No Longer Just a Symptom: Binge Eating Disorder

The American Psychiatric Association recently approved numerous changes to the Diagnostic and Statistical Manual of Mental Disorders, the guidebook for mental health diagnoses. The section of the book addressing eating disorders was revamped, and the APA added a new eating issue called binge eating disorder. Distinct from disorders that have binge eating as one symptom, this new diagnosis applies to people who do not have symptoms of other eating disorders.

What Is It?

The older version of the DSM recognized three eating disorders: anorexia, bulimia, and “eating disorder not otherwise specified,” which was used as a blanket diagnosis for disordered eating that did not fit the diagnostic criteria for other eating disorders.

Prior to the approval of the DSM-V, the only disorder that explicitly incorporated binge eating was bulimia, but to qualify for a diagnosis, a person had to engage in both binging and purging. Binge eating disorder eliminates that requirement. Symptoms of binge eating disorder include:

  • Recurring episodes of binging on large quantities of food
  • Eating when not hungry or until feeling uncomfortably full on a regular basis
  • Eating alone due to embarrassment about one's binge eating
  • Feelings of disgust, guilt, or shame about one's eating habits
  • Eating at an unusually rapid pace

Many people occasionally binge when they are stressed or have a food craving. Binging once or twice a year or during times of stress is not sufficient to warrant a diagnosis. Instead, the behavior must be regular and persistent, and must interfere with the person's life by, for example, causing psychological symptoms, endangering health, or resulting in rapid and unhealthy weight gain. Additionally, binge eaters must binge at least two days per week for six months to qualify for a diagnosis.

How Is It Treated?

Like other eating issues, binge eating doesn't just cause psychological symptoms. It can also have serious health consequences, including obesity, kidney problems, heart problems, gallbladder disease, liver problems, bone deterioration, and skin and hair issues. People with severe cases often require medical treatment before they're able to begin addressing the causes. Some people who binge may need care in inpatient facilities designed for people with eating disorders or in the hospital.

After a person with binge eating disorder is stabilized, there are a variety of treatment approaches. People with eating issues often benefit from group therapy. This process allows them to share stories with others, to discuss coping mechanisms, and to feel less alone in their struggles. Individual psychotherapy is also helpful because it helps people with the issue discover the underlying causes of binging and develop healthy strategies for dealing with stress. Many people with eating issues seek out cognitive behavioral therapy, which helps them identify problematic thought patterns that lead to binging. Once these thoughts are identified, they can be slowly reframed into healthier thoughts that lead to healthier behaviors.

Medication to treat mental health issues such as depression, anxiety, or obsessive compulsion—which commonly co-occur with eating disorders—may also help people move past binge eating. Antidepressants can be particularly helpful.

References:

  1. Binge eating disorder - DSM-V. (n.d.). Castlewood Treatment Center for Eating Disorders. Retrieved from http://www.castlewoodtc.com/2012/01/binge-eating-disorder-dsm/
  2. Binge eating disorder. (n.d.). EDReferral.com. Retrieved from http://edreferral.com/binge_eating_disorder.htm
  3. Fairburn, C. G., & Cooper, Z. (2011). Eating disorders, DSM-5 and clinical reality. The British Journal of Psychiatry, (198), 8-10. doi: 10.1192/bjp.bp.110.083881