Binge eating

Binge eating is an eating disorder where a person feels compelled to overeat on a regular basis.

Information written and reviewed by Certified Doctors.

Contents

Introduction

Binge eating is an eating disorder where a person feels compelled to overeat on a regular basis.

People who binge eat consume very large quantities of food over a short period of time and they often eat even when they are not hungry. Binges are often planned and can involve the person buying "special" binge foods.

Episodes of binge eating often alternate with periods where the person severely cuts down on the amount of food they eat, which can make the problem worse.

Binge eating usually takes place in private, with the person feeling that they have no control over their eating. They will often have feelings of guilt or disgust after binge eating. These feelings highlight underlying psychological issues, such as:

  • low self-esteem and lack of confidence
  • depression – feelings of extreme sadness that last for a long time
  • anxiety – a feeling of unease, such as worry or fear, that can range from mild to severe

These feelings can be made worse over time while the person is still binge eating.

Read more information about the causes of binge eating.

Who is affected by binge eating?

Anyone can be affected by binge eating. Unlike anorexia, where more women than men are affected, binge eating affects men and women equally. The condition tends to be more common in older adults than in younger people.

Binge eating and bulimia

People who binge eat and those with bulimia (another type of eating disorder) often eat until they are uncomfortably full. People with bulimia then purge (flush out) the food they have eaten by making themselves vomit or by taking laxatives (medicine to help empty the bowels).

Unlike those with bulimia, people who binge eat do not purge themselves to control their weight, and are more likely to try to limit weight gain by having periods of eating very little. However, this often leads to more binge eating and sometimes weight gain, which can lead to obesity (see below).

Binge eating and obesity

Binge eating is often associated with obesity, where someone is very overweight with a body mass index (BMI) of 30 or over. Obesity is a serious health problem that can lead to a number of serious chronic (long-term) health conditions, such as:

Being obese can also shorten your life expectancy. For example, the life expectancy of obese adults who are over the age of 40 can be shortened by six or seven years.

Read more about the symptoms of binge eating for details of other health conditions related to obesity.

Seeing your Doctor

Visit your doctor if you think that you have a binge eating problem. They will be able to diagnose the condition and refer you to a specialist, such as a psychiatrist or a psychologist. In some cases, you may also be referred to a dietitian.

In diagnosing binge eating, your doctor will ask you about your eating habits and look for three or more of the following signs:

  • you eat much faster than normal during a binge
  • you eat until you feel uncomfortably full
  • you eat a large amount of food when you are not hungry
  • you eat alone or secretly due to being embarrassed about the amount of food you are consuming
  • you have feelings of guilt, shame or disgust after binge eating

People who regularly eat this way are likely to be diagnosed with a binge eating disorder.

Treating binge eating

Binge eating is a treatable condition and a number of different treatment options are available. For example, treatments include:

If you are overweight, a healthcare professional may draw up a weight loss plan once any psychological issues have been dealt with. This is to help you lose weight in a safe and effective way.

People can recover from binge eating if they can understand the psychological issues causing their condition, adopt regular eating patterns and receive realistic advice about food.

Read more about how binge eating is treated.

Symptoms

The symptoms of binge eating usually include a person eating in private and feelings such as having no control and guilt or disgust after binge eating.

People who binge eat consume very large quantities of food over a short period of time and they often eat even when they are not hungry. Binges are often planned and can involve the person buying "special binge foods".

Binge eating can also have a number of physical effects on the body as a result of fluctuating blood sugar levels. These include:

  • sugar cravings
  • headache
  • sweating and tremor

Complications of binge eating

Weight gain is the main complication of binge eating. Many people with the disorder are already overweight.

If you are carrying too much weight you are vulnerable to other health problems that are associated with obesity. These include:

  • high cholesterol – high levels of cholesterol in your blood increases your risk of heart disease and stroke
  • high blood pressure (hypertension) – this also increases your risk of cardiovascular conditions such as stroke or heart disease
  • diabetes – a chronic (long-term) condition caused by too much glucose (sugar) in the blood
  • asthma – where the lung airways become inflamed
  • osteoarthritis – a condition that causes pain and swelling in the joints
  • chronic back pain
  • heart disease – where the heart’s blood supply is blocked by a build-up of fatty substances in the coronary arteries (the main blood vessels of the heart)

Read more information about obesity.

Causes

There is no single cause for binge eating. However, like most eating disorders, it is seen as a way of coping with feelings of unhappiness and low self-esteem.

The binge eating cycle

People who binge eat often display a particular pattern of behaviour known as the binge eating cycle. The binge eating cycle (described below) is difficult to break.

  • binge eating leads to a surge in blood sugar that causes the pancreas to produce insulin (a hormone that helps to break down fat and carbohydrate in the body)
  • the insulin causes blood sugar levels to fall rapidly, resulting in a false message being sent to the brain that more food is needed to top up glucose levels
  • this results in cravings for sugary foods to provide a quick glucose fix, so the person eats large quantities of food even when they are not hungry
  • eating large amounts of sugary foods leads to a rapid increase in blood sugar levels and the production of insulin, causing the cycle to begin again

Depression

It is estimated that about 50% of people who binge eat have been depressed at some point in their life. However, it is not clear whether depression causes binge eating or whether binge eating causes depression.

Read more information about depression.

Stress and anxiety

Stress is another common trigger of eating disorders. Stressful events, such as moving house, job or school, or the death of a friend or relative, can sometimes cause someone to binge eat.

People with eating disorders usually experience difficulties in their personal life. Those who binge eat are often ashamed at the amount of food that they consume. They may also feel that their lack of control around food mirrors the lack of control they have over their personal lives.

Research has suggested that there are other factors or emotions that may bring on an episode of binge eating, including:

  • anger
  • boredom
  • worry or anxiety
  • sadness
  • low self-esteem

There are also specific behaviours that are more common in people with a binge eating disorder. These include:

  • impulsive behaviour – acting quickly without thinking about the consequences
  • alcohol misuse – regularly drinking more than the recommended daily amount of alcohol
  • avoiding discussing feelings and emotions openly
  • not feeling responsible for yourself or your actions

Trying to lose weight

The social pressure of trying to achieve a slim body shape can sometimes cause a person to binge eat.

People who binge eat may be unable to achieve their desired body shape. This can result in a sense of inadequacy, causing them to overeat and feel guilty afterwards.

It is not known whether dieting and binge eating are related. However, some people binge eat after:

  • skipping meals
  • not consuming enough food each day
  • avoiding certain foods

These are unhealthy methods of trying to lose weight and alter body shape, and these methods increase a person's risk of binge eating.

Treatment

It is important that you seek medical advice if you think that you have a binge eating disorder. Your doctor will assess you and recommend the best course of treatment for you:

  • a self-help programme
  • psychological therapy
  • a selective serotonin reuptake inhibitor (SSRI) antidepressant

These are described in more detail below.

Self-help programme

A self-help programme is the first step towards recovery. There are many different types of self-help and it is important to find one that suits you. Your doctor may be able to recommend a self-help book or self-help group that would be suitable in your area.

You may be able to find information on self-help books from your local library or from the eating disorders charity Beat, which also has information on finding self-help and support groups for eating disorders.

If you are referred to a mental health professional for help, they might encourage you to work through a self-help book under their supervision. This is called "guided self-help".

Psychological therapy

People who binge eat are encouraged to stop relying on the cycle of bingeing and guilt as a way of dealing with their emotional problems.

It is possible to make a full recovery from binge eating by using certain types of psychological therapy, such as:

  • cognitive behavioural therapy (CBT) for binge eating disorder (CBT-BED) – a specially adapted type of CBT that involves talking to a therapist and working out new ways of thinking about situations, feelings and food
  • an adapted form of dialectical behaviour therapy (DBT) – you discuss all aspects of your binge eating disorder with a therapist. DBT has been used effectively to treat other mental health disorders associated with impulsiveness
  • interpersonal therapy (IPT) – another form of brief therapy that has been shown to be helpful in treating patients with binge eating and bulimia

Selective serotonin reuptake inhibitors

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that can help reduce binge eating. They are usually prescribed in combination with therapy.

SSRIs boost levels of a substance called serotonin. When serotonin is released in the brain, it helps to lift your mood. NICE recommends the use of SSRIs to help reduce binge eating, but the long-term effects of the treatment are unknown.

Known side effects of SSRIs include:

Read more information about selective serotonin reuptake inhibitors (SSRIs).

Losing weight

Although there are a number of psychological treatments available to treat binge eating, they might have a limited effect on your body weight.

However, underlying psychological issues need to be dealt with first to allow someone to regain control of their eating habits.

If you are overweight, you should follow a weight-loss plan that is drawn up by a healthcare professional, such as your doctor or a dietitian (a food and nutrition specialist). The plan may involve the following:

  • keeping a food diary to highlight when you binge and the types of food you binge on that you think are fattening – you will be encouraged to include these in your eating plan to reduce the urge to binge on them
  • avoiding eating sugary foods, as eating quality carbohydrates (see below) will provide a slow and sustained energy release throughout the day
  • eating regular meals and snacks, and including complex carbohydrates, such as brown rice, wholemeal bread and cereal, lentils and potatoes – this will help keep you feeling full as well as stabilise your blood sugar
Content supplied by NHS Choices