Binge Eating Disorder

Binge Eating Disorder

By Gina Cipriano

The American Psychiatric Association’s (APA, 2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) explains that Binge eating disorder (BED) occurs when a person eats a large quantity of food, in a short period of time, in an uncontrolled manner. After eating, the person does not engage in any compensatory behaviors such as purging or exercising in order to “undo” the binge (APA, 2013). Approximately, “3.5% of women and 2.0% of men” had BED within their lifetime, which makes it more prevalent than anorexia or bulimia (Schaefer et al., 2020, p.388). BED may co-occur with other mental health issues such as anxiety, depression, and substance use disorders. People with BED may feel shame and guilt about their binges, which may lead them to hide their symptoms.

BED is theorized to occur for some of the following reasons:

Cognitive Reasons:

Sometimes, BED may occur because of cognitive dietary restraint. Cognitive dietary restraint is tricky as it entails a person telling themselves to eat less (Schaumberg et al., 2016). While a person may be initially successful in this endeavor, they may end up feeling deprived from food and not feel satiated (Schaumberg et al., 2016). Ultimately, this may lead to an overwhelming urge to binge (Schaumberg et al., 2016).

Emotional Reasons:

Binges may occur due to a person lacking other coping skills to use when they feel overwhelming emotions. Schaefer et al. (2020) conducted a study that found when a person was experiencing negative emotions, they were more like to engage in binge eating. Additionally, after the binge, people felt decreases in their negative emotions. In some ways, BED serves as means of coping with emotions such as guilt and sadness, but it ultimately leads people to feel shame after the binge has stopped occurring.

Cultural Reasons:

Food insecurity occurs if a person has difficulties obtaining food, and it affects approximately 12% of the American population (Rasmusson et al., 2018). Increased food insecurity has been linked to increased binge eating behaviors (Rasmusson et al., 2018). Ultimately, a person may restrict food due to cognitive or environmental reasons (Rasmusson et al., 2018). A person with food insecurity may only receive food stamps at one point during the month, which can contribute to them restricting later in the month. Ultimately, this leads to a binge-restrict cycle that is related to the times they can access food (Rasmusson et al., 2018).

Therapy can assist a person with BED achieve some of the following endeavors: - Balancing caring for ones’ body with food while not labeling foods as “good” or “bad”- Providing mindfulness strategies to use when eating - Exploring the relationship between a person and their body - Unpacking cultural and environmental messages that have influenced dietary habits and contributed to placing worth in appearances- Achieving body neutrality which entails recognizing what bodies “do” for people versus what they “look” like - Engaging in joy-filled movement- Advocating against weight-based discrimination - Learning emotional regulation strategies - Finding resources to combat food insecurity - Ending the binge-restrict cycle associated with dietary restraint
References American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders(5th ed.). https://doi.org/10.1176/appi.books.9780890425787Rasmusson, G., Lydecker, J. A., Coffino, J. A., White, M. A., & Grilo, C. M. (2018). Household food insecurity is associated with binge-eating disorder and obesity. International Journal of Eating Disorders, 52(1), 28-35. https://doi.org/10.1002/eat.22990 Schaefer, L. M., Smith, K. E., Anderson, L. M., Cao, L., Crosby, R. D., Engel, S. G., ... & Wonderlich, S. A. (2020). The role of affect in the maintenance of binge-eating disorder: Evidence from an ecological momentary assessment study. Journal of Abnormal Psychology, 129(4), 387.Schaumberg, K., Anderson, D. A., Anderson, L. M., Reilly, E. E., & Gorrell, S. (2016). Dietary restraint: What's the harm? A review of the relationship between dietary restraint, weight trajectory and the development of eating pathology. Clinical Obesity, 6(2), 89-100. https://doi.org/10.1111/cob.12134 For eating disorder treatment in a private setting in Palm Beach Gardens, we are ready to help.