Binge eating disorder (BED)

What is binge eating disorder (BED)?

Binge eating disorder (BED) is a serious mental illness. People with binge eating disorder regularly experience episodes of binge eating (at least once a week), which involve eating large quantities of food, rapidly, in a short period of time. During these episodes people can feel out of control and unable to stop themselves from eating.

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 in a larger body or have a higher weight, while others may be in smaller bodies at a lower weight.

Binge eating disorder affects people of all ages, genders and from all backgrounds. It is the most common eating disorder in Australia, making up 47 per cent of people with an eating disorder. Despite this, public awareness of binge eating disorder is low, compared with anorexia nervosa and bulimia nervosa. Just over half of the people who experience binge eating disorder are women.

People with binge eating disorder often feel ashamed or guilty about engaging in binge eating. This is often linked with high levels of distress, and it can be a way that people cope 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:

• Recurrent binge eating episodes, in which a person eats a large amount of food in a relatively short period of time.
• Feeling a sense of loss of control while in engaging in binge eating and not feeling able to stop eating, even if uncomfortably full.

These episodes occur frequently, involve portions of food larger than would be considered normal periods of overeating, and are often accompanied by feelings of intense shame and guilt.

Physical symptoms of binge eating disorder

Physical signs and symptoms of binge eating disorder include:

• feeling tired
• not sleeping well
• feeling bloated, constipated, or developing food intolerances
• changes in weight
• gastrointestinal issues
• cardiovascular issues.

Psychological symptoms of binge eating disorder

Psychological signs and symptoms of binge eating disorder can include:

• preoccupation with eating, food or body shape or weight
• body dissatisfaction or concern about size, shape or weight
• 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 of binge eating disorder can include:

• periods of uncontrolled, impulsive or continuous eating
• eating until uncomfortably full and feeling unable to stop
• eating alone or in secret, secretive behaviours around food
• unexplained disappearance of food, hiding or hoarding food
• evading questions about eating and weight
• avoiding social situations or becoming more socially withdrawn
• spending large amounts of money on food, or shoplifting food
• self-harming behaviour, use of substances and suicidality.

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/or high cholesterol
• arthritis
• social isolation and loneliness
• depression or anxiety.

Diagnosis and treatment of binge eating disorder

If you think you (or someone you know) might have binge eating disorder, it is important that you see your doctor as soon as possible. The sooner you seek help, the sooner you can start to recover, and the more effective treatment can be.

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 supports around you.

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

The types of healthcare professionals who might be involved include:

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

There are a range of psychological treatments available to treat eating disorders.

Research indicates that the most effective therapies for binge eating disorder include:

• Cognitive Behavioural Therapy Enhanced (CBT-E)
• Cognitive Behaviour Therapy – Guided Self Help (CBT-GSH)
• Interpersonal Therapy (IPT).

Your healthcare professionals will need to ask several questions to help you work out the link between the way you think and your eating behaviour. Support groups can be helpful as an additional source of support, alongside treatment from healthcare professionals.

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

Where to get help

• In an emergency, always call triple zero (000)
• A GP (doctor) 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 Line Tel. 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 8 am to midnight AEST, 7 days