How Binge Eating Became A Recognized Eating Disorder
- 2 Minutes Read
Until recently, binge eating was seen as a failure of self-control, or a character flaw. Now medical experts suggest it has organic causes, and can be treated.
When you hear the term "eating disorder", you usually imagine a stick-thin female with anorexia, correct? Images of obese people gorging on bags of cookies or containers of ice cream aren't on your radar screen, since over-eating is believed to be a personal choice. But medical experts increasingly agree that Binge Eating Disorder (BED) may not simply be a matter of choice. BED is estimated to be far more prevalent than anorexia, and new research, using MRI brain scans, links BED to specific brain signaling pathways. The American Psychiatric Association gives BED a unique diagnosis code in the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by:
B. The binge-eating episodes are associated with 3 or more of the following:
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior and does not occur exclusively during the course Bulimia Nervosa or Anorexia Nervosa.
People with bulimia binge and then purge, exercise or fast to compensate for the excessive calorie intake. Their weight typically stays within the normal range. But people with BED do not purge or compensate. They just keep gaining weight, frequently becoming obese. The consequences of all those calories become visible. Binge eaters typically feel embarrassed, guilty, out of control and powerless to stop.
Binge eating is not unique to women. Men are increasingly diagnosed with BED, and represent roughly half of cases. Contrast that statistic with anorexia cases: about 10% are men. It's easy to miss BED in men. It's more socially acceptable for men to gorge on food (think of all those hot dog eating contests), so the binge eating can go on for a long time before anyone, including the binge eater himself, recognizes it's a problem.
Binge eating disorder has been getting some research attention, thanks to more sophisticated brain scanning techniques. For example, research has shown that brain reward signals in obese people are less responsive than in normal weight people. Result: an obese overeater doesn't perceive "reward" signals that shut off eating behavior, so they just keep eating. Other research will examine how binge eaters respond to visual cues of food. Eventually some of this research might lead to effective medical intervention techniques.
Most binge eaters would rather get help now. But the solution is not another diet. You need to identify and deal with the triggers to the behavior. The good news is that you don't have to struggle alone. Psychotherapy can work well for binge eaters.
If you or a loved one has BED, check out the eating disorder support website at National Eating Disorders Association.
Originally published on 21 August 12
Updated on 13 September 2019