Binge Eating Disorder (BED) is a very common condition but very under-recognised. The estimates are that at least 2% and up to 5% of the general adult population struggle with binge eating, that's up to 1 in 20 adults, and it is split relatively equally between male (40%) and female (60%) sufferers.
Many sufferers tend be be 'yo-yo dieters', and can believe that the problem is their willpower, or inability to stick to a diet in order to lose weight. In fact, yo-yo dieting and repeated dieting can often be a trigger for binge eating, along with other factors.
What IS Binge Eating Disorder?
Binge Eating Disorder (BED) is characterised by repeated episodes of uncontrolled binge eating followed by feelings of extreme shame and distress.
To diagnose Binge Eating Disorder, three or more of the following must be present:
- Eating much more rapidly than normal (during the episode);
- Eating until uncomfortably full;
- Eating large amounts of food when you are not physically hungry;
- Eating alone or secretly;
- Binge eating as above at least once a week for at least three months;
- Feeling shame, guilt, disgust and embarrassment about the behaviour.
- Strong feelings of dislike or even hatred towards you own body, and/or about your weight.
While some people may occasionally overeat, such as at holiday events like Christmas or Thanksgiving, or at a party, this does not mean they have BED, as this is usually a 'one time' or relatively rare event for them.
Mild Binge Eating Disorder is defined as having 1-3 episodes a week. Severe Binge Eating Disorder is defined as having 10+ episodes a week.
People with Binge Eating Disorder do not use purging as part of the behaviour. A person with BED does not throw up, take laxatives or over-exercise to try and “make up” for a bingeing episode. If these behaviours are also present, then the diagnosis is Bulimia, not Binge Eating Disorder.
What Causes Binge Eating Disorder?
The most common root cause of Binge Eating Disorder in our experience is an emotional trauma or past event/experience. Clients with Binge Eating Disorder report struggling with food and/or their body image for many years, often since childhood. They will also be aware on some level that their binge eating episodes are emotional eating events - using food to self-soothe or comfort themselves, or to distract themselves from difficult feelings/stressful experiences.
Body size: Almost 50% of people with BED are obese, and 25–50% of patients seeking weight loss surgery meet the criteria for BED. In our experience, the majority of clients are 'Serial Dieters', and have spent years trying to lose weight through weight loss clubs such as Weight Watchers, Slimming World, Motivation, Unislim, Jenny Craig etc.
Dieting alone will rarely if ever resolve Binge Eating Disorder, as the underlying emotional issues are not being addressed. In fact, dieting is itself a trigger for binge eating, as one of the triggers is hunger / lack of adequate nutritionally dense food.
Other psychological conditions: Almost 80% of people with BED will experience some other form of psychological distress, most commonly anxiety or low mood/depression. These co-occurring conditions are almost always as a result or consequence of the Binge Eating Disorder. BED significantly impacts gut function. When our gut is not working properly, we cannot manufacture serotonin - the 'feel good' hormone, and our cortisol - stress hormome - levels increase. High cortisol leads to anxiety, low serotonin leads to depression.
Other psychological conditions including phobias, post-traumatic stress disorder (PTSD), alcohol and/or medication/drug use can pre-date the onset of Binge Eating Disorder and are often also linked to the negative past experience or event that triggered emotional eating.
A much smaller sub-group of BED sufferers will have had Anorexia Nervosa in the past.
Physical and Health Conditions: Due to the impact of Binge Eating over a long period of time, it is very common for clients with Binge Eating Disorder to also experience physical symptoms like IBS, constipation, diarrhea, reflux, nausea, headaches, colitis, constant tiredness, lack of concentration/poor memory and poor skin, hair and/or nails.
It is also very common for clients with BED to have 'co-occurring' conditions, the most common of which are underactive thyroid, PCOS, endometriosis, migraine headaches, and inflammatory conditions such as fibromyalgia, ME or arthritis/rheumatoid arthritis.
Binge Eating Disorder Behaviours: Apart from the BED diagnostic behaviours of over eating for reasons other than hunger, Binge Eating Disorder sufferers will often engage in secret eating and/or night eating (ie coming back downstairs at night to eat when everyone else is asleep). Eating in secret may happen in the house, for example eating in the bathroom, or standing in front of the fridge or cupboard and eating quickly when nobody else is in the kitchen; or often in the car or car park of a shop or service station.
What Type of Person has Binge Eating Disorder?
The answer to this question has two parts:
1. What are the demographics - age, gender, economics, of BED sufferers?
2. What is the personality type of a BED sufferer?
Demographics of Binge Eating Disorder Sufferers
The short answer to this question is - anyone can be affected. Here is a small sample of feedback we have received over the years from clients:
Age How long have you been struggling with food and/or your body image?
38 "As long as I can remember. Became aware of it in my teenage years.".
47 "As long as I can remember".
34 “All my life but mostly from 16, remember having negative feelings at 13"
51 "Since Childhood"
58 "38 years"
35 "For as long as I can remember. It's been a battle my whole life".
36 "Since I was a teenager"
42 "At least 10 years"
39 "31 Years"
49 "Oh dear, since I was a pre-teen"
40 "Since the age of 8"
The most important part of this feedback to note is how long the problem has been going on. Because if it is that 'old', how on earth can a 'Quick Fix' diet/weight loss program be the solution? The simple answer is, it can't. This is because the real problem is not food, or weight. The real problem is what started the pattern of emotional eating or comfort eating as a way of coping.
Many of our clients share old experiences - common examples are:
- a parent or partner who was/is an alcoholic;
- a parent, often a mother, who was/is narcissistic;
- a trauma in the family - an unexpected or unusual death, an accident, a severe illness (self or another family member);
- Physical, emotional or sexual abuse;
- A parent with chronic depression, anxiety or their own eating disorder;
- Parents in conflict - violence, emotional or psychological conflict/abuse between parents;
- An experience of bullying at any age;
- Conflict in another relationship for example partner abuse/marriage breakdown.
So the true solution to freedom from binge eating and emotional eating is a combination of supportive therapy AND nutritional therapy & gut rehabilitation - addressing the problem from BOTH angles. This is where true freedom lies.
What is the personality type of a Binge Eating Disorder sufferer?
Clients who struggle with binge eating almost always share a common personality type:
- They are 'all or nothing', black and white thinking, perfectionistic people - either doing everything right, or everything wrong, ESPECIALLY when it comes to eating!
- They tend to be 'People Pleasers', very concerned about keeping other people happy at their own expense;
- They have a very strong 'Inner Critical Voice', constantly criticising and putting themselves down in their heads;
- They strive to appear very confident and worry free - often being the one everyone else turns to for support, but would never DREAM of asking for support for themselves;
- There is a very deep rooted fear of being rejected for being needy and a deep horror of ever appearing vulnerable - even though they would NEVER judge anybody else badly for needing support from them.
PHEW. That's a lot to take in.
If you feel you need our specialist support in resolving a long standing battle with food and your weight, and suspect or know you have Binge Eating Disorder, then please book a complimentary online consultation with us to chat things through and see if our Eating Freely program is the correct option for you. You can also visit the Program Information pages on our website to learn more about our one to one Eating Freely Program for Binge Eating Disorder, available in Ireland (Dublin, Wicklow, Wexford, Kilkenny, Cork, Athlone and Tullamore) or our Online Group Program if you are not in Ireland or convenient to one of our Eating Freely Therapists.
We look forward to meeting you.