Binge Eating

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

People who binge eat consume very large quantities of food over a short period of time, even when they are not hungry.

Binges are often planned in advance and can involve the person buying "special" binge foods.

In rare cases, people describe themselves as being in a "dazed state" during a binge – particularly binges during the night – and they are not able to recall what they ate.

People who binge eat feel they have no control over their eating. They often binge in private because they feel embarrassed, guilty or disgusted with their behaviour after they have finished eating.

Episodes of binge eating sometimes alternate with periods where the person cuts down on the amount of food they eat.

This can lead to a vicious cycle that is difficult to break – where blood sugar levels rise and fall rapidly, and false messages are sent to the brain, which result in cravings for food when your body doesn't need it.

Who is affected

Anyone can be affected by binge eating.

While the condition is slightly more common in women than men, the numbers of men and women affected are more equal than in other eating disorders, such as anorexia nervosa.

The condition tends to first develop in young adults, although many people do not seek help until they are in their 30s or 40s.

It’s estimated that there is around a 1 in 30 to 1 in 50 chance of a person developing binge eating disorder at some point during their life.

Getting help

Many people will occasionally binge on food – this doesn't necessarily mean you have a binge eating disorder. However, you should see your GP if you binge regularly and excessively, particularly if the binges are having an effect on your physical and/or mental health.

Your GP can diagnose the condition and may be able to refer you to a specialist, such as a psychiatrist or a psychologist.

Your GP will ask you about your eating habits and look for 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 have a binge eating disorder.

What causes binge eating?

It's not clear what causes binge eating, but, like most eating disorders, it's seen as a way of coping with feelings of unhappiness and low self-esteem.

Things that may increase your risk of developing problems with binge eating include:

low self-esteem and a lack of confidence
depression or anxiety
feelings of stress, anger, boredom or loneliness
dissatisfaction with your body and feeling under pressure to be thin
stressful or traumatic events in your past
a family history of eating disorders, which may be related to your genes
differences in your brain or the level of hormones produced by your brain compared to people who don't binge eat

Binge eating can sometimes develop following a strict diet, particularly if you skipped meals, cut certain foods out and didn't eat enough food. These are unhealthy ways to lose weight and may mean you're more likely to binge at another time.

How binge eating is treated

Binge eating is treatable and most people eventually get better with appropriate help and support.

The main treatments are:

self-help programmes – this may be individually with a book or online course, or as part of a self-help support group
guided self-help (self-help supervised by regular contacts with a professional)
specialist group intervention
individual (one-to-one) psychological therapy – such as cognitive behavioural therapy (CBT)
medication called selective serotonin reuptake inhibitors (SSRIs)

These treatments can help you overcome the psychological issues associated with your binge eating, but they won't usually have a significant impact on your weight.

If you are overweight, a healthcare professional may also draw up a weight loss plan to follow during treatment or after any psychological issues have been dealt with.

Risks of binge eating

Binge eating can be associated with serious psychological problems, including depression and anxiety disorders. These feelings can be made worse over time while the person is still binge eating.

A common physical effect of binge eating is weight gain, which can lead to obesity. This can put you at risk of a number of related physical health problems, some of which can be life-threatening.

These include:

high cholesterol and high blood pressure – which can increase your risk of cardiovascular diseases, such as coronary heart disease and stroke
diabetes – a long-term condition that causes your blood sugar level to become too high
osteoarthritis – a condition that causes pain and swelling in the joints
some types of cancer – such as breast cancer and bowel cancer

Therefore, it's important to seek help if you think you may have a binge eating problem, because you may need support to help you tackle both your psychological and physical problems.

Causes of bine eating.

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.

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.

Symptoms of binge eating

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)

Treating binge eating

Binge eating disorders are usually treatable and most people will eventually get better with appropriate help and support.

The main treatments are outlined below.

Self-help programmes

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

You can 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".

For some people, a self-help programme alone may be enough to help them overcome their eating problems.

Psychological therapy

You may also be referred for psychological therapy to help tackle the underlying problems that cause you to binge eat.

The three main types of therapy used to help people who binge eat are:

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) – therapy that mainly focuses on improving your ability to control and regulate your emotions
interpersonal therapy (IPT) – therapy that focuses on relationship-based issues and how they may be influencing your eating habits

These therapies can be very effective in helping people who binge eat, although it's not clear how long-lasting the results are.

It’s common to experience some periods where the problem improves (remission) and periods where they get worse (relapses), especially in the early stages of treatment.

Selective serotonin reuptake inhibitors (SSRIs)

Some people may be prescribed a type of antidepressant medication called a selective serotonin reuptake inhibitor (SSRI) instead of, or in addition to, a self-help programme.

SSRIs boost levels of a chemical called serotonin in the brain, which may help lift your mood and lead to an improvement in your eating habits. However, the long-term effects of the treatment for binge eating are unknown.

Common side effects of SSRIs include:

feeling agitated, shaky or anxious
feeling or being sick
indigestion
diarrhoea or constipation
loss of appetite and weight loss
dizziness
blurred vision
difficulty sleeping (insomnia) or feeling very sleepy
low sex drive

These side effects will often improve over time, although some can persist.

Read more about the side effects of SSRIs.

Losing weight

Although the treatments mentioned above won’t address your weight directly, you may experience some weight loss if you are able to control your bingeing – particularly if you combine treatment with regular exercise.

If you are struggling to lose weight, your GP or a weight loss management health professional (such as a dietitian) will be able to draw up a weight loss plan that will provide you with the nutrition your body needs to be healthy, as well as helping you to lose weight.

You may be advised to follow this plan alongside your other treatments, or after your psychological issues have been dealt with.

Your plan may involve:

keeping a food diary to see if there is any pattern to when you binge and to highlight the types of food you binge on
having regular, planned meals and not skipping meals
eating healthy snacks between meals to stop you getting hungry
not depriving yourself of specific foods – you may be encouraged to include some unhealthy foods in your eating plan to reduce your urge to binge on them
having a balanced, calorie-controlled diet as recommended by your GP or other healthcare professional
exercising regularly – most adults should do at least 150 minutes of moderate-intensity exercise every week

It's important that you lose weight healthily. Extreme dieting and cutting out meals can make binge eating worse.

Read more about treatments for obesity, losing weight and healthy eating.