Binge eating, also called compulsive overeating, is a new diagnostic category within the spectrum of eating disorders. It is defined by the psychiatrists' diagnostic manual (DSM-IV-TR) as an eating disorder where a person has "recurrent episodes of binge eating associated with subjective and behavioral indicators of impaired control over, and distress about, binge eating and the absence of regular use of inappropriate compensatory behaviors (ex. vomiting, laxatives, fasting)."

Prevalence of Binge Eating Disorder

Binge eating affects 1 to 3% of the general population. While this number may seem small, it does account for the 15 to 20% of people who are in weight-control programs. This means that up to one in five of those who are already concerned about their weight are struggling with BED.
This prevalence rate is not well-established because binge eating has only recently attracted the attention of clinicians and researchers. It was created in response to the obesity epidemic that is currently posing a health threat to our country. While the obese may be amongst the largest population that develops this disorder, obesity is not a criterion.

Surprisingly, the gender differences within this disorder are similar. In general, men and women do not differ in their developmental variables for the disorder. These variables include age at which they were first overweight, age at first diet, age at onset of binge eating, self-esteem, and eating-related to psychopathology. However, women reported higher body dissatisfaction and eating in response to negative emotions. Men had a higher history of substance abuse problems and Axis 1 psychiatric problems.

Binge Eating and Bulimia Nervosa

The development of BED also evolved out of the definition of Bulimia Nervosa, but it has one clear distinction. Binge eaters do not engage in compensatory behaviors like bulimics do, meaning they do not purge or take medications to get the food out of their bodies. People with Bulimia Nervosa eat up to four times the amount of a normal binge eater and then proceed to expel it from their body because of the distress they feel from consuming such a large amount of food. Since these disorders are closely related it has been shown that they can lead to each other in a reciprocal fashion.

Causes of Binge Eating

There are two factors researchers have deduced that constitute the etiology of binge eating. Biological factors seem to play a prominent role. Considerable research has been conducted concerning the heritability and genetics behind obesity. Within the realm of obesity are the prevalence of dieting and the complications that accompany it. Many individuals with obesity try time and time again to diet but are unsuccessful. Their inability to change their weight leads to frustration, which in turn, causes many to turn to food as a comfort source. They give in to the temptation and out of desperation begin to binge.

There is also a genetic mutation that may contribute to both obesity and binge eating. Branson et al. sequenced a gene in four hundred sixty-nine obese individuals. The purpose of this study was to see if the function of the melanocortin 4 receptor gene could be correlated with obesity and binge eating. The study found that out of twenty-four obese subjects that had a mutation in the gene, all of these carriers reported binge eating. Only 14.2 percent of the obese subjects who did not have the mutation reported binge eating.

Another factor that leads to binge eating is a dysphoric mood, such as depression and anxiety. It has been found that people with BED have low self-esteem and greater depressive symptoms than people who are obese without BED. Because the onset of this disorder occurs primarily between the ages of sixteen and twenty, it would seem that sufferers develop their distorted self-perception at a young age and form this disorder by late adolescence. Western society promotes many conflicting and unrealistic messages about body image which are absorbed by people at from a young age, so this may be a factor in low self-esteem.

Treatments for Binge Eating

Researchers and therapists have identified four treatment options that seem to be effective in the treatment of BED. They include medications, cognitive-behavioral therapy (CBT), behavioral weight loss therapy, and interpersonal therapy. Medication treatment involves antidepressant drugs SSRIs, which lessen the effects of dysphoric mood and thus alleviate the symptoms of BED. CBT has been proven to be the most effective and widely used form of therapy for BED sufferers. CBT focuses on teaching people to overcome impulses to binge eat and start to think about food in a different way. Self-monitoring therapy is a subset of CBT that takes the patient through several stages and encourages them to review their progress on a weekly basis. Studies confirm that CBT combined with some form of medication is the best recipe for treating BED and having an improved chance recovery.

References:
Bulik, C.M., Sullivan, P.F., & Kendler, K.S. (2003). Genetic and environmental contributions to obesity and binge eating. International Journal of Eating Disorders, 33, 293-298.
Pull, C.B. (2004). Binge eating disorder. Current Opinion in Psychiatry, 17, 43-48.
Reichborn-Kjennerud, T., Bulik, C.M., Tambs, K., Harris, J.R. (2004). Genetic and environmental influences on binge eating in the absence of compensatory behaviors: a population-based twin study. International Journal of Eating Disorders, 36, 307-314.
American Psychiatric Association. (2000). Binge eating disorder. Diagnostic and Statistical Manual of Mental Disorders (4th ed.), 785-7.
Article written by L. Doswell, edited and reviewed by M. Williams, Ph.D.

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