Binge Eating Disorder is a serious and common eating disorder characterized by recurrent episodes of binge eating without the use of compensatory behaviors
Binge Eating Disorder (BED) is a serious and common eating disorder characterized by recurrent episodes of binge eating without the use of compensatory behaviors such as purging or excessive exercise. BED is associated with significant physical and psychological morbidity and is the most common eating disorder in the United States, and some studies have reported that it has a lifetime prevalence rate of 5-13%, meaning that this percentage of the population will experience it at some point in their life. Despite its prevalence, BED is often under-diagnosed and undertreated due to a lack of awareness and understanding of the disorder.
One reason for the under-diagnosis of BED is that it is often mistaken for overeating or a lack of self-control. Binge eating is defined as consuming a large amount of food in a short period of time and feeling a lack of control over eating during the episode. This behavior is often seen as a moral failing or a lack of discipline, leading to shame and stigma for those who struggle with BED. This can prevent individuals from seeking help and lead to a delay in diagnosis. Reviews on BED epidemiology have revealed that less than half of adults with BED are recognized in healthcare. Minority status, deprivation, violence, trauma, and major mental health illnesses were identified as possible risk factors for developing the disorder. A decade-old survey of physicians reported that more than 40% had never even assessed their patients for BED.
Unlike other eating disorders, the ratio of females to males diagnosed with binge eating disorder is around 6:4. Not to mention the fact that many individuals with BED have comorbid obesity, and are often brushed off in the healthcare setting as needing to engage in some sort of diet and exercise program without receiving evaluation for an underlying disorder (like BED) that needs specific treatment.
BED is that it is often comorbid with other mental health disorders, such as depression, anxiety, and substance use. In a 2009 study of 404 patients with BED, 73.8% had at least one additional lifetime psychiatric disorder and 43.1% had at least one current psychiatric disorder.
This can lead to misdiagnosis or a focus on treating the comorbid disorder rather than the BED itself. In addition, BED is more common in individuals who are overweight or obese, and the societal stigma surrounding obesity can also discourage individuals from seeking help for their binge eating, as alluded to above.
It is important to accurately diagnose and treat BED in order to improve the physical and mental health of those affected by the disorder. BED is associated with a number of negative physical health consequences, including increased risk of obesity, diabetes, cardiovascular disease, high blood pressure, pain conditions, sleep disorders, irritable bowel syndrome, and even fibromyalgia. It is also associated with significant psychological distress and low self-esteem that can be debilitating.
Treatment for BED often involves a combination of psychotherapy, such as cognitive behavioral therapy, and medications, such as antidepressants. Psychotherapy can help individuals with BED learn coping mechanisms for managing stress and emotions, and can also address any underlying psychological issues that may be contributing to binge eating. Medications can help to alleviate the symptoms of comorbid mental health disorders and may also be helpful in reducing the frequency of binge eating episodes.
In conclusion, Binge Eating Disorder is a common and serious disorder that is often under-diagnosed and undertreated. It is important for individuals struggling with binge eating to seek help in order to improve their physical and mental health. With proper diagnosis and treatment, those with BED can learn to manage their binge eating and improve their overall quality of life. If you are wondering if you may have BED and would like to speak to a non-judgmental obesity medicine provider who may be able to provide a diagnosis and coordinate treatment, Mochi Health can help! Our team of doctors and registered dieticians offer assistance with treating obesity and related conditions, including BED. Check us out here. We can’t wait to meet you.
Eva Shelton, M.D.
Harvard Medical School, Brigham and Women's Hospital