Binge Eating Disorder and the Need for Compassion
What is Binge Eating Disorder?
Binge Eating Disorder (BED) is a serious mental illness that will affect 1 in 50 of us in our lifetime (1). It was only officially recognised as an Eating disorder within the DSMV (a diagnostic manual of mental health conditions) in 2013. Individuals with BED eat large quantities of food, often a much larger amount than someone may want to eat, over a short period of time (known as binge eating). Individuals with BED are not greedy or lacking will power, but often find it difficult to stop during a binge, even if they want to, which can be very distressing.
Characteristics of a binge eating episode include (1):
Eating much faster than normal.
Eating until feeling uncomfortably full.
Eating large amounts of food when not physically hungry.
Eating alone through embarrassment at the amount being eaten.
Feelings of disgust, shame or guilt during or after the binge.
Someone who experiences at least one of these distressing binge eating episode a week for at least 3 months is likely to be diagnosed with BED. However, you don’t need to have a formal diagnosis to be struggling or indeed be deserving or worthy of help.
Highest Eating Disorder Prevalence
BED is the most common eating disorder, being more prevalent than anorexia and bulimia combined, however, it is the least understood (2). Binge eating usually happens in private, which makes it difficult to notice in an individual as they may eat regular meals outside their binges. This means that many suffer from BED alone and often don’t reach out for help for fear of how others might react. BEAT, the UK’s eating disorder charity, has created a video which explains this well: https://www.beateatingdisorders.org.uk/edaw.
Approximately 79% of people with BED have a psychiatric disorder and 49% have a lifetime history of two or more co-morbid disorders (3). The prevalent co-morbid conditions with BED include: specific phobia (37%), social phobia (32%), post-traumatic stress disorder (26%) and alcohol abuse or dependence (21%) (4). BED is a serious mental health illness as 1 in 3 people with BED consider taking their own life and 1 in 6 attempts it (5).
BED can result from numerous psychological, social, cultural and biological factors (6). There are many determinants that can make someone feel the urge to binge eat, often it is not down to just one thing but multiple determinants (or triggers) all at once/ combined.
Some of the determinants (triggers) of binge eating (6):
Difficult or overwhelming feelings (i.e. feeling low, bored, angry, upset or anxious).
Used as a method to numb emotions or manage uncomfortable feelings.
Distorted body image perception.
Substance abuse.
Breaking a food rule (can lead to all-or-nothing thinking i.e. I broke my rule by eating something “bad” so I might as well eat all of it)*
Mental health impairment.
Poor sleep / insomnia
Changes to appetite hormones e.g. ghrelin and leptin
Perfectionism.
Letting yourself get too hungry or restriction*
Dieting or being put on diets or having food-restricted as a child*
Physical, emotional and sexual abuse.
Trauma
Food insecurity
Social media usage (can cause body dissatisfaction, which can lead to a loss of control when eating).
Lack of perceived structure.
**We cannot and must not overlook the role of restriction and dieting in BED. This is especially pertinent when dieting is promoted and encouraged under the guise of “health”.
Weight Stigma in BED and the Need for Compassion
Unfortunately, many people with BED suffer from weight discrimination, although it is important to mention BED doesn’t have a “look” and exists across the weight spectrum. Research has shown that adults who experience weight-based stigmatisation engage in more frequent binge-eating (7). Addressing our culture’s fat phobia is a crucial part of helping to reduce the prevalence of all eating disorders including BED.
It is a terrible myth that those with BED or binge eat are greedy, addicted to food or lack willpower. Often the root of binge eating disorder is very much psychological where binge eating is a coping mechanism someone may go to in order to manage emotional distress. In tandem, many experience physiological binges whereby restriction and many hours of eating very little results in needing to eat much larger quantities later in the day and often in a rushed manner because the body is essentially starving.
Individuals with BED should never be recommended diets for weight loss, in fact, dieting is very often part of the underlying cause. Weight stigma can also lead to healthcare avoidance (8) as individuals with large bodies report concern they will not be taken seriously by healthcare professionals because of their weight and often feel their weight is blamed for all of their medical problems (9).
We must challenge the harmful and damaging weight discriminating opinions so many people carry about BED so that the individuals living with this terrible mental illness can find kindness and compassion when they bravely reach out for help.
Who Does BED Affect?
BED can affect anyone of any age, gender, ethnicity or background. This mental illness does not exclude certain people, however, certain people are more likely to be affected. Transgender individuals experience eating disorders at rates significantly higher than cisgender individuals and as early as 12 years, gay, lesbian and bisexual teens may be at a higher risk of binge-eating than heterosexual peers (10).
Another myth with eating disorders in general and BED is that only females suffer from it, however, approximately 40% of those with BED are male (10). Research also suggests that recurrent binge eating is more common in black women compared to white women and doctors are less likely to diagnose EDs in black individuals (11). It is so important that awareness around this is raised as these marginalised individuals are often pushed aside and do not receive the help and care that is required.
What to Do if You Are Experiencing BE or BED?
If you’re worried that you or someone you know is suffering from BED, it’s important to seek treatment as early as possible to ensure the best chance of recovery. The first step would usually be booking an appointment with your GP - it may be difficult to talk about your illness with a doctor, but remember, it is an illness, and it is every bit as serious as any other eating disorder.
For more info on BED: https://www.beateatingdisorders.org.uk/types/binge-eating-disorder/treatment
BEAT has free, confidential helplines open 365 days a year:
Adult helpline: 08088010677
Youthline: 08088010711
You can also join BEAT’s online support group for BED, which is anonymous and allows you to speak to people going through similar experiences to you. Tuesday and Friday @ 6:45pm:
https://www.beateatingdisorders.org.uk/nightingale
References