Binge eating disorder

Binge eating disorder is a serious mental illness. People with binge eating disorder regularly (at least once a week) eat large quantities of food, rapidly, in a short period of time. They feel out of control and unable to stop themselves from eating. This is often linked with high levels of distress.

People with binge eating disorder do not typically try to ’compensate’ for their eating with behaviours such as vomiting or excessive exercise. This means that some people with binge eating disorder may be overweight or obese.

Being overweight or obese does not necessarily mean you have binge eating disorder. Some people may be overweight or obese due to long-term overeating, or continual snacking on smaller amounts of food during the day.

Binge eating disorder affects people of all ages and from all backgrounds. In 2012 over 260,000 Australian women and 160,000 men experienced binge eating disorder, making it the most common eating disorder. The number of males diagnosed with eating disorders is rising. It is thought that equal numbers of males and females may have binge eating disorder.

Public awareness of binge eating disorder is fairly low, compared with anorexia nervosa and bulimia nervosa, even though there are more people with this condition.

People with binge eating disorder often feel ashamed or guilty about the food they are eating. People often binge eat when they are under stress, and use as a way of coping with difficult emotions.

Symptoms of binge eating disorder

There are a number of signs and symptoms that suggest someone might have the condition and needs to seek help.

The two key features of binge eating disorder are:

• eating a very large amount of food in a short period of time (for example, two hours)
• feeling a sense of loss of control while eating (for example, feeling like you can’t stop eating).

These episodes occur frequently, and involve portions of food larger than would simply be considered ‘overeating’.

Physical symptoms of binge eating disorder

Physical signs and symptoms include:

• feeling tired
• not sleeping well
• feeling bloated or constipated
• rapid weight gain.

Psychological symptoms of binge eating disorder

Psychological signs and symptoms can include:

• preoccupation or obsession with eating, food or body image
• sensitivity to comments about food, dieting, exercise or body image
• feelings of shame, guilt and self-loathing, especially after a binge eating episode
• feelings of extreme distress, sadness and anxiety, especially after a binge eating episode
• a distorted body image or extreme dissatisfaction with body shape
• low self-esteem, depression, anxiety or irritability.

Behavioural symptoms of binge eating disorder

Behavioural signs and symptoms can include:

• unexplained disappearance of food – hiding binge eating episodes
• secretive behaviour around food – hoarding food or hiding wrappers and packaging
• evading questions about eating and weight
• becoming more antisocial and withdrawn
• erratic behaviour – spending large amounts of money on food, or shoplifting food
• self-harming behaviour, use of substances and suicide attempts.

Long-term effects of binge eating disorder

Untreated and ongoing binge eating disorder can result in many physical and mental health problems. These include:

• cardiovascular disease
• type 2 diabetes
• high blood pressure and high cholesterol
• arthritis – especially in weight-bearing joints like knees and hips
• social isolation and loneliness
• depression or anxiety.

Diagnosis of binge eating disorder

To diagnose binge eating disorder or other eating disorders, a doctor will need to:

• do a full physical examination
• do blood tests
• ask questions about your health, including your emotional health and wellbeing, medical history and lifestyle.

Understanding the warning signs and symptoms and seeking help as soon as possible will help your recovery.

Treatment of binge eating disorder

Treatment for binge eating disorder needs to address both your physical and mental health. Early treatment is the best way to help you towards a full recovery. The journey can be difficult, but you can get there with the right help and commitment.

A GP with experience supporting people with eating disorders can be a good first point of contact. Once binge eating disorder is diagnosed, your doctor will assemble a team of healthcare professionals who will be best suited to help you.

The types of healthcare professional who might be involved include:

• a psychiatrist
• a psychologist
• a dietitian
• a family therapist
• a social worker.

There are a range of psychological treatments available to treat eating disorders. Cognitive behaviour therapy (CBT) and interpersonal therapy are the two treatments of choice for binge eating disorder.

CBT works on changing the unhelpful thoughts and behaviours that are causing and maintaining the eating disorder. This is the most researched and recommended treatment for adults. Your healthcare professionals will work with you to help you work out the links between your thinking, your emotional response and your eating behaviour

Your healthcare professionals will need to ask a lot of questions to help you work out the link between the way you think and your eating behaviour. Support groups can be helpful, but do not replace treatment from healthcare professionals.

Other treatment options include medications for any physical conditions that you might have and, in some cases, medication to help your mental health (for example, antidepressants).

Where to get help

• In an emergency, always call triple zero (000)
• A GP with experience supporting people with an eating disorder
• Eating Disorders Victoria Hub Tel. 1300 550 236 – support from Monday to Friday 9.30 am to 4.30 pm
• Community health centre
• Lifeline Tel. 13 11 14
• Suicide LineTel. 1300 651 251
• Kids Helpline Tel. 1800 55 1800
• Butterfly Foundation for Eating Disorders – National Helpline Tel. 1800 ED HOPE (1800 33 4673) – support from 8am – midnight AEST, seven days a week