Dr Zana Marovic, Phd

Clinical Psychologist, Johannesburg

Binge Eating Disorder

Binge Eating Disorder

The key features of binge eating disorder are:

  • Frequent episodes of uncontrollable binge eating
  • Feeling extremely distressed or upset during or after bingeing
  • No regular attempts to “make up” for the binges through vomiting, fasting, or over exercising.

People with binge eating disorder struggle with feelings of guilt, disgust, and depression. They worry about what the compulsive eating will do to their bodies and beat themselves up for their lack of self-control. They desperately want to stop binge eating, but they feel like they can’t.

Unlike other eating disorders, which primarily occur in women, binge eating disorder also affects a significant number of men. Binge eating usually begins in late adolescence or early adulthood, often after a major diet. But most people don’t seek help until much later when weight gain from their binge eating is causing health problems.


Emotional eating and food addiction

It’s common to turn to food for comfort but when eating becomes the main strategy for managing emotions and dealing with stress, it can develop into an unhealthy and uncontrollable food “addiction.”

Signs of Emotional Eating

Using food to:

  • fill a void in your life
  • feel better or cheer yourself up
  • calm down or soothe your nerves
  • escape from problems
  • cope with stress and worries
  • reward yourself

People with binge eating disorder suffer from this psychological food addiction. Like the alcoholic that can’t say no to a drink, they can’t say no to food. Often, their binge eating is triggered by a depressed or anxious mood, but they may also overeat when they’re tense, lonely, or bored. They eat to feed their feelings, rather than their bodies.

The problem is that emotional eating doesn’t solve anything. It may be comforting for a brief moment, but then reality sets back in, along with regret and self-loathing. Emotional eating also leads to problems of its own—including weight gain and obesity.

Unfortunately, weight gain only reinforces compulsive eating. It’s not that people with binge eating disorder don’t care about their bodies; they agonize over their ballooning weight. But the worse they feel about themselves and their appearance, the more they use food to cope. It becomes a vicious cycle: eating to feel better, feeling even worse, and then turning back to food for relief.


Signs and symptoms of binge eating disorder

Behavioral symptoms of binge eating and compulsive overeating
  • Inability to stop eating or control what you’re eating
  • Rapidly eating large amounts of food
  • Eating even when you’re full
  • Hiding or stockpiling food to eat later in secret
  • Eating normally around others, but gorging when you’re alone
  • Eating continuously throughout the day, with no planned mealtimes
Emotional symptoms of binge eating and compulsive overeating
  • Feeling tension that is only relieved by eating
  • Embarrassment over how much you’re eating
  • Feeling numb while bingeing—like you’re not really there or you’re on auto-pilot.
  • Never feeling satisfied, no matter how much you eat
  • Feeling guilty, disgusted, or depressed after overeating
  • Desperation to control weight and eating habits
The difference between binge eating disorder and bulimia

Binge eating disorder is similar to bulimia in that both eating disorders involve consuming massive amounts of food in a short time period. But unlike bulimics, binge eaters DO NOT regularly try to purge or work off the extra calories consumed. People with binge eating disorder may occasionally try to fast or restrict calories, but many have given up all dieting efforts due to a long history of repeated failure.


Causes of binge eating and compulsive overeating

Most experts believe that it takes a combination of things to develop an eating disorder — including a person’s genes, emotions, and experience.

Biological causes of binge eating disorder

Studies show that biological abnormalities contribute to binge eating. For example, the hypothalamus (the part of the brain that controls appetite) may not be sending correct messages about hunger and fullness. Researchers have also found a genetic mutation that appears to cause food addiction. Finally, there is evidence that low levels of the brain chemical serotonin play a role in compulsive eating.

Psychological causes of binge eating disorder

Depression and binge eating are strongly linked. Apparently up to half of all binge eaters are either depressed or have been before. There is further evidence that low self-esteem, loneliness, and body dissatisfaction are involved in compulsive overeating. People with binge eating disorder may also have trouble with impulse control and managing and expressing their feelings.

Social and cultural causes of binge eating disorder

Social pressure to be thin can add to the shame binge eaters feel and fuel their emotional eating. The way one is raised can also increase the risk for binge eating disorder. Some parents unwittingly set the stage for bingeing by using food to comfort, dismiss, or reward their children. Children who are exposed to frequent critical comments about their bodies and weight are also vulnerable. Another factor which has been linked to binge eating is sexual abuse in childhood.


Effects of binge eating disorder

Binge eating leads to a wide variety of physical, emotional, and social problems. People with binge eating disorder report more health issues, stress, insomnia, and suicidal thoughts than people without an eating disorder. Depression, anxiety, and substance abuse are common side effects as well. Binge eating also interferes with a person’s
relationships and career. For example, you may skip work, school, or social activities in order to binge eat. But the most prominent effect of binge eating disorder is weight gain.

Obesity and binge eating

Over time, compulsive overeating usually leads to obesity. Obesity, in turn, causes numerous medical complications.

Common physical effects of binge eating disorder include:

  • Type 2 diabetes
  • Gallbladder disease
  • High cholesterol
  • High blood pressure
  • Heart disease
  • Certain types of cancer
  • Osteoarthritis
  • Joint and muscle pain
  • Gastrointestinal problems
  • Sleep apnea
Learning how to eat right

In order to stop the unhealthy pattern of binge eating, it’s important to start eating for health and nutrition. Healthy eating involves making balanced meal plans, choosing healthy foods when eating out, and making sure you’re getting the right vitamins and minerals in your diet.

Overcoming binge eating disorder also involves getting emotional eating under control. Eating right and listening to your body is an essential step in stopping binge eating. Other strategies that help include practicing relaxation techniques, staying connected to family and friends, and making time for things you enjoy as part of your daily schedule.

Use positive psychology & self-compassion

Dieters are really hard on themselves and self-critical.  Being hard on yourself may do more harm than good to your self esteem and confidence.   Dieters who self-criticize telling themselves nasty things such as:  “I am fat” are setting themselves for over-eating.

Turning your inner critic around and bringing into your mind a compassionate response is crucial, since studies have shown that even a modest dose of self-compassion can help prevent the destructive self-criticism and negative feelings that can fuel overeating.


Tips for Overcoming Binge Eating

  • Eat breakfast. Skipping breakfast often leads to overeating later in the day, so start your day right with a healthy meal. Eating breakfast also jump starts your metabolism in the morning. Studies show that people who eat breakfast are thinner than those who don’t.
  • Avoid temptation. You’re much more likely to overeat if you have junk food, desserts, and unhealthy snacks in the house. Remove the temptation by clearing your fridge and cupboards of your favorite binge foods.
  • Stop dieting. The deprivation and hunger of strict dieting can trigger food cravings and the urge to overeat. Instead of dieting, focus on eating in moderation. Find nutritious foods that you enjoy and avoid labeling foods as “good” or “bad.”
  • Exercise. Not only will exercise help you lost weight in a healthy way, but it also lifts depression, improves overall health, and reduces stress. The natural mood-boosting effects of exercise can help put a stop to emotional eating.
  • Destress. Learn how to cope with stress in healthy ways that don’t involve food. For some helpful stress relief strategies 


Treatment and help for binge eating disorder

While there are many things you can do to help yourself stop binge eating, it’s also important to seek professional support and treatment.

Health professionals who offer treatment for binge eating disorder include psychiatrists, nutritionists, therapists, and eating disorder and obesity specialists.

Therapy for binge eating disorder

Binge eating disorder can be successfully treated in therapy. Therapy can teach you how to fight the compulsion to binge, exchange unhealthy habits for healthy onesmonitor your eating and moods, and develop effective stress-busting skills.

Two types of therapy are particularly helpful in the treatment of binge eating disorder and compulsive overeating:

  • Cognitive-behavioral therapy – Cognitive-behavioral therapy focuses on the dysfunctional thoughts and behaviors involved in binge eating. One of the main goals is for you to become more self-aware of how you use food to deal with emotions. Your therapist may ask you to keep a food diary or a journal of your thoughts about eating, weight, and food. The therapist will also help you recognize your binge eating triggers and learn how to avoid or combat them. Cognitive-behavioral therapy for binge eating disorder also involves education about nutrition, healthy weight loss, and relaxation techniques.
  • Interpersonal psychotherapy – Interpersonal psychotherapy for binge eating disorder focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. Your therapist will also help you improve your communication skills and develop healthier relationships with family members and friends. As you learn how to relate better to others and get the emotional support you need, the compulsion to binge becomes more infrequent and easier to resist.
Medications for binge eating disorder

A number of medications may be helpful in binge eating disorder treatment.

  • Antidepressants – Research shows that antidepressants decrease binge eating in people with bulimia.
  • Appetite suppressants – Studies on the appetite-suppressing drug sibutramine, known by the brand name Meridia, indicate that it reduces the number of binge eating episodes and promotes weight loss.
  • Topamax – The seizure drug topiramate, or Topamax, may decrease binge eating and increase weight loss. However, Topamax can cause serious side effects, including fatigue, dizziness, and burning or tingling sensations.

Treatment for Eating Disorders