Eating disorders – Binge eating
Binge eating is an eating disorder where a person feels compelled to overeat on a regular basis through regular binges.
People who binge eat consume very large quantities of food over a short period of time, even when they are not hungry.
Binges are often planned in advance and can involve the person buying "special" binge foods.
In rare cases, people describe themselves as being in a "dazed state" during a binge – particularly binges during the night – and they are not able to recall what they ate.
People who binge eat feel they have no control over their eating. They often binge in private because they feel embarrassed, guilty or disgusted with their behaviour after they have finished eating.
Episodes of binge eating sometimes alternate with periods where the person cuts down on the amount of food they eat.
This can lead to a vicious cycle that is difficult to break – where blood sugar levels rise and fall rapidly, and false messages are sent to the brain, which result in cravings for food when your body doesn't need it.
Who is affected
Anyone can be affected by binge eating.
While the condition is slightly more common in women than men, the numbers of men and women affected are more equal than in other eating disorders, such as anorexia nervosa.
The condition tends to first develop in young adults, although many people do not seek help until they are in their 30s or 40s.
It’s estimated that there is around a 1 in 30 to 1 in 50 chance of a person developing binge eating disorder at some point during their life.
Many people will occasionally binge on food – this doesn't necessarily mean you have a binge eating disorder. However, you should see your GP if you binge regularly and excessively, particularly if the binges are having an effect on your physical and/or mental health.
Your GP can diagnose the condition and may be able to refer you to a specialist, such as a psychiatrist or a psychologist.
Your GP will ask you about your eating habits and look for the following signs:
you eat much faster than normal during a binge
you eat until you feel uncomfortably full
you eat a large amount of food when you are not hungry
you eat alone or secretly due to being embarrassed about the amount of food you are consuming
you have feelings of guilt, shame or disgust after binge eating
People who regularly eat this way are likely to have a binge eating disorder.
What causes binge eating?
It's not clear what causes binge eating, but, like most eating disorders, it's seen as a way of coping with feelings of unhappiness and low self-esteem.
Things that may increase your risk of developing problems with binge eating include:
low self-esteem and a lack of confidence
depression or anxiety
feelings of stress, anger, boredom or loneliness
dissatisfaction with your body and feeling under pressure to be thin
stressful or traumatic events in your past
a family history of eating disorders, which may be related to your genes
differences in your brain or the level of hormones produced by your brain compared to people who don't binge eat
Binge eating can sometimes develop following a strict diet, particularly if you skipped meals, cut certain foods out and didn't eat enough food. These are unhealthy ways to lose weight and may mean you're more likely to binge at another time.
How binge eating is treated
Binge eating is treatable and most people eventually get better with appropriate help and support.
The main treatments are:
self-help programmes – this may be individually with a book or online course, or as part of a self-help support group
guided self-help (self-help supervised by regular contacts with a professional)
specialist group intervention
individual (one-to-one) psychological therapy – such as cognitive behavioural therapy (CBT)
medication called selective serotonin reuptake inhibitors (SSRIs)
These treatments can help you overcome the psychological issues associated with your binge eating, but they won't usually have a significant impact on your weight.
If you are overweight, a healthcare professional may also draw up a weight loss plan to follow during treatment or after any psychological issues have been dealt with.
Risks of binge eating
Binge eating can be associated with serious psychological problems, including depression and anxiety disorders. These feelings can be made worse over time while the person is still binge eating.
A common physical effect of binge eating is weight gain, which can lead to obesity. This can put you at risk of a number of related physical health problems, some of which can be life-threatening.
high cholesterol and high blood pressure – which can increase your risk of cardiovascular diseases, such as coronary heart disease and stroke
diabetes – a long-term condition that causes your blood sugar level to become too high
osteoarthritis – a condition that causes pain and swelling in the joints
some types of cancer – such as breast cancer and bowel cancer
Therefore, it's important to seek help if you think you may have a binge eating problem, because you may need support to help you tackle both your psychological and physical problems.
Binge eating and bulimia
Although binge eating is similar to another eating disorder calledbulimia, the two conditions are different.
In people with bulimia, periods of binge eating are followed by attempts to purge (flush out) the food they have eaten – for example, by making themselves vomit or by taking laxatives.
People who binge eat do not purge themselves to control their weight, but may try to limit weight gain by having periods of eating very little between binges.
Treating binge eating
Binge eating disorders are usually treatable and most people will eventually get better with appropriate help and support.
The main treatments are outlined below.
A self-help programme is often the first step towards recovery. There are many different types of self-help and it's important to find one that suits you. Your GP may be able to recommend a self-help book or self-help group that would be suitable.
You can find information on self-help books from your local library or from the eating disorders charity Beat, which also has information on finding self-help and support groups for eating disorders.
If you are referred to a mental health professional for help, they might encourage you to work through a self-help book under their supervision. This is called "guided self-help".
For some people, a self-help programme alone may be enough to help them overcome their eating problems.
You may also be referred for psychological therapy to help tackle the underlying problems that cause you to binge eat.
The three main types of therapy used to help people who binge eat are:
cognitive behavioural therapy (CBT) for binge eating disorder (CBT-BED) – a specially adapted type of CBT that involves talking to a therapist and working out new ways of thinking about situations, feelings and food
an adapted form of dialectical behaviour therapy (DBT) – therapy that mainly focuses on improving your ability to control and regulate your emotions
interpersonal therapy (IPT) – therapy that focuses on relationship-based issues and how they may be influencing your eating habits
These therapies can be very effective in helping people who binge eat, although it's not clear how long-lasting the results are.
It’s common to experience some periods where the problem improves (remission) and periods where they get worse (relapses), especially in the early stages of treatment.
Selective serotonin reuptake inhibitors (SSRIs)
Some people may be prescribed a type of antidepressant medicationcalled a selective serotonin reuptake inhibitor (SSRI) instead of, or in addition to, a self-help programme.
SSRIs boost levels of a chemical called serotonin in the brain, which may help lift your mood and lead to an improvement in your eating habits. However, the long-term effects of the treatment for binge eating are unknown.
Common side effects of SSRIs include:
feeling agitated, shaky or anxious
feeling or being sick
diarrhoea or constipation
loss of appetite and weight loss
difficulty sleeping (insomnia) or feeling very sleepy
low sex drive
These side effects will often improve over time, although some can persist.
Although the treatments mentioned above won’t address your weight directly, you may experience some weight loss if you are able to control your bingeing – particularly if you combine treatment with regular exercise.
If you are struggling to lose weight, your GP or a weight loss management health professional (such as a dietitian) will be able to draw up a weight loss plan that will provide you with the nutrition your body needs to be healthy, as well as helping you to lose weight.
You may be advised to follow this plan alongside your other treatments, or after your psychological issues have been dealt with.
Your plan may involve:
keeping a food diary to see if there is any pattern to when you binge and to highlight the types of food you binge on
having regular, planned meals and not skipping meals
eating healthy snacks between meals to stop you getting hungry
not depriving yourself of specific foods – you may be encouraged to include some unhealthy foods in your eating plan to reduce your urge to binge on them
having a balanced, calorie-controlled diet as recommended by your GP or other healthcare professional
exercising regularly – most adults should do at least 150 minutes of moderate-intensity exercise every week
It's important that you lose weight healthily. Extreme dieting and cutting out meals can make binge eating worse.