If you have a binge eating disorder, you uncontrollably eat excessive amounts of food on a frequent basis. The amount of food consumed is so massive that it causes you distress. The difference between binge eating disorder and bulimia nervosa (also marked by periods of binge eating) is that people with binge eating disorder do not follow up their binge episodes with compensatory methods like regurgitation or laxative use.
Currently binge eating disorder is classified as an “Eating Disorder Not Otherwise Specified” in the Diagnostic and Statistical Manual of Mental Health Disorders fourth Edition (DSM IV).
Diagnostic Criteria for Binge Eating Disorder
Binge eating disorder is not identified as a mental health disorder by the DSM IV. However, it is listed under appendix B as a possible inclusion in future editions of the DSM. Under this appendix, certain diagnostic requirements are outlined.
The general criteria for binge eating disorder is “recurrent episodes of binge eating in the absence if regular inappropriate compensatory behavior characteristic of bulimia nervosa.”
The binge eating episodes are associated with at least three of the following symptoms:
- Rapid eating, eating until uncomfortably full, eating large amounts of food even when not hungry, embarrassment about quantity of food leads one to eat alone, and feeling self-disgust, guilt or depression after an episode
- Distress from the binge eating
- Binge eating that occurs a minimum of 2 days a week for at least 6 months
Diagnosing Binge Eating Disorder
DSM-IV requires at least 2 days of binge eating. An episode of binge eating without the endpoint can be very difficult to identify; the events tend to be unstructured and flow together.
A 2 day requirement for a binge eating diagnosis has little logical or medical basis in diagnosis: there is little difference between a person who binge eats once and one who binge eats for two or more days. Studies consistently show that people diagnosed with binge eating disorder do not lose weight when they reduce the number of days in which binge eating occurs.
Another problem with diagnosing binge eating disorder is that many cases can also be diagnosed as bulimia nervosa. Both bulimics and binge eaters may use extreme methods to control their weight.
Characteristics of Binge Eating Disorder
Your eating habits may be distinctly different from the eating habits of obese people without the disorder and those who suffer from bulimia nervosa. You may have a very chaotic and/or unorganized way of eating such as: periods of binge eating and non-binge eating. In addition, you may be unable to control your eating habits.
While these characteristics can lead to obesity, obesity is not always caused by binge eating disorder. Obese people without binge eating disorder may be consistent in their dietary habits, which may include overeating. Furthermore, obesity is often caused by inadequate exercise in proportion to the amount eaten. Binge eaters enforce extreme control over their weight gain in between episodes of binge eating.
How Prevalent is Binge Eating Disorder?
Because binge eating disorder is such a newly-recognized mental health disorder, it is difficult to get accurate statistics about its prevalence. However, current studies suggest that the prevalence rate approximately 2 – 3% of the general population. Approximately 8% of obese people have a binge eating disorder, although some researchers suggest that the prevalence rate is closer to 20 – 40% for obese and overweight people.
Binge eating disorder is common among men and women, although women are 1.5 times more likely to have this disorder. The majority of people diagnosed with binge eating disorder are 30-50 years old.
Comorbidity and Binge Eating Disorder
If you meet the diagnostic criteria for binge eating disorder typically present with other psychological issues such as a sense of worthlessness and/or social impairment. Approximately 50 – 60% of binge eating cases also involve clinical depression, substance addictions and/or anxiety disorders.
What Treatments are Available for Binge Eating Disorder?
There are several possible treatments for binge eating disorder which have shown effective. In several studies, anti-depressants were significantly effective in helping individuals control their eating habits and reduce the frequency of binge eating occurrences. Serotonin and norepinephrine reuptake inhibitors and anti-consultants have shown effective when treating this disorder.
Cognitive behavioral therapy may also be effective when treating binge eating disorder. The cognitive aspects of therapy can help you identify your unhealthy habits and the behavioral aspects can help you control these habits. Other forms of therapy such as group therapy for overeaters has proven effective in treating binge eating disorder.
American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.
Grilo, C. M. (2002). Eating disorders and obesity: a comprehensive handbook. New York: The Guildford Press.