Binge eating is more common than anorexia or bulimia, but still hidden

For many people, the term “eating disorder” will conjure up in their mind its two most familiar forms: anorexia nervosa and bulimia nervosa. What they don’t know, however, is that “binge eating disorder” is more common than the other two combined and can significantly reduce quality of life.

Rather than overeating, which most people do from time to time, binge eating reflects a recurring behavior pattern of losing control, binge eating, and feeling shame and guilt afterwards.

Binge eating disorder was not recognized as a diagnosis until 2013, much later than anorexia and bulimia. And a lack of awareness about binge eating means that people with the disorder don’t get the help they need from doctors.

As our research project recently discovered, people with binge eating disorder are also underrepresented in eating disorder studies, limiting researchers’ ability to develop treatments.

Understand the basics of binge eating

Unlike bulimia, or the type of anorexia that involves binge eating and purging, people with binge eating disorder do not attempt to compensate with strategies such as purging or excessive exercise after a binge episode.

Furthermore, unlike anorexia or bulimia, which predominantly affect women, binge eating disorder affects 3.5% of women and 2% of men in their lifetime.

Although it may first appear in childhood and adolescence, binge eating usually occurs in early adult life. It is important to note that it is a phenomenon that can be seen in people of all sizes, although many individuals who experience it are in a higher weight range.

According to the US National Library of Medicine, there are five criteria for diagnosing binge eating disorder:

1. Recurrent episodes of binge eating characterized by the ingestion, in a limited period of time, of a greater amount of food than most people would eat under similar circumstances. It is accompanied by a lack of control over eating during the episode.

2. Binge episodes are associated with three or more of the following factors: eating much faster than normal, eating until you feel uncomfortably full, eating large amounts of food when you don’t feel physically hungry, eating alone out of embarrassment, and feeling disgusted , depressed or very guilty afterwards.

3. The anguish caused by binge eating.

4. Binge eating, on average, at least once a week for three months.

5. Binge eating is independent of other disordered eating behaviors, such as vomiting after eating, as occurs in bulimia.

Other warning signs of binge eating disorder are:

• Frequent weight fluctuations.

• Fad diets, including eliminating entire food groups (carbs, sugar, dairy, etc.).

• Extreme preoccupation with weight and body shape.

• Tendency to steal or hoard food.

• Withdrawal from friends and usual activities.

• Eating in secret and hiding evidence (such as food wrappers).

Long-term health complications associated with this type of eating disorder include heart disease, type 2 diabetes, obesity, and osteoarthritis (due to wear and tear on the cartilage that cushions the ends of the bones in the joints).

hidden in plain sight

Despite knowing all this, binge eating is still considered the “hidden” eating disorder. Without the extreme weight loss or purging behaviors that can accompany other eating disorders, binge eating is less recognizable. Moreover, they can come to be considered as an occasional excess.

The stigma and shame surrounding this behavior is significant and can prevent people from accessing help and treatments that could combat the disorder. Here’s a fact: less than half of people who experience binge eating seek and receive treatment. And because patients don’t describe it to their doctors, it’s common for them to receive treatments related to weight loss or other health complications from binge eating.

As a consequence of the lack of awareness and debate, there are hardly any researchers working in the field of eating disorders.

The gap in research

Recruiting people who have bingeed for studies on eating disorders is essential to better understand the disease and improve treatments. However, our experience in recruiting participants for our own study indicates that it can be a significant challenge. Despite our efforts, the number of participants with anorexia or bulimia far exceeds that of binge eaters.

Current treatments for adults with binge eating disorder include cognitive behavioral therapy, antidepressants and, in some countries, the drug lisdexamfetamine, which is the only drug so far approved for the disorder.

We desperately need to educate and raise awareness about the fact that binge eating is a prevalent – ​​and potentially deadly – ​​eating disorder. Only then will we be able to combat the current stigma and provide enough information on the factors that drive this behavior to try to address it.

Article translated thanks to the collaboration with Fundación Lilly.

Hannah Kennedy, Post-doctoral fellow, Department of Psychological Medicine, University of Otago

This article was originally published on The Conversation. Read the original.