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People who live with binge eating disorder don't just eat too much. They deal with a condition that disrupts every aspect of their health and lives.

Experts estimate that two percent of American men and 3.5 percent of American women live with binge eating disorder. A binge eating disorder is about more than just occasionally overeating. People who have binge eating disorder periodically lose control around food. They "eat everything in sight" without considering the consequences. This isn't a personal choice. It's a compulsion rooted in dysfunctional brain chemistry that requires sustained medical treatment to overcome. And it's a condition that disrupts almost every aspect of health. Here are some examples.

Binge eating disorder has a medical definition. Binge eaters display three out of the following five symptoms: Eating much more rapidly than normal, eating until uncomfortably more than full, eating huge portions of food even when not feeling physical hunger, eating alone out of embarrassment, and negative self-assessment after a binge eating episode.

Symptoms of binge eating disorder

Binge eating disorder most commonly emerges in late adolescence to early adulthood. It's a condition that is most common between the ages of 18 and 35. The people who develop a binge eating disorder often have just finished a stressful calorie-deprivation diet.

There is something about that experience that subtly changes brain chemistry to set off an unfortunate sequence of symptoms:

  • First, the future binge eater develops a negative body image. This could be due dissatisfaction with body image even after doing a lot of hard work to lose weight. People who develop a binge eating disorder are more likely to pay attention to parts of their body they don't like and less likely to pay attention to their more attractive features.
  • At this stage, there is a self-critical inner dialog. There's unhappiness over appearance. There is an obsession over food. It's analogous to the often-repeated admonition "Don't think about a pink elephant." Future binge eaters exert tremendous self-control over their normal appetites, but from time to time they "lose it" and eat uncontrollably.
  • The first and following episodes of binge eating generate guilt and even more obsession over intake. Binge eaters deal with their guilt by eating in secret. They start avoiding social events where they might lose control over, say, a buffet table or a celebratory cake. They start hiding and hoarding food. They eat inappropriate food, such as moldy food or food taken out of the trash. They eat until they hurt.

Binge eaters don't necessarily become obese, and obese people aren't necessarily binge eaters. But binge eaters develop many of the health problems associated with obesity even when they are not overweight.

  • Degenerative arthritis (osteoarthritis). Binge eaters may wear out their joints because of sheer overweight. But they may also have joint problems that are related to trace nutrient deficiencies if they tend to binge on sweets. They are more prone than most to develop degenerative arthritis secondary to dislocation. The bones at a joint don't quite fit together and rub against the synovial lining that cushions the joint until has degenerated.
  • Edema (swelling). When binge eaters binge on high-sodium foods, they may have issues with fluid retention. 
  • Gall bladder disease. Binge eaters face a double-whammy of risk factors for gallbladder disease. From time to time they consume foods that contribute to the formation of gallstones in mass quantities and rapidly. But when they restrict their diets out of guilt about their disease, the gallbladder does not release as much bile, and they are at greater risk of a gallbladder attack.
  • Heart disease as a result of elevated triglyceride levels. It's possible to have "normal" total cholesterol, LDL, and HDL, and still develop atherosclerosis due to high triglycerides. 
  • High blood pressure. The constant stress of hiding one's condition contributes to high blood pressure. The psychological need to hide binge eating from doctors means a lower likelihood of timely treatment.
  • High cholesterol levels. There's only a loose connection between the consumption of high-cholesterol foods and high cholesterol levels in the bloodstream. However, the liver can make cholesterol from excess carbohydrates.This is a much greater factor in high cholesterol levels for binge eaters. Excess carbs that aren't stored as fat are sometimes converted to cholesterol.
  • Increased rates of fibromyalgia, insomnia, and irritable bowel syndrome (IBS). These are probably related to changes in the brain that trigger the disease.
  • Obstructive sleep apnea when binge eating results in overweight. However, binge eaters are prone to worse symptoms even with less weight gain.
  • Type 2 diabetes, even with lower weight gain, because of the stress of dealing with large dumps of sugar into the bloodstream after binge eating.
There is bad news and good news about the long-term prospects for people living with binge eating disorder. The bad news is that binge eating disorder lasts just as long and carries an equally high rate of suicide as anorexia nervosa or bulimia nervosa. The good news is that people who have binge eating disorder who get appropriate medical treatment and who do the hard work of making changes in their lives are more likely to go into remission.

  • 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.
  • Pearl RL, White MA, Grilo CM. Overvaluation of shape and weight as a mediator between self-esteem and weight bias internalization among patients with binge eating disorder. Eat Behav. 2014 Apr. 15(2):259-61..
  • 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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