Binge eating disorder (BED) is the most common eating disorder in which you consume unusually large amounts of food while feeling unable to stop eating and losing control. People who binge use food to deal with unwanted emotions or stress. Binge eating is the most common eating disorder in the United States with overall  about 3.5% of women and 2% of men are being affected with binge eating disorder. A study suggests that 40% or more of people with binge eating disorders are male. During a binge, you may eat even when you are hungry and keep eating long after you are full. It usually begins in the late teens to your early twenties, although at any age may occur. BED probably affects 1 to 5% of all adults. Among mildly obese people in self-help, 10 to 15% have binge disorder. BED is a chronic illness that can last for many years. Binge eating episodes occur on average at least twice per week for six months. BED can take place in men and women of normal weight, often leading to the development of unwanted weight gain or obesity, which might promote more compulsive eating. BED affects three times the number of people diagnosed with anorexia and bulimia together.

Causes of Binge eating disorder

 The exact cause of BED is unknown, but a variety of factors influence the development of this disorder. Binge eating disorder is being linked to other mental health conditions. Nearly half of people with BED have a history of depression. These are the following factors which cause BED:

• Biological factor

Biological abnormalities such as genetic mutations or hormonal variations can lead to obsessive eating and food dependence. Approximately 95% of BED patients had a parent with BED. If your parent or siblings have an eating disorder, then you are a greater risk of developing one.

• Psychological factor

There is a strong correlation between binge eating and depression. 80% of people with BED have at least one psychological disorder, including body dissatisfaction, feeling very lonely, low self-esteem, depression, anxiety, and phobia

• Emotional trauma  

Stressful life incidents such as violence, death, weight discrimination, separation from a family member or a car accident are being found to be risk factors. Bullying of children can also contribute to weight gain.

• Changes in brain

There are indicators that people with BED can experience changes in brain function, resulting in increased responses to food and less self-control.

• Dieting 

 Most people with binge-eating disorder have a history of dieting. During the day, dieting or reducing calories can cause an urge to binge eat, particularly if you have symptoms of depression.

• Body size

 Approximately 50% of BED patients are overweight and 25 to 50% of patients seeking weight loss surgery meet BED requirements. Weight problems are both a cause and a consequence of the disorder.

Symptoms and signs of Binge eating disorder

Binge eating differs from overindulging, it is a serious condition because of chronic and uncontrollable overeating. Most people who suffer from this condition have not received appropriate care in a safe, constructive manner to cope with negative emotions. Thus, people with BED find eating comfortable and soothing. Following are some behavioural or emotional signs and symptoms of BED:

• Eating constantly when you are full.
• Weight fluctuation (mostly weight gain).
• Eating more quickly than usual.
• Unable to control what you eat or avoid eating.
• Eating normally in front of many people but gorging while in isolation.
• Eating a large quantity of food without being physically hungry.
• Experience feelings of stress or anxiety that can keep you at ease only when you are eating.
• The sensation of low self-esteem.
• When binging, feeling numb or lack of sensation. 
• Feeling guilty or disgusted after overconsumption.
• Never experiencing satiation (a state of satisfaction regardless of how much food is being eaten).

 There are many physical, social and emotional difficulties involved in the effects of BED. Some of these complications are cardiovascular disease, diabetes, insomnia (sleep apnea), hypertension, muscle or joint pain, gastrointestinal difficulties, depression and anxiety.

Risk of Binge eating disorder

BED is being linked to several major emotional, physical and social health risks. Approximately 50% of BED patients are overweight. However, because of the high-calorie intake during binge episodes, the disorder is a risk factor to gain weight and thus become obese. Obesity increases the risk of developing a heart attack, stroke, type 2 diabetes and cancer. Other BED-related health risks include sleep problems, asthma, chronic pain condition and irritable bowel syndrome. There may be a condition with fertility issues, pregnancy complications and polycystic ovary syndrome in women with BED. About 13% of people experience a reduced ability to function properly in social situations with severe dysfunction. People with BED have a high rate of hospitalization, significantly lower quality of life because of having higher visits to emergency departments compared to healthy people.

Treatment for Binge eating disorder

The goal of the treatment is to reduce eating binges and develop a healthy eating habit. Binge eating has a strong link with low self-image and other negative emotions. Treatments may also help to address certain mental health issues such as depression and anxiety. With proper help and treatment to cure binge eating, you can learn how to take control of your eating. 

1. Psychotherapy 

Psychotherapy also referred to as talk therapy can teach you how to exchange unhealthy habits to healthy ones and reduce binging episodes.  Examples of psychotherapy include:

• Cognitive behavioural therapy (CBT)

CBT may help you cope better with issues that can cause binge-eating episodes such as negative feelings about your body or mood. It can also help to give you a better sense of control over your behaviour and help you regulate your eating patterns. The self-help form of therapy is cheaper and more accessible where you can find them on websites and mobile devices that provide support. Self-help CBT has proved to be an effective alternative to traditional CBT.

• Interpersonal psychotherapy 

Interpersonal psychotherapy focuses on your relationship with others. The aim of this therapy is to improve your interpersonal skills, such as how you relate to your family, friends and others. This may help to reduce binge eating that’s triggered by problematic relationships and unhealthy interaction. This therapy is effective for people with more severe forms of binge eating and lower self-esteem.

• Dialectical behaviour therapy 

This therapy can help you tolerate stress, control your emotions and strengthen your relationships with others that will reduce the desire to binge eat. 

2. Medications 

Lisdexamfetamine dimesylate (Vyvanse) is the first FDA-approved medication to treat moderate to severe binge-eating disorder in adults. Vyvanse may be habit-forming, the common side effects include a dry mouth and insomnia but there may be more severe side effects. The antiseizure drug topiramate (topomax) may also help with BED, but its side effects can include memory problems, sedation and speech problems. Antidepressants primarily serotonin reuptake inhibitors can also help to reduce binge-eating and eating obsession related to it. Although few medications can be effective in managing binge-eating episodes, they may not have a significant impact on weight loss.  

3. Nutrition counselling 

With the help of a nutrition specialist, you can maintain a normal eating pattern but it also helps you to learn about nutrition and balanced diet. You may also get referred to a weight management programs either during or following psychological treatment. These programs provide nutritional counselling and help you learn how to achieve a healthy weight in the safest way. 

Diagnosing binge eating disorder 

With secrecy, shame and denial being the characteristics of the condition that diagnoses the disorder can be challenging. Therefore the disease can go undetected for a long period. The binge-eating disorder gets discovered when a person is seeking professional help with weight loss, treatment for obesity or mental health-related problems such as depression. If BED gets suspected then the doctor will begin the evaluation by completing a medical history and physical examination. The doctor may perform several tests to check for any related complications.

• Physical exams 

A physical examination will include measuring your height, weight and checking your vital signs such as heart rate, blood pressure, examining your abdominal, listening to your heart and lungs.

• Lab tests 

A lab test may include a complete blood count and more tests to check electrolytes, protein and the function of your kidney, liver and thyroid. This can also require a urine test. 

• Other studies

X-rays test may help with checking your heart problems. Electrocardiograms may detect heart irregularities. Tests may also assess how much energy your body uses which can help with the planning nutritional requirements. 

A person with binge-eating disorder may get referred to a psychiatrist or psychologist for the purpose of diagnosing and treating mental illness. They use specially designed interview and assessment methods to test a person with binge-eating disorders. With the help of the tests and results of it, doctors can recommend the proper treatment for you or anyone in your family with this disorder.