Binge Eating Disorder - What it is… and what it’s not.
Any person, at any stage of their life, can experience an eating disorder. There are currently more than one million Australians living with an eating disorder.
Eating disorders are not a choice, but are a serious mental illness that can have significant impacts on all aspects of a person’s life - physical, emotional and social. The earlier an eating disorder is identified and treatment is begun, the greater the opportunity for recovery and improved quality of living.
What is BED
Binge Eating Disorder (BED) is an eating disorder characterised by eating large amounts of food in one sitting. Someone with BED will typically also not engage in behaviours which serve to counteract the effects of the binge (such as vomiting or purging, fasting, excessive exercise or use of laxatives). In addition, someone with BED will most likely experience feeling a lack of control around eating.
Whilst it is not uncommon for all of us to engage in overeating on occasion, an objective binge associated with BED is characterised as eating an amount of food that is definitely larger than most people would eat in a similar period of time, in a similar context and will most likely take place in secret. In addition, an objective binge will often evoke feelings of guilt and shame. General overeating, however, will more likely be associated with having eaten a large amount of food, and experiencing feelings of fullness, but having enjoyed oneself, perhaps in the presence of others.
Contrary to common assumptions, BED, like most eating disorders, has a significant element of restriction and deprivation, which can be physical or psychological in nature. Body image dissatisfaction, being overly focussed with appearance, weight and shape, low self-esteem and low self-worth are common examples. Difficulties with managing emotions are also common, as are feelings of shame, guilt, depression and anxiety.
Who has BED
Among the eating disorder population, BED is the most common, making up 47% of all people with an eating disorder. It is also the only eating disorder that affects almost an equal number of males and females.
It’s also important to consider that we might not be able to tell if someone has BED just by looking at them. There are many assumptions that a person with BED will be in a particular body, but that is actually not the case. In fact, BED is present in 25% of the population of individuals who fall in the ‘normal’ weight range (measured by BMI), 31.% of people in the ‘overweight’ weight range & 47% of people in the obese weight range. It is important to note that BMI is a measure with limited accuracy, as it fails to take into account other factors that contribute to an individual's weight. However in this research, it allows us to see that contrary to assumptions & stereotypes, BED affects people of all sizes.
What causes BED
There is no single cause for BED and the factors can vary from person to person. Some of the known factors include:
Genetic predisposition which may include having a parent who has had disordered eating patterns.
Environmental factors such as perhaps being involved in a sport or activity which emphasises the importance of being a particular size or weight or shape in order to fit the stereotype or perform well.
Cultural or social factors such as growing up in a diet centric culture with emphasis on controlled eating with dieting and body image.
Individual factors such as trauma can also make someone more susceptible, as bingeing could be used as a self-soothing strategy.
The function of bingeing…
It is important to acknowledge that behaviours, whether considered to be life supporting or detrimental, usually serve a function to the individual. Binges often occur in response to emotions, rather than hunger. Binge eating can be a way of coping with uncomfortable thoughts, emotions and sensations such as boredom, loneliness, anxiety, anger or distress.
Bingeing can therefore provide temporary relief to individuals by providing distraction or numbing them from what is going on in their lives, but are often followed by feelings of guilt, shame, disgust, anxiety and depression.
Binge eating can also be triggered by preoccupation with food, such as what to eat & when to eat, and negative thoughts and feelings related to weight and shape.
Barriers to diagnosis
Unfortunately due to assumptions such as those previously mentioned related to weight and size of individuals with BED, there are some barriers to gaining an accurate diagnosis of BED and therefore being treated with aligned best practice evidence based intervention.
Other barriers to diagnosis may include:
A general lack of awareness and misconceptions such as those aforementioned related to weight and size of individuals with BED by health professionals.
Clinicians being unfamiliar with BED.
Individuals with BED may not feel comfortable to disclose their symptoms to health professionals due to feelings of embarrassment or shame, or may not be aware that it is a condition that you can gain support and treatment for.
Individuals with BED may not realise their behaviours constitute as a diagnosable condition if the conversation is not proactively discussed with their healthcare provider.
Treatment for BED…
Fortunately there are a range of psychological therapies to assist individuals in recovering from BED. These include Cognitive Behavioural Therapy (CBT), Guided-Self-Help (GSH-ED), Dialectical Behavioural Therapy (DBT) and Family Based Treatments.
A team approach is important in the successful treatment of eating disorders, and this applies also to BED, so as part of working with a mental health practitioner (psychologist or social worker), individuals will also benefit working closely with a medical practitioner such as a GP and/or dietician who can assist with food related guidance and monitor their physical health.
Finally, it is important for you to find clinicians that are the right fit for you! When looking for a psychologist for example, you are going to want to ensure that the space that you are working in is non-judgemental and allows you to feel comfortable and safe. In addition, finding a practitioner who takes a non-diet and health at every size approach, will be helpful.
Finally, us humans are made up of many facets. For that reason, it is important that you feel that you can explore other aspects of your health and wellbeing more generally with your psychologist, in addition to gaining specific support around the eating disorder.
Final words…
If you, or someone you know, is experiencing symptoms of BED and would like to find out more, please take a look at the extra resources provided below. Please contact us if you would like to find a practitioner from our team who would be best suited to support you or your loved one!