A complete guide to binge eating: what you need to know

What is binge eating?

Binge eating is the defining characteristic of binge eating disorder (BED). It is a type of eating disorder and severe mental illness.

Binge eating involves eating large amounts of food whilst feeling out of control. People may feel disconnected from what they’re doing and unable to stop eating. It’s a distressing feeling.

Some people with BED may plan their binges, almost like a ritual. However, others will feel triggered to binge when they encounter emotional stress. It can be hard to spot in others, as most people binge in private but eat regular meals in front of others.

How common is binge eating?

In 2020, Kings College London posted a report on eating disorder prevalence in the UK in collaboration with eating disorder charity Beat.

Out of almost 9,000 participants, they found that 43.3% had symptoms of BED.

They found that binge eating was more common in women than men overall. However, they found that men were much more likely to develop symptoms at an older age than women.

For example, their findings showed that 41.3% of men began to binge eat from the age of 25 and onwards compared to 18.4% of women.

What causes binge eating?

Some experts propose that it has a similar underlying mechanism as substance use disorder.

People with BED have difficulty with rewarding behaviour and controlling inhibitions. For example, when something negative happens, they will find comfort in food to relieve the negative feelings.

This becomes like a “food addiction”, particularly for high-sugar and high-fat foods which generate the most pleasurable response.

Other research has found that people with BED have differences in their brains in the areas responsible for impulse control and processing of sensory information about food.

Risk factors for binge eating

Some environmental, psychological and social factors may mean some are more likely to develop BED than others.

Risk factors include:

• childhood obesity
• loss of control eating in childhood - the feeling that you have to eat or the inability to stop or resist eating
• having other addictions (e.g. substance abuse)
• a family history of eating problems or obesity
• family conflicts and parenting problems
• having a parent with psychological difficulties
• mental health disorder
• physical or sexual abuse
• body dysmorphia - a distorted perception of what your body looks like

These factors don’t guarantee you will binge eat. They do increase your risk.

What are the signs of binge eating?

Binge eating affects you physically and mentally. There are a variety of symptoms. Some symptoms you may not realise may be related to your binge eating:

Behavioural and psychological signs are the first to appear. These symptoms will gradually result in physical changes.

Depending on the severity of the disorder, some will binge from 1 to over 10 times per week. The latest edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) grades BED severity as follows.

What is the difference between overeating and binge eating?

While eating a lot of food may sound enjoyable, it’s not. Binge eating is very different from simply overeating.

Finding the occasional comfort in food or overindulging every once in a while is common. This is known as emotional overeating.

However, these episodes are typically infrequent and not associated with a loss of control or a sense of extreme guilt, unlike BED.

What are the risks of binge eating disorders?

Eating disorders can significantly affect your health and BED is no different. It can cause serious health complications and medical conditions such as:

• becoming overweight or obese
• high blood pressure
• high cholesterol
• heart disease
• type 2 diabetes
• fertility problems
• muscle and joint pain
• arthritis
• gall bladder problems
• sleep apnoea
• damage to the stomach and oesophagus
• certain cancers
• mental illness

Some of these conditions can be fatal if BED is not treated. That’s why it’s important to seek help.

How is binge eating disorder diagnosed?

If you think you have BED, you should see your GP as soon as possible.

Your GP will ask about your eating habits, food intake and your mental health. They will also check your overall health and your weight.

If they think you may have BED or another eating disorder, they will refer you to an eating disorder specialist. The specialist will diagnose you based on the symptoms and decide on a suitable treatment course.

It can be difficult to speak out. But, the sooner you get treatment, the sooner you can reclaim your relationship with food and improve your health.

How do I treat binge eating disorder?

Due to the complex nature of the condition, you will likely need a multidisciplinary approach to treating it.

Therapy

The first treatment you will be offered is a guided self-help regime. This will usually be an online programme or a self-help book combined with sessions with a healthcare professional.

If this does not work, you may be offered cognitive behavioural therapy (CBT). This is a type of therapy that focuses on your thoughts and feelings and how they affect your behaviours. There is also a type of CBT that focuses on eating disorders.

The charity Beat also runs a variety of anonymous online support groups for people with eating disorders, which you can learn more about on their website.

Medication

Some people may also require medication, especially if they have an underlying mental health disorder. You will also need treatment if your eating disorder has caused complications such as type 2 diabetes or high blood pressure.

Diet

Your therapist will help you come up with a food and diet plan to help you avoid bingeing. In addition, you should try to:

• eat a variety of nutrient-dense foods (e.g. vegetables and lean proteins) - they are more beneficial for your health than sugary or fatty foods
• eat little and often (ideally every 4 - 6 hours) - this will help keep your blood sugar levels stable and will help reduce any cravings
• eat mindfully - this involves eating slowly and chewing your food properly, as well as sitting at a table with no distractions (e.g. watching TV)
• keep a journal - this will help you spot patterns around your binges such as how you felt or what happened during the day

There is also some evidence that certain nutrients may help cut down binges, such as:

• digestive enzymes - help with digestion
• probiotics - help balance gut bacteria
• zinc - can help increase your mood
• chromium - may help reduce carbohydrate cravings
• magnesium - helps improve insulin resistance and reduce sugar cravings
• B vitamins - help stabilise blood sugar levels
• essential fatty acids (EFAs) like omega 3s - help reduce inflammation and regulate your metabolism
• L-glutamine - an amino acid that may help reduce cravings

Always ask your doctor before taking any supplements to ensure it’s safe for you to take.

Should treatment for binge eating involve weight loss?

Your specialist will suggest that weight loss shouldn’t be the focus of your recovery. Weight gain is a symptom of the mental illness.

However, improving your health and maintaining a healthy weight should be a long-term part of your recovery.

CBT will help you focus on regulating your eating habits such as meal planning. This will help with your weight management over time.

Your doctor may recommend weight loss treatments once you have treated your BED (i.e. you have not binged for an extended period) and your weight is causing medical problems.

If you occasionally overeat and don’t have BED, you may be eligible for certain prescription weight-loss medications.