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Binge eating is the habitual consumption of mass quantities of food with a sense of being out of control. Binge eaters often eat in secret because they are ashamed of their disease, but treatment and even cure are possible.

Binge eating is an eating disorder that impels people to super-size meals that they eat very quickly with a sense of being out of control. Binge eating differs from bulimia in that binge eaters do not attempt to compensate for excess calorie consumption by purging or exercise. But once a week or more, they eat very quickly until they feel stuffed (and maybe still eat a little more) when they are not physically hungry, feel guilty about it, try to hide it, and become depressed. (Technically, it's only necessary to meet three of those qualities to be diagnosed with binge eating disorder.)

In the United States, about 3.5 percent of women and 2.5 percent of men are binge eaters. Binge eating usually starts in late adolescence or early adulthood. It is linked to marijuana use but not to binge drinking. The disease seems to run in families, but not everyone in a family will have it. Binge eating disorders occur later in life than other eating disorders, are more common in males than other eating disorders, and are disproportionately more common among people of African, Asian, and Hispanic descent than other eating disorders.

Gay and bisexual men who have a binge eating disorder tend also to have addictive disorders. Lesbian and bisexual women who have a binge eating disorder tend also to suffer depression.

What causes binge eating?

There are several strong predictors for developing a binge eating disorder.

  • Children who observe parents who have binge eating disorders are more likely to develop their own binge eating disorder.
  • Children who are overweight at age 10 are significantly to have issues with binge eating by age 20.
  • Teenagers who are chronically upset with their body shape at age 14 are significantly more likely to become binge eaters by age 20.
  • Families that encourage binge eating, not surprisingly, produce binge eaters.
  • People who spend a lot of time looking at parts of their body they consider unattractive (not necessarily just their fatness or thinness) are more likely to become binge eaters.

There are patterns of brain development that are linked to binge eating disorders, but it is not known that they cause the disorder. Increased gray matter gyrus rectus volume is correlated to having a "sweet tooth". Decreased  white matter in the medial temporal lobe, and in the parietal lobe, is associated with reduced control over eating. There is no straightforward predictive relationship, however, between what is seen on a brain scan and the severity of a binge eating disorder.

Tumors of the ventromedial hypothalamus or paraventricular nucleus can trigger binge eating, but this symptomatic of a different disease.

What are some of the symptoms of a binge eating disorder?

Binge eating disorders occur in people of all sizes. 

  • 19 percent of binge eaters are normal weight.
  • 36 percent of binge eaters are overweight but not obese.
  • 45 percent of binge eaters are obese.

Binge eating disorder is often only recognized through its complications. Women who deal with binge eating disorder are more likely also to have polycystic ovarian syndrome (PCOS), and both men and women who binge eat are more likely to have sleep apnea, type 2 diabetes, asthma, hypothyroidism, Cushing's syndrome, and, ironically, nutritional deficiencies. But the common symptom in binge eating disorder is persistent depression with its devastating effects of self-image and self-esteem.

How is binge eating syndrome treated?

People who have binge eating syndrome are often blamed for their disorder. They may be told "just go on a diet". But binge eating disorder is about more than just overeating. It is driven by persistent depression that binge eaters try to medicate with food.

Often the root of that persistent depression is anxiety. People who live with a kind of ongoing angst fail to develop the life skills that deliver the successes, both realistic and unrealistic, that they seek in life. They become depressed about their competence to "make it in the world", and they turn to food for comfort. But because they can't control their cravings for food, they feel even worse about themselves, and lose their ability to control food intake again. This causes more shame, which is covered up with secrecy, which presents reaching out for help.

Many binge eaters are stuck in a cycle of binge eating and guilt that goes on for years at a time. When they finally reach out for professional help, however, they are usually treated with a combination of antidepressant medication, behavior modification, and long-term monitoring.

Lisdexamfetamine (Vyvanse) is the only FDA-approved antidepressant for use treating binge eating disorder in the United States.

Binge eaters who tend to consume excess calories at night may be treated with sleep aids, including melatonin.

A supportive approach to binge eaters almost always includes developing an understanding that you are more than your weight. Binge eaters are encouraged to find activities that are "healthy at any size." Self-acceptance and compassionate therapy are essential to making the psychological changes that sustain controlled eating.

  • Oberndorfer TA, Frank GK, Simmons AN, Wagner A, McCurdy D, Fudge JL. Altered insula response to sweet taste processing after recovery from anorexia and bulimia nervosa. Am J Psychiatry. 2013 Oct 1. 170(10):1143-51.
  • Sonneville KR, Horton NJ, Micali N, Crosby RD, Swanson SA, Solmi F, et al. Longitudinal associations between binge eating and overeating and adverse outcomes among adolescents and young adults: does loss of control matter?. JAMA Pediatr. 2013 Feb. 167(2):149-55.
  • Wade TD, Treloar SA, Heath AC, Martin NG. An examination of the overlap between genetic and environmental risk factors for intentional weight loss and overeating. Int J Eat Disord. 2009 Sep. 42(6):492-7.
  • Photo courtesy of SteadyHealth

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