unhappiness and distress about their
overeating, body shape, and weight
For a healthcare professional to diagnose BED, three or
more of the following symptoms must be present:

eating much more rapidly than normal

eating until uncomfortably full

eating large amounts without feeling hungry

eating alone due to feelings of embarrassment and shame

feelings of guilt or disgust with oneself

 CAUSES
BODY
GENETICS
SIZE

OTHER
PSYCHOLOGICA
EMOTIONA
L CONDITIONS L TRAUMA

BODY
GENDER
IMAGE

BINGE CHANGES IN
EATING THE BRAIN
 HEALTH RISKS
BED is associated with several significant physical,
emotional, and social health risks.

Up to 50% of people with BED have obesity. However,

the disorder is also an independent risk factor for
gaining weight and developing obesity. This is due to
the increased calorie intake during binging episodes. On
its own, obesity increases the risk of heart disease,
stroke, type 2 diabetes, and cancer.
However, some studies have found that people with BED
have an even greater risk of developing these health
problems, compared with people with obesity of the same
weight who don’t have BED.

Other health risks associated with BED include sleep

problems, chronic pain conditions, asthma, and
irritable bowel syndrome (IBS)
In women, the condition is associated with a risk of
fertility problems, pregnancy complications, and the
development of polycystic ovary syndrome (PCOS).

Research has shown that people with BED report

challenges with social interactions, compared with
people without the condition.
Additionally, people with BED have a high rate of
hospitalization, outpatient care, and emergency
department visits, compared with those who don’t
have a feeding or eating disorder.

Although these health risks are significant, there are a

number of effective treatments for BED.
 DIAGNOSIS
While some people may occasionally overeat, such as at
Thanksgiving or a party, it does not mean they have BED,
despite having experienced some of the symptoms listed
above.
BED typically starts in the late teens to early twenties,
although it can occur at any age. People generally need
support to help overcome BED and develop a healthy
relationship with food. If left untreated, BED can last for
many years.
To be diagnosed, a person must have had at least one
binge eating episode per week for a minimum of three
months.
The severity ranges from mild, which is characterized
by one to three binge eating episodes per week, to
extreme, which is characterized by 14 or more episodes
per week.

Another important characteristic is not taking action to

“undo” a binge. This means that, unlike bulimia, a
person with BED does not throw up, take laxatives, or
over-exercise to try and counteract a binging episode.

Like other eating disorders, it’s more common in women

than men. However, it’s more common among men than
other types of eating disorders.
 TREATMENT
The treatment plan for BED depends on the causes and severity
of the eating disorder, as well as individual goals.
Treatment may target binge eating behaviors, excess weight,
body image, mental health issues, or a combination of these.
Therapy options include cognitive behavioral therapy,
interpersonal psychotherapy, dialectical behavior therapy, weight
loss therapy, and medication. These may be carried out on a one-
to-one basis, in a group setting, or in a self-help format.
In some people, just one type of therapy may be required, while
others may need to try different combinations until they find the
right fit.
A medical or mental health professional can provide advice on
selecting an individual treatment plan.
 Cognitive behavioral therapy:
Cognitive behavioral therapy (CBT) for BED focuses on
analyzing the relationships between negative thoughts,
feelings, and behaviors related to eating, body shape, and
weight. Once the causes of negative emotions and
patterns have been identified, strategies can be developed
to help people change them.
Specific interventions include setting goals, self-
monitoring, achieving regular meal patterns, changing
thoughts about self and weight, and encouraging healthy
weight-control habits.
  Interpersonal psychotherapy
Interpersonal psychotherapy (IPT) is based on the idea that
binge eating is a coping mechanism for unresolved personal
problems such as grief, relationship conflicts, significant life
changes, or underlying social problems.
The goal is to identify the specific problem linked to the
negative eating behavior, acknowledge it, and then make
constructive changes over 12–16 weeks.
Therapy may either be in a group format or on a one-to-one
basis with a trained therapist, and it may sometimes be
combined with CBT.
It is the only other therapy with long-term outcomes as good
as CBT. It may be particularly effective for people with more
severe forms of binge eating and those with lower self-esteem.
 Dialectical behavior therapy
Dialectical behavior therapy (DBT) views binge eating as
an emotional reaction to negative experiences that the
person has no other way of coping with.
It teaches people to regulate their emotional responses so
that they can cope with negative situations in daily life
without binging.
The four key areas of treatment in DBT are mindfulness,
distress tolerance, emotion regulation, and interpersonal
effectiveness.
 Weight loss therapy
Behavioral weight loss therapy aims to help people
lose weight, which may reduce binge eating behavior
by improving self-esteem and body image.
The intent is to make gradual healthy lifestyle changes
in regards to diet and exercise, as well as monitor food
intake and thoughts about food throughout the day.
Weight loss of about 1 pound (0.5 kg) per week is
expected.While weight loss therapy may help improve
body image and reduce weight and the health risks
associated with obesity, it has not been shown to be as
effective as CBT or IPT at stopping binge eating.
  Medications
Several medications have been found to treat binge eating
and are often cheaper and faster than traditional therapy.
However, no current medications are as effective at treating
BED as behavioral therapies.
Available treatments include antidepressants, antiepileptic
drugs like topiramate, and drugs traditionally used for
hyperactive disorders, such as lisdexamfetamine.
In addition, side effects of treatment may including
headaches, stomach problems, sleep disturbances,
increased blood pressure, and anxiety.
Because many people with BED have other mental health
conditions, such as anxiety and depression, they may also
receive additional medications to treat these.
HOW TO OVERCOME
BINGING
The first step in overcoming binge eating is speaking to a
medical professional. This person can help with a
diagnosis, determine the severity of the disorder, and
recommend the most appropriate treatment.
In general, the most effective treatment is CBT, but a
range of treatments exists. Depending on individual
circumstances, just one therapy or a combination may
work best.
No matter which treatment strategy is used, it is
important to also make healthy lifestyle and diet choices
when possible.
Here are some additional helpful strategies:
Keep a mood
and mood
diary

Start
Practice
exercising, take
good sleep mindfullness

Find
Choose
someone to
healthy foods
talk to
10 Clever Ways to Stop Eating Late at Night
Identify the Cause
Some people eat most of their food late in the evening or
during the night. To change this habit, you need to identify
the cause of the problem. Nighttime eating may be the
result of overly restricted daytime food intake, leading to
ravenous hunger at night. It may also be caused by habit
or boredom.
However, nighttime eating has also been linked to some
eating disorders, including binge eating disorder and night
eating syndrome. These two disorders are characterized by
different eating patterns and behaviors, but can have the same
negative effects on your health. In both, people use food to
curb emotions such as sadness, anger or frustration, and they
often eat even when they are not hungry.

Binge eaters also tend to eat very large amounts of food in

one sitting and feel out of control while they are eating. On
the other hand, people with nighttime eating syndrome tend to
graze throughout the evening and wake up during the night to
eat, consuming more than 25% of their daily calories at night.
Both conditions have been linked to obesity, depression and
trouble sleeping.
Identify Your Triggers:
As well as identifying the overall cause of your overeating, you
may find it useful to look for a specific pattern of events that
usually sets off your eating behavior. People reach for food for
many reasons. If you’re not hungry but nonetheless find
yourself eating at night, think about what led up to it. Often you
will find you are using food to meet a need that isn’t hunger.
With nighttime eating syndrome, your entire eating pattern may
be delayed due to your lack of daytime hunger.
One effective way to identify the cause of your nighttime eating
and the things that trigger it is to keep a “food and mood” diary.
Tracking your eating and exercise habits alongside your feelings
will help you identify patterns, enabling you to work on
breaking any negative cycles of behavior.
Use a Routine:
If you’re overeating because you aren’t eating enough during
the day, then getting yourself into a routine can help.
Structured eating and sleeping times will help you spread
your food intake over the day so that you’re less hungry at
night.
Getting good sleep is very important when it comes to
managing your food intake and weight.
Lack of sleep and short sleep duration have been linked to
higher calorie intakes and poor-quality diets. Over a long
period of time, poor sleep can increase your risk of obesity
and related diseases.
Having set times for eating and sleeping can help you
separate the two activities, especially if you are prone to
waking in the night to eat.
Plan Your Meals:
As part of your routine, you may also benefit from
using a meal plan.
Planning your meals and eating healthy snacks can
reduce the chances that you will eat on impulse and
make poor food choices.
Having a meal plan can also reduce any anxiety about
how much you are eating and help you spread your
food throughout the day, keeping hunger at bay.
Seek Emotional Support:
If you think you may have nighttime eating syndrome or
binge eating disorder, then you may want to seek
professional help.
A professional can help you identify your triggers and
implement a treatment plan.
These plans often use cognitive behavioral therapy (CBT),
which has been shown to help with many eating disorders.
Creating an emotional support network will also help you
find ways to manage negative emotions, which otherwise
might lead you to the fridge
De-Stress:
Anxiety and stress are two of the most common reasons
why people eat when they aren’t hungry. However, using
food to curb your emotions is a bad idea.
If you notice that you eat when you are anxious or stressed,
try to find another way to let go of negative emotions and
relax.
Relaxation techniques you may find useful include
breathing exercises, meditation, hot baths, yoga, gentle
exercise or stretching.
Eat Regularly Throughout the Day:
Overeating at night has been linked to erratic eating patterns
that can often be categorized as disordered eating. Eating at
planned intervals throughout the day in line with “normal”
eating patterns can help keep your blood sugar stable.
It can also help prevent feelings of ravenous hunger,
tiredness, irritability or a perceived lack of food, which can
lead to a binge. When you get really hungry, you are more
likely to make poor food choices and reach for high-fat, high-
sugar junk foods. Generally speaking, eating less than 3 times
per day is thought to reduce your ability to control your
appetite and food choices. However, it’s important to note
that results in this area have been mixed.
Distract Yourself:
If you are preoccupied with thoughts of food because
you’re bored, then find something else you enjoy doing in
the evening.
This will help keep your mind occupied.
Finding a new hobby or planning evening activities can
help prevent mindless late-night snacking.
Include Protein at Every Meal:
Different foods can have different effects on your appetite.
If you eat due to hunger, including protein at every meal may
help curb your hunger.
It could also help you feel more satisfied throughout the day,
stop you from being preoccupied with food and help prevent
snacking at night.
People with compulsive overeating typically eat excessive
amounts of food—but not because they’re hungry. Instead, they
eat to feel better, to feel happy. The opposite happens. They feel
a loss of control, as if they have no willpower. And the eating
begins again.
People with compulsive overeating may sometimes eat in
binges, but they may also engage in “grazing” behavior, picking
at food throughout the day. They may
excessively dwell on thoughts about food, sometimes secretly
fantasizing about eating and contriving ways to eat alone.
Compulsive overeating often leads to weight gain, but people of
all sizes can struggle with it. Psychological illnesses as well as
physical medical conditions, such as diabetes, hypertension, and
heart disease, often add complexity to the unhealthy behavior.
Compulsive overeating describes a behavior of excessive
food consumption with a lack of hunger. People with
compulsive overeating may sometimes eat in binges
where they consume copious amounts of food in a short
period of time or they may engage in grazing behavior.
This grazing behavior is when individuals constantly pick
at food during the day but are not hungry. Individuals who
compulsively overeat may excessively dwell on thoughts
about food and may even secretly fantasize about eating
and create circumstances where they can eat alone.
 CAUSES
Compulsive overeating is a form of disordered eating,
which means that a combination of genetics,
psychological issues and socio-cultural factors generally
contribute to the cause of this behavior.

Because many people struggling with overeating are of

normal or higher weights, they often don’t realize their
overeating and co-occurring weight issues stem from
emotional issues.
 WARNING SIGNS
Weight gain

Depression

Anxiety

Feelings of guilt or shame

Post-traumatic stress disorder

Personality disorder

Withdrawal from social situations or events

Fatigue
 SIGN & SYMPTOMS
Eating what most people would think is an unusually large
amount of food
Eating much more quickly than usual, or eating slowly and
consistently throughout the day and/or night
Eating past satiety or until feeling uncomfortably full
Eating despite feeling full or not feeling hungry at all
Eating alone due to shame or embarrassment about the quantity
of food consumed
Feeling disgusted, depressed or guilty after overeating
Night eating
Impulsive eating
Compulsive food behaviors like hiding food and eating food out
of the garbage
Binge eating
 TREATMENT
It is important for an individual who is compulsively eating to
speak with an eating disorder treatment provider. This
conversation can shed light on whether the compulsive
overeating is associated with bulimia, binge eating disorder, or
possibly OSFED. 
Individuals often turn to compulsive eating in order to
assuage negative emotions, to fill a void, or to cope with daily
triggers and stressors. Those that suffer often experience
negative self-talk, negative self-perception, and often other
mental health disorders such as anxiety or depression.
In addition, it noted that desirable foods that do not live up to
expectations may cause an individual to consume more in
hopes of increasing the volume of pleasure upon
consumption. 
Often, those who suffer from compulsive overeating
benefit from:

Individual therapy

Group therapy

Nutrition evaluation and counseling

Medical care

Integrative interventions such as yoga and art

Purging disorder is an eating disorder that involves
“purging” behavior to induce weight loss or manipulate
body shape.
Purging can mean a number of things, including:

self-induced vomiting

misuse of laxatives or medications

excessive exercise

fasting
While it’s not as well-known as other eating disorders,
purging disorder is a recognized eating disorder. It’s
categorized as an “Other Specified Feeding or Eating
Disorder.”

Purging disorder is defined as engaging in purging

behaviors without it being in response to a binge-eating
episode.
 CAUSES
Higher weight or body mass index (BMI)
Fear of gaining weight
A focus on being thin
Unhappiness or frustration with their body
A history of dieting to lose weight
Feelings of losing control over their eating even if they
don't eat too much
Less care from their mother while growing up
 WARNING SIGN & SYMPTOMS
Comments or behaviors that show a lot of worry about food,
dieting, or weight loss
Frequent trips to the bathroom
Signs or smells of vomiting
Cuts or calluses on hands from forced vomiting
Dental problems or sensitive teeth
Frequent use of mouthwash, mints, or gum
Wrappers from laxatives or diuretics
 SYMPTOMS
recurring episodes of purging behaviors to lose weight,
including:
self-induced vomiting
laxative or diuretic misuse
misuse of enemas
fasting
excessive exercise
significant emotional distress or disruption to social, work,
or personal life
fear of gaining weight or obsession with losing weight
self-esteem issues heavily influenced by body shape or
weight
 SIDE- EFFECTS
feeling faint
tooth decay
throat swelling
facial swelling
mood swings
irregular heartbeat and other heart problems
scarred hands
pregnancy complications
kidney failure
digestive issues or constipation
dehydration
nutrient deficiencies
electrolyte or chemical imbalances
Self-induced vomiting can also lead to severe damage to
other areas of your body over time, including your:

Teeth
esophagus
digestive system
cardiovascular system
 TREATMENT
Treatment for purging disorder can vary based on each person.
Some people may benefit from more intensive inpatient
treatment and recovery programs, while others might prefer
outpatient therapy options.
Inpatient treatment is more common in cases that require
medical monitoring or daily assessments. Outpatient treatment
might include psychotherapy and nutrition counseling.
Medications aren’t used to treat purging disorder. Rather, they
may be prescribed to treat concurrent mood disorders that may
be causing additional stress or making it harder to cope with
recovery.
Talk with your doctor about medication options.
A condition where a
person spits up food
from the stomach,
rechews it and either
swallows it again or
spits it out. It tends to
occur within 30
minutes of every
meal. The cause is
unknown.
Rumination disorder, also known as
rumination syndrome, is a rare and
chronic condition. It affects infants,
children, and adults.

People with this disorder regurgitate

food after most meals. Regurgitation
occurs when recently ingested food
rises into the esophagus, throat, and
mouth, but isn’t involuntarily or
forcefully expelled from the mouth as
it is in vomiting.
 RISK FACTORS
Rumination disorder can affect anyone, but it’s most
commonly seen in infants and children with intellectual
disabilities.
Factors that may increase the risk of rumination disorder in
both children and adults include:

having an acute illness

having a mental illness
experiencing a psychiatric disturbance
undergoing major surgery
undergoing a stressful experience
 CAUSES
Regurgitation is thought to be unintentional, but the
action required to regurgitate is likely learned.
For example, someone with rumination disorder may
unknowingly never have learned how to relax their
abdominal muscles.
Contracting the diaphragm muscles can lead to
regurgitation.
 SYMPTOMS
The main symptom of this disorder is the repeated regurgitation
of undigested food. Regurgitation typically occurs between a
half hour to two hours after eating. People with this condition
regurgitate every day and after almost every meal.

Other symptoms may include:

bad breath
weight loss
stomach aches or indigestion
tooth decay
dry mouth or lips
 DIAGNOSIS
There’s no test for rumination disorder.
Physical exam
Medical history.
A diagnosis is mostly based on the signs and symptoms you
describe.
People with rumination disorder often don’t have other
symptoms such as true vomiting or an acid sensation or taste
in their mouth or throat.
Certain tests may be used to rule out other medical
conditions.
For instance, blood tests and imaging studies might be used
to rule out gastrointestinal disorders.
 TREATMENT
Treatment for rumination disorder is the same in both
children and adults. Treatment focuses on changing the
learned behavior responsible for regurgitation

Diaphragmatic breathing training:

It involves learning how to breathe deeply and relax the
diaphragm.
Regurgitation cannot occur when the diaphragm is relaxed.
Apply diaphragmatic breathing techniques during and right
after meals. Eventually, rumination disorder should disappear.
Other treatments for rumination disorder can include:

changes in posture, both during and right after a meal

removing distractions during meal times
reducing stress and distractions during meal times
psychotherapy
There is currently no medication available for rumination
disorder
`