Binge Eating Disorder: More than just overeating

Binge-Eating Disorder (BED) is one of the newest official diagnoses listed in the DSM-V - the big reference book of diagnostic criteria used in the US. Specifically, the DSM defines Binge-eating disorder as the presence of "recurrent episodes [of] binge eating that must occur, on average, at least once per week for 3 months".

Is that all that Binge-Eating Disorder is?

However, this broad definition leaves a lot to be desired. What exactly is a binge? Does everyone having Thanksgiving have Binge-Eating Disorder for a day? Do you still have Binge-Eating Disorder if you also restrict or purge? Things get pretty complicated, pretty quick, unless you understand the issue well.

To sort this out, let's think about why the DSM makes therapists assess how often someone binges, and how long those binging episodes have gone on for. Simply, it is to help therapists rule out one-off, or rare, instances of overeating that may culturally appropriate or so infrequent that they don't bother the person. 

Eating too much on Thanksgiving, while sometimes uncomfortable or awkward, can't be considered a mental health problem in itself.

Instead, a binge is defined in two parts: (1) eating a large amount of food in a short period of time and (2) feeling a lack of control over the eating episode.

It is about more than just the food

The rest of the diagnostic criteria also help shed light on what is a symptom of a binge-eating problem vs. what is normal overeating. Criteria B asks therapists to look into how someone feels during and after one is done eating. 

• Is eating a stressful experience? 
• Does it cause physical pain and discomfort?
• Does eating lead to feelings of depression excessive guilt?
• Does eating make the person feel embarrassed?

Saying "yes" to any of these issues may mean someone has a binge-eating problem.

How do other eating disorder symptoms affect Binge-Eating Disorder?

This is a topic that could be written about forever, but to keep things short for the purpose of a blog, other eating disorder behaviors can deeply impact binge-eating behaviors. For example, one of the most common setups for a binge episode is a period of earlier restrictive eating/under-eating.

Binging also tends to prompt someone to consider purging behavior, which can include intentional vomiting. However, a binge could also trigger someone to use laxatives, diuretics, enemas, or even compulsive exercise to 'undo' what was eaten.

These behaviors can, in short, set each other off and create feedback loops where one symptom behavior leads to the next.

What can be done? Is there hope?

There is always hope for recovery from an eating disorder. The solution to all eating disorder behaviors really comes down to two big learning lessons: finding healthier ways to deal with painful emotions and figuring out how to eat normally. 

Eating normally is learning how to start eating when you are hungry and stop eating when you are full. Healthy coping skills, self-talk, a healthy self-image, and an reasonable appreciation for your good/bad qualities all help to manage emotions in effective ways.

This may sound complicated, but it is very do-able, especially when you are working with the right professionals who are trained, experienced, and compassionate supporters.

If you are unsure if you are experiencing Binge-Eating Disorder, call us today. We offer free 15 minute phone consultations and can tell you if we think we offer the right help for you and your situation. Reach out now and find hope.