Binge Eating

Binge eating disorder (BED) is more than an occasional over indulgence on your favorite food.

It is characterized by regular overeating – as many as two or more times per week – followed by an intense sense of shame and guilt. This may be followed by periods of normal eating and dieting. The difference is that the urge to overeat will resurface and a cycle of feeling out control of eating continues, despite an individual’s’ desire to quit the behavior.

A person’s report of feeling “out of control” while eating along with at least three of the following symptoms are proposed for meeting diagnostic criteria for (BED):

  • Eating much more rapidly than normal
  • Eating until uncomfortably full
  • Eating large amounts of food, even when not physically hungry
  • Eating alone out of embarrassment at the quantity of food being eaten
  • Feelings of disgust, depression, or guilt with overeating.

These behaviors must occur 2 times per week over the course of 6 months with no compensatory behaviors (purging, laxatives or other inappropriate means to compensate for overeating). If the compensatory behaviors are present the diagnostic criteria is met for Bulimia Nervosa.

What constitutes an episode of binge eating?

A binge is considered the consumption of excessive amounts of food over a short period of time, about two hours. In some cases a binge can last for an entire day and total more than 20,000 calories (a normal day’s diet is between 1,500 and 3,000 calories).

How does Binge Eating Disorder differ from compulsive overeating?

There is some overlap in eating behavior, however compulsive overeaters can also be “grazers” who will return to pick at food all day, but may not necessarily consume a large quantity of food at any given setting. The overall consumption of calories is extremely high, but spaced out over the course of the day and night. Individuals often spend enormous amounts of time thinking about food and fantasizing about eating.

Treatment of BED and compulsive overeating often includes a comprehensive approach of targeting biological, psychological and social factors. These include individual psychotherapy, group psychotherapy, psycho-educational and skills group, psychotropic medication, nutrition counseling, and an exercise wellness program. Treatment targets thoughts and feelings that lead to the behavior and serve to maintain the continuation of maladaptive eating patterns. Interpersonal skills and emotional regulation skills help to improve coping in more adaptive ways and promote healthy forms of communication and assertiveness skills. The development of self-control and self-efficacy in handling emotional and interpersonal problems in effective, non-destructive ways promotes self-esteem. The danger of treating this disorder with another FAD diet, diet pills, or worse viewing it as simply a character defect is likely to promote the continuation of the illness by not addressing the emotional and psychological components of the behavior.