Binge Eating Disorder Diagnosis
Binge Eating Disorder (BED) is the most common eating disorder in the United States, yet there isn’t nearly enough conversation regarding BED diagnoses. It's much more likely to hear about eating disorders like anorexia or bulimia.
In fact, BED is three times more common than anorexia and bulimia combined. Even as the most prevalent eating disorder, BED is highly underdiagnosed and undertreated.
Shame, embarrassment, and a lack of awareness lead to difficulties in individuals openly speaking up and seeking help.
BED is a serious illness that significantly impairs quality of life. Being informed and educated is important so that accurate diagnosing is met with appropriate treatment and adequate care.
Binge Eating Disorder Diagnostic Criteria
BED is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which identifies the following criteria for a BED diagnosis.
BED is diagnosable when an individual is repeatedly binge eating, generally at least once a week for three months, and is highly distressed as a result of their behaviors.
Binge eating episodes are defined as eating large quantities of food in a discrete period of time, for example, within 2-hours. The quantity of food is an amount of food that is clearly greater relative to the typical amount one would eat under similar circumstances and in a reasonably short duration.
During a binge eating episode, the individual experiences a lack of control over what or how much food is eaten, and feels as if they cannot stop.
Episodes of binge eating correspond with at least three or more of the following:
Eating at a rapid pace, much faster than usual
Eating to the point of discomfort and pain due to uncomfortable fullness
Chaotically eating large amounts of food even while not physically hungry
Secretly eating alone, because of embarrassment and shame from how much food is being eaten
Feeling depressed, very guilty, and disgusted with oneself afterward
With BED, the individual does not recurrently use unhealthy compensatory behaviors such as purging, as in bulimia, to counter and make up for the food eaten.
When one suffers from BED, the binge eating episodes do not occur exclusively during the course of bulimia and anorexia; a BED diagnosis happens outside of a direct influence of those eating disorders.
Binge Eating Disorder Signs & Symptoms
The National Eating Disorders Association (NEDA) states emotional, behavioral, and physical signs and symptoms.
Evidence binge eating occurred, which may include the disappearance of large quantities of food in short periods or hidden empty wrappers and food containers indicating large consumptions
The individual appears uncomfortable when eating with others
Recent new practices with food or fad diets, like eliminating entire food groups (vegetarianism/veganism, no sugar, no carbs, etc.)
Fearful of eating in public
Steals food or hoards food in unusual places
Makes time available in their life to schedule binge sessions or creates rituals around binge eating episodes
Withdraws from typical routine, activities, and regular friends
Frequently diets
Shows a high degree of concern with body weight and shape
Frequently checks in the mirror for perceived flaws in appearance
Secretive repeated episodes of binge eating, feeling “out of control”
Disruption in normal eating behaviors; may include eating throughout the day without set mealtimes, skipping meals or eating small portions, or engaging in fasting or dieting
Developing and participating in food rituals (only eating particular foods or food groups, excessive chewing, etc.)
Eating alone often due to shame
Disgust, depression, or guilt are felt after binge eating
Low self-esteem
Gastrointestinal complaints (stomach cramps, constipation, acid reflux, bloating, etc.)
Difficulties concentrating or focusing
Noticeable fluctuations in weight
It’s a myth that BED only occurs in people with larger bodies. People can suffer from BED at any body size. Weight stigma and weight bias play huge factors in this myth, causing great harm overall.
What Causes Binge Eating Disorder?
There’s no single cause of BED, rather there are numerous biological, psychological, and social factors that contribute to the development and onset of BED.
With a genetic predisposition, BED may be more likely in some families. People who suffer may either have a family member who struggles with food, substance abuse issues, or other mental health concerns.
Psychologically, those with BED are known to suffer from low self-esteem, negative body image, and feelings of inadequacy and loneliness. Mood and anxiety disorders oftentimes intersect with BED.
In our society, dieting and weight loss drive the cultural narrative, suggesting that people have total control over their eating and weight. This unhealthy messaging fosters shame and inadequacy, influencing the development of BED.
What Is the Difference Between Binge Eating and Overeating?
Does binge eating and overeating automatically mean a BED diagnosis? The short answer is, no. “Binge eating” and “overeating,” are frequently used interchangeably, however, there’s actually a notable difference between the two.
As described above in the BED diagnosis criteria, binge eating is characterized by consuming significantly large quantities of food in one sitting or short period, and it feels as if you’re unable to stop eating only once you’ve been forced to by reaching uncomfortable fullness and discomfort.
A binge eating episode can feel like an out-of-body experience, set on autopilot, where your body and mind feel taken over, and you don’t have control over what or how much you’re eating.
Overeating is a normal, common tendency that we all experience from time to time in which you eat beyond fullness. It’s simply a part of life, because “perfect eating” doesn’t exist. Overeating could look like having an extra serving of dinner or choosing to enjoy dessert when you’re already feeling physically full. Depending on the situation, overeating can be intentional or unintentional.
Binge eating and overeating can be experienced separately from BED. Just because you binged, it doesn’t mean that you meet the criteria for a BED diagnosis. If you overate, or ate and felt uncomfortably full, it also doesn’t mean that was considered a binge. Realistically, maybe you did neither and it happened to be the proper amount of food your body was asking for at the time.
Recovery From Binge Eating Disorder
It can be discouraging and intimidating to step out and ask for help when you’re unsure if the binge eating will ever end. BED is treatable and recovery with a life of food freedom is possible!
You don’t have to figure it out on your own. As an eating disorder counselor skilled in treating BED, my goal is to advocate for you, guide you, and work with you to overcome BED.
If you are in search of a therapist who specializes in eating disorders, disordered eating, and healing your relationship with your body, please feel free to visit my website or email me to see if working together might be a good fit for you. My office is based in Salado, Texas, and I can provide virtual therapy services across the state of Texas.
Good on therapy? Great! I also have a weekly newsletter called Sunday Soothies you might be interested in signing up for. If you ever get a case of the Sunday Scaries, cozy up with your inbox every Sunday morning and soothe your way into your week! Join the Soothie Crew here.
