We spoke with two registered dietitians experienced in supporting clients to overcome binge eating or a binge eating disorder about what binge eating is, what causes it, and how to address it.
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What is binge eating?
Binge eating is used in common jargon, but we often use it to mean something different than its clinical definition. In everyday language, binge eating typically means mindlessly eating a large amount of food that leaves you uncomfortably full. For example, you sit down to watch TV and end up finishing a full bag of chips without realizing it.
However, the DSM-5 (the diagnostic and statistical manual used to diagnose and define mental health disorders) states that an episode of binge eating must include both of the following:
- Eating, in a discrete period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
- The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Per the DSM-5, there must also be three of the following present:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of being embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty after overeating
What causes binge eating?
Despite people assuming that binge eating is a separate issue from restriction, they often go hand in hand. If you’re familiar with intuitive eating or have worked to end a cycle of chronic dieting, you may have heard of the binge-restrict cycle. This happens when you restrict your food intake (perhaps for a diet), then you start to feel obsessed with food because your body is deprived, then you binge eat (a natural response to semi-starvation), feel super guilty about the bingeing, and restrict again. The cycle can continue for a while, leaving people feeling frustrated and ashamed. It’s not a fun cycle to be stuck in, to say the least.
For that reason, one of the first steps to reducing binge eating is ensuring you’re eating enough throughout the day by establishing a consistent, adequate eating pattern. Esther Tambe, MS, RD, CDN, CDCES, owner and founder of Esther Tambe Nutrition, says, “Food deprivation, whether mental or physical restriction, can lead to intense feelings of hunger and preoccupation with food.” The goal is to prevent this food preoccupation and the binge eating that follows. If you’re unsure what eating enough looks like for you, working with a dietitian may help.
Deprivation-driven binge eating can also be caused by food insecurity; in fact, research shows that people who have experienced or are experiencing food insecurity are more likely to demonstrate binge eating behaviors. Krystal Dunham, MS, RDN, LD, owner and operator of The Mother Road Dietitian, says, “Not having regular access to sufficient food can increase the risk of binge eating.”
In addition to restriction or food insecurity, binge eating can be caused by trauma or intense stress. Tambe says, “Binging occurs due to an overwhelming experience—stress, trauma, or some trigger—that can cause you to respond with food, lose a sense of control, and now consume the foods that have been restricted and then some.” Tambe adds that restriction can exacerbate stress- or trauma-driven binge eating, and Dunham agrees: “Sometimes people binge after going through significant life events, such as a divorce or a death, stressing about an obligation at work or even a big move,” she says.
Furthermore, Dunham highlights that binge eating can even be a learned behavior. “Some individuals may have seen this behavior from a loved one growing up or had peers that binge ate from time to time,” she says. “Sometimes [binge eating] habits can develop from the people around you influencing the way you eat in general.”
What qualifies binge eating as a disorder
Binge eating can be a sign of binge eating disorder, an eating disorder included in the DSM-5. Dunham says, “Binge eating disorder (BED) is an eating disorder characterized by regular binge eating episodes in which individuals consume large amounts of food and experience a loss of control while doing so.” Tambe highlights that it’s often accompanied by dissociation.
Binge eating disorder, and any eating disorder, can be diagnosed by a licensed mental health professional or a physician. Unfortunately, some professionals don’t feel comfortable diagnosing patients with eating disorders because they aren’t super familiar with eating disorders, so trying to find a provider who has some eating disorder experience can help expedite the assessment and diagnosis process.
There is one caveat here: “Unfortunately, diagnostic criteria for BED can oversimplify behaviors which can lead to some individuals being undiagnosed or misdiagnosed,” Dunham says. If you suspect that you or someone you know has been undiagnosed or misdiagnosed for BED due to oversimplified diagnostic criteria, it’s essential to seek a second opinion from a qualified mental health professional. They can conduct a thorough assessment and provide a more accurate diagnosis, ensuring that appropriate treatment and support can be tailored to the individual’s specific needs.
Misconceptions about binge eating
Binge eating has a certain stigma associated with it, which leads to misconceptions. The most common one is that binge eating only affects those with bigger bodies. Dunham highlights the impact of the media in perpetuating this misconception and hindering those who don’t fit the media’s narrow depictions from getting the necessary support. “Binge eating can impact any individual regardless of their BMI, size, or weight”, says Dunham. You can’t tell someone’s eating behaviors purely by looking at them.
Additionally, especially when it comes to binge eating disorder, people may assume binge eating is purely about food and that restricting access to binge foods will resolve binge eating. However, Dunham says, “Binge eating is often associated with trauma, therefore, restricting binge foods usually doesn’t eliminate bingeing.” You may need the support of a mental health professional to work through these deeper issues.
Overcoming binge eating
Both Tambe and Dunham recommend seeking professional help and support if you are struggling with binge eating. “You do not have to do this alone,” Tambe says. A mental health professional can help you process the stress or trauma underlying binge eating, and help you develop adaptive coping skills, while a registered dietitian can help ensure you’re eating enough.
In the short term, Tambe encourages taking it one meal at a time. “Don’t dwell on everything that went wrong,” she says. “Think about how to nourish yourself for the next meal.”
Binge eating is often distressing, and it can be caused by restriction, food insecurity, trauma, and social conditioning. Sometimes, it’s a sign of a binge eating disorder. For help overcoming binge eating, consider working with a mental health professional and registered dietitian to process underlying trauma and ensure you eat enough to prevent deprivation-driven bingeing.