Binge eating disorder is the most stigmatized of the eating disorders. Binge eating goes undiagnosed far longer than other eating disorders as many are afraid to talk to medical providers. Most who suffer from the disorder are certain that no one can understand the shame, the isolation, or the pain of binge eating. They believe that they are the only people on the planet who engage in such secretive behaviors. They find themselves trapped between their desire to stop and their inability to disrupt the cycle.
If this is you, the primary aim of this article is to assure you that you are not alone and there are providers who can help. Read the following data points:
- The most common eating disorder is Binge Eating Disorder (BED).
- Estimates report 1 in 20 people engage in binge eating regularly.
- Binge eating disorder was officially added to the psychiatric treatment manuals as late as 2013. This means many providers have yet to adopt effective screening tools to help clients get treatment.
- Global research found a 35% increase in binge eating behavior during the COVID-19 crisis.
- Binge eating disorder is found among all age groups, races, and income levels, and is more common among women.
- 94% of sufferers of binge eating disorder have a co-occurring mental health problem such as a mood disorder or anxiety.
- Up to 50% of binge eating disorder behavior is attributed to genetic factors.
What Exactly is Binge Eating Disorder?
Many clients feel uncomfortable with the idea that binge eating is a recognized psychiatric disorder with strong genetic components. For many, they have internalized society’s misjudgments and have grown comfortable with the ideas that say, “I am just weak-willed and out of control. I have done this to myself.” With this mindset, it can be very hard for clients to seek treatment as some believe Binge Eating Disorder, in itself, is considered a character flaw instead of a serious psychiatric issue. Furthermore, the idea that Binge Eating Disorder is in the same category as anorexia nervosa makes clients even more uncomfortable. I have had a client ask, “How could my binge eating behaviors be similar to those ‘real’ eating disorders where people are afraid of food and eat very little?”
This client’s question gets at the heart of the majority of eating disorder treatment. What exactly are the commonalities between binge eating disorder and other types of eating disorders, such as anorexia or bulimia? Like most things involving human behavior, the answer is both terribly simple and complex at the same time. In short, it begins with an individual pursuing thinness, or in other worlds, starting a diet. This image below illustrates a common progression for most eating disorders:
How is Binge Eating Disorder Assessed?
There are specific criteria related to the diagnosis of binge eating disorder. Some of the criteria include:
- Frequency of binging?
- Length of time one engages in a binge?
- How does one feel during the binge?
- How does one feel about the binging? After the binging?
- How long has the binging been occurring?
- Are there compensatory behaviors in place? (such as restricting between meals, diet pills, etc.)
If you suspect that Binge Eating Disorder may be a problem for you, please reach out to us for a thorough assessment. If you are in a large body and feel as though you will not be heard or well understood by your medical team, use the link at the bottom of this article to find a weight-neutral provider listed on the Association of Size Diversity and Health website. This will ensure that you are given access to care that is evidence-based and equitable, regardless of your size.
What Might Binge Eating Disorder Treatment Look Like?
Like other eating disorders, the treatment team for BED includes a weight-neutral dietitian, physician, psychologist, psychiatrist, and often an exercise physiologist or physical therapist. Treatment should be holistic in nature taking into account the clients’ trauma history, mental health, medical conditions, and current lifestyle. Outpatient treatment is where most clients begin, but fantastic residential treatment facilities are also available for clients who desire more intensive support.
Nutrition rehabilitation for binge eating disorder is not at all what clients may think. Considering the graphic above the first thing to be addressed is the pattern of restricting food and chronic dieting. This can be both relieving and terrifying for the client. Most clients will quickly name that they do not want to continue dieting and meal skipping, but they see no other way of approaching food. Giving yourself permission to eat can be a painful process. Re-learning to trust our hunger and to meet it adequately requires patience, introspection, vulnerability, and openness to where the body takes us.
Finally, if treatment is to be effective, the most important component is inviting the client’s autonomy and voice into the recovery process. Too often, shame, guilt, scolding, scare tactics, and even withholding of treatment are used to “force” patients in large bodies to stop unwanted behaviors. This is harmful and has no place in medical care. Unfortunately, I have heard too many stories of patients who have experienced these injustices nearly every time they enter a medical building.
Please use the link below to find a weight-neutral provider or check out the availability of various team members on the Integrated Care Clinic website. We are currently taking on new clients and would be honored to hear your story.