Binge eating disorder (BED) is the most common form of eating disorders.  Are you surprised to hear this?  So, why is it important for us to talk about BED?  Well, I strongly believe that BED is a major factor in the overweight and obesity epidemic.  And, these diseases put us at high risk for diabetes, heart disease, high blood pressure, disturbed sleep, and other disease and conditions. 

Yes, these diseases are complex, and there are many contributing factors.  However, at some point in our lives, we must really examine our unhealthy eating habits and why we often use food to cope and numb our feelings.  You see,  all of those feelings and emotions that we try to numb are valid and legitimate.  However, we need to find ways to handle and express them in a less destructive manner.

So, let me break this down for you.  This post is not about losing weight so you can stop rolling your eyes and biting your nails.   In fact, BED occurs in people who are underweight, normal weight, and overweight.   However, I recognize that weight loss and dieting are among the top health searches on the internet.  Additionally, as a registered dietitian nutritionist, more women ask me about how to lose weight more than any other topic. 

So, here we are.  You, me, and a terrific group of vulnerable and transparent sisters talking about our eating habits.

What is Stress Eating?

Stress eating is an early sign of binge eating disorder.  It is defined as eating in response to acute or chronic stress. However, it also involves eating in response to negative emotional states when you’re not hungry. Stress eating is also called emotional eating because your emotions (not your body) determine when, what, and how much you eat.  These emotional states include:

• Fear
• Anger
• Anxiety
• Depression
• Guilt
• Resentment
• Frustration 
• Sadness
• Boredom
• Helplessness
• Hopelessness  

When Renee looked at the list, she admitted that she stress eats because she is frustrated with her marriage. Additionally, she resented that she did most of the childcare and cleaning even though both she and her husband work full-time. So, she stress eats. Often.

What is Compulsive Eating?

Stress eating often leads to compulsive eating.  So, compulsive eating is defined as a loss of control over your eating.  Kendra often described it as “descending into darkness.”  She stated, “Once I start eating, I just can’t stop myself.  Sometimes, it’s not that I crave a particular food.  In fact, I lie to myself and say that I will have just two cookies.  However, two turns into six, and six turns into the whole bag.”  She sighs and hangs her head.

Does this sound familiar?

Well, here’s the interesting part.  Experiencing a loss of control when eating is a key component in the definition of a binge eating disorder.

Feeling that you can’t control your eating is a key sign of a binge eating disorder.

Binge Eating Disorder

So, how prevalent is BED?   According to the National Institute of Mental Health (NIMH), the overall prevalence of BED among adults is 1.2%, and the lifetime prevalence is 2.8% of Americans over age 18 has BED, and 2.8%.  Not surprising, BED is twice as high in women (1.6%) than men (0.8%).  Furthermore,  the National Eating Disorders Association reports that BED is three times more common than anorexia and bulimia combined.  Surprisingly, it is also more common than breast cancer, HIV, and schizophrenia.  Unfortunately, only about 28% of people with a BED receive treatment.

The NIMH also reports that individuals with BED also tend to have other conditions. For example,

• Anxiety disorder (65%)
• Mood disorder (46%)
• Impulse control disorder (43%)
• Substance abuse disorder (23%)

In 2013, the American Psychiatric Association finally included BED as one of the newest eating disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-5.  Of course, BED is not a new disorder, but it finally was recognized as such.

Now, don’t be alarmed because BED is classified as a “mental disorder.” I reassured Angie that one of the best things about adding BED to the DSM-5 is that most insurance companies cover it as an official diagnosis. 

Causes of Binge Eating Disorder

So, let’s be honest.  Food is both nourishing and comforting.  And, for many of us, nursing from our mother’s breast and hearing her heartbeat was our first experience of being nourished and comforted with food.  Thus, it is understandable why food is used as a coping mechanism.

On average, BED starts around age 21. And while there has not been as much research on the causes of BED as compared to anorexia and bulimia, researchers believe that it is caused by:

• Daily living in an obesogenic and food-saturated society
• Societal and media pressure to look “thin and beautiful”  
• Rigid dieting practices and restricted eating
• Biological factors and brain chemistry that may influence binge eating eating
• Childhood associated trauma (e.g. verbal and physical abuse, body shaming, sexual assault, or post-traumatic stress syndrome)
• Psychological disorders (e.g. anxiety, depression, mood disorder, impulse control disorder)
• Inability to cope with stress in healthy ways

Binge Eating Disorder usually starts around age 21

Diagnosing a Binge Eating Disorder

I know that it is a lot to take in but bear with me. Health professionals use the following criteria in the DSM-5 to diagnose a BED.  When talking with Angie, I used simple language instead of technical terms as much as possible. 

• Frequent episodes of binge eating.  In fact, an episode must have both of the following: 
  • Eating more food than what most people would eat in a similar amount of time (e.g., within two hours)  2-hour period)
  • Feeling that you cannot stop eating or control what or how much you eat
  • For example, Angie often eats an entire pint of ice cream in 15 minutes. 
• The binge eating episodes are associated with three (or more) of the following: 
  • Eating faster than normal and eating until you feel uncomfortably full
  • Consuming large amounts of food even when you’re not feeling physically hungry
  • Eating alone because you feel embarrassed by how much you eat
  • After dinner, Angie eats two large candy bars hidden in her purse in 10 minutes.  Although she feels stuff, she goes to the pantry and eats some cookies.
• Feeling disgusted with yourself, depressed, or very guilty after each binge
  • Angie feels disgusted that she “has no control” and calls herself names.
• Looking and feeling very distressed about binge eating
  • After her binge, Angie lies on the couch and stares blankly at the TV for several hours before going to bed crying.
• The binge eating occurs, on average, at least once a week for 3 months
  • Angie binge eats almost every day.  In fact, she normally eats seconds at most of her meals.
• The binge eating is not followed by behaviors such as vomiting and using laxatives; it also does not occur as part of bulimia nervosa or anorexia nervosa
  • Although Angie binge eats several times a week, she does not vomit or use laxatives.

Treatment for Binge Eating Disorder

So, now we get to the big question.  How is BED treated? Like other eating disorders, BED is a complex disease and is best treated with a combination of treatments by various health professionals.  Treatment aims to:

• Minimize your binge eating episodes
• Bring your weight within the normal range for your height and age
• Manage associated physical conditions (e.g. diabetes, high blood pressure, or elevated cholesterol)
• Manage associated mental conditions (e.g. anxiety, depression, impulse control, or mood disorder)
• Use healthy alternatives to cope with stress other than eating

See Your Doctor

Since BED is primarily a medical problem, then you should seek medical help.  And, this is important because if a physician diagnoses you, your health insurance may cover treatment (minus your co-pay).

Yeah, I know you hate doctors and you feel ashamed of your eating.  But, please stick with me here.  I had to convince Renee that seeing a doctor was in her best interest.  I asked her, “Would you see a doctor if you suspected you had an ear infection, diabetes, or cancer?” She grudgingly admitted that she would and made an appointment.   

In addition to a medical exam and running some tests, your doctor will also check to see if you have other related issues such as diabetes, high cholesterol, high blood pressure, heart problems, gastric reflux, and sleep-related disorders.  In addition to diagnosing her with BED, Renee’s doctor also diagnosed her with high blood pressure and obesity.  However, she didn’t stop there.  She should also referred Renee to a psychologist and a registered dietitian nutritionist.

I know this is a lot to take in. However, you are a vital part of your healthcare team and you should ask questions, research treatment options, and advocate for yourself.

Join Overeaters Anonymous

Well, one of the most important keys to recovery is to admit that you’re a binge eater and a food addict.  Furthermore, you must also admit that a large part of your life revolves around food.  Now, if these statements sound like it came from the 12 steps from Alcoholics Anonymous (AA), it did.   

Angie joined Overeaters Anonymous (OA) to deal with her BED.  She stated, “I know I’m a food addict, and it was very hard for me to admit it.  I checked them out online and this is the first step I need to take.”

OA is a  global, community-based fellowship program that helps men and women struggling with binge eating, compulsive eating, bulimia, anorexia, over exercising, or other problematic eating.  OA is a Twelve-Step program that uses the principles of AA.  It is built around abstinence (from overeating), support from peers, regular meetings, and discussions surrounding food addiction.  OA is effective because it addresses the physical, mental, and spiritual dimensions of health.

Angie travels a lot for work and was happy to discover that most cities that she visits have a chapter of OA that meets regularly.

Create New Habits and Self-Care Routines

Now, you don’t want to miss this part.  There are several self-care practices that you can use to help you cope with your stress, anxiety, BED.  I recommended journal writing, practicing daily meditation and deep breathing, and using aromatherapy to Kendra. 

Journaling

Kendra was initially hesitant about journaling.  She stated, “I hate to write and I don’t think I can do it every day.” However, after learning about the benefits of journal writing and completing a 7-day gratitude journal writing challenge, Kendra wrote in her journal several days a week, especially on the days when the urge to binge eat was overwhelming.

• “I list 5 things for which I am grateful every day.”
•  “The brain dumping activities help me to just list all of the negative emotions that ran through my mind.”
•  “Sometimes I write a short poem about my feelings and doodle on the page.”

Mediation and Deep Breathing

Meditation means different things to different people.  Kendra added a 5-minute box breathing activity to her daily prayer and Bible reading routine.  She also did her breathing exercises when she felt impulsive and out of control.  Furthermore, she focused on learning to wait well and curbing her impulsiveness. 

• “The breathing activity was a game changer. It slowed me down just enough to take the edge off my eating.  It didn’t work all of the time, but it helps.”
• “I also used 10 minutes of my lunch break to give clear my head with a walking meditation.”

Aromatherapy and Essential Oils

I encouraged Kendra to intentionally use aromatherapy and essential oils in her self-care toolkit.  Remember, aromatherapy is not just for your “bad days.”  Instead, use it also for daily maintenance and as a weekly or monthly booster, depending on how you’re feeling.  Kendra focused on using essential oils for anxiety and stress relief.  

Specifically, she used them by:

• Adding a few drops to a folded tissue or cotton ball and sniffing a few inches from the nose throughout the day.
• Adding a few drops to your bubble bath.
• Mixing a few drops with a carrier oil and rub on your pulse points.  
• Mixing with a carrier oil and massaging your body.
• Spraying on your pillows and sheet for a good night’s sleep.  

Now, It’s Your Turn

Well, I hope you feel more educated about stress eating, compulsive eating, and BED.  While it is naturally to sometimes feel ashamed and out of control because of your BED, you are not alone and help is available.

• Make an appointment with your doctor to evaluate your binge eating and other potential health issues.
• Ask your doctor for a referral to a psychologist understand the issues around your binge eating.
• Ask your doctor for a referral to a registered dietitian nutritionist to develop a healthy eating plan.
• Attend an Overeaters Anonymous group meeting.
• Purchase a book by Overeaters Anonymous.
• Add journaling, meditation and deep breathing, and aromatherapy to your self-care practice.

Well, we look forward to hearing about your experience in the comment section of this blog.  And, you can join the conversation on the Keep It Tight Sisters Page.

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Eat. Move. Breathe.