Binge eating disorder (BED) is a seemingly straightforward label for a really complex condition. The binge eating part sounds clear enough: eating too much, too fast, until you’re too full. And the disorder part implies the eating pattern has health consequences.
But the simplicity of the name doesn’t capture the wide array of binge eating disorder symptoms, causes, triggers, and profound emotional effects this condition can have. It doesn’t reveal how devastating it can be.
On the other hand, it also doesn’t hint at the hope there is for treating what has become the most common eating disorder in America, according to the National Institute of Diabetes, Digestive, and Kidney Diseases.
While binge eating disorder may be widely misunderstood in the public (and in your personal life), there are trained experts who deeply understand the complexities of this eating disorder and how to help people who are dealing with it. It may not be an easy journey, but it is a worthwhile one to get your life back. The first step is learning how to spot the signs of binge eating disorder. Full disclosure: Some of the details this article covers may be triggering if you are dealing with something similar. (If you need help, you can reach the National Eating Disorders Helpline at 800-931-2237.)
What is a binge eating disorder? | Physical binge eating disorder symptoms | Emotional binge eating disorder symptoms | Behavioral binge eating disorder symptoms| Diagnosis | Complications | Causes and risk factors | Treatments | Binge eating help
What is binge eating disorder, exactly?
The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) describes binge eating disorder as eating more than an average amount of food in a limited timeframe—usually around two hours—while feeling out of control.
That’s a very basic description of this disorder, but most people will have a variety of behaviors and feelings around binge eating. According to the National Eating Disorder Association (NEDA), the key factors for diagnosis include:
- Recurrent episodes of binge eating
- Extreme distress over binge eating episodes
- Not compensating for binge eating with behaviors like purging or exercise
- Episodes that include three or more of the following:
- Eating very rapidly
- Eating until you feel uncomfortably full
- Eating large quantities of food despite not feeling physically hungry
- Eating alone due to embarrassment about how much you are consuming
- Feeling disgusted, depressed, or guilty about overeating
For some, binge eating starts as a way to cope and self-soothe in a bad situation, for example, when a person is dealing with trauma or abuse. For others, it’s a response to food insecurity. That’s when there is plenty to eat after payday and not enough later on, which can trigger you to eat while you can.
However the pattern begins, it can quickly become overwhelming. Binge eating is hard on your mind and body. An episode is usually followed by a toxic blend of physical discomfort and feelings of shame or self-loathing—none of which are your fault. If the condition isn’t treated, it can disrupt your life, harm your health, and even bring about an early death.
What are behavioral binge eating disorder symptoms?
Exactly what people do during a binge eating episode varies from person to person—it’s a lot different from simply overeating at dinner. Not everyone experiences all of these symptoms, and you may have others that aren’t mentioned here. If you occasionally eat your breakfast in a rush to get out the door, that would not signify binge eating disorder. It’s when you display multiple eating behaviors and generally feel out of control in these moments that could signal a problem.
Even so, a few behaviors stand out as binge eating disorder symptoms, according to the NEDA. They can include:
- Eating large amounts in brief periods
- Eating in a rush
- Hiding food or certain eating behaviors
- Hiding the evidence of eating, like wrappers and packages
- Withdrawing from others
- Avoiding events where people will be eating
- Eating on intense impulse, rather than on a schedule
- Restricting what you eat in public and bingeing when you’re alone
Creating lifestyle schedules or rituals around binge eating, such as avoiding activities with friends to make time for binge eating or rituals like not allowing foods to touch
People with binge eating disorder do not use compensatory behaviors, meaning they don’t purge, use laxatives, fast, or overexercise to try and rid themselves of the calories they’ve eaten (unlike people with anorexia or bulimia, who do engage in these behaviors). While this might seem counterintuitive, people with binge eating disorders often do go through periods of food restriction and fad dieting, however. It’s just that after a binge eating episode, they do not try to directly “make up for” the calories they’ve consumed with those other behaviors.
What are physical binge eating disorder symptoms?
During a binge episode, you might not notice anything other than the drive to keep eating. But afterward, a host of physical symptoms may begin. According to a 2019 study published in the journal Nutrients, these can include:
- Stomach discomfort, pain, or cramping
- Nausea or feeling ill
- Difficulty concentrating
- Bloating
- Low energy
- Heartburn or other signs of acid reflux
- Diarrhea
- Constipation or feeling blocked
- Weight gain
If the eating pattern continues, you might notice that your body’s hunger and fullness signals change too. If you are less sensitive to those signals, it can affect your ability to stop eating during a binge episode.
It’s important to know that even though weight gain is a symptom, not everyone with binge eating disorder is overweight, and most people diagnosed with obesity don’t have binge eating disorder—BED can develop at any weight. Since people with BED often take great pains to hide their eating behaviors, you may not even know if a friend or loved one is struggling with this.
What are emotional binge eating disorder symptoms?
During a binge eating episode, the main thing you feel is out of control. You might feel embarrassed or afraid to eat around other people. You might feel scared to eat certain kinds of food that are viewed as unhealthy, like carbs or sugar, even though they are perfectly okay to enjoy, according to the NEDA.
When you have binge eating disorder, you’re also likely to be awash in feelings such as anxiety, shame, guilt, disgust, and even anger. In fact, a 2020 study published in the journal Psychiatria Danubina found that behaving anxiously as a response to anger was found to be a predictor for disordered eating—including binge eating—in people with depression.4
All of these feelings are part of the human experience. Everyone has them. But if you have an eating disorder, they can drive a destructive cycle. Negative emotions like anxiety and anger can trigger binge eating. Binge eating episodes then fuel more negative feelings. They may even leave you with the feeling that you hate yourself.
If you have a mood disorder such as depression or anxiety, BED may be even harder on you emotionally. A 2016 study published in Obesity Research and Clinical Practice shows that roughly 20% of those with mood disorders have trouble with binge eating. And people with binge eating disorder experience more severe anxiety than others.
You’re dealing with what Rachel Goode, Ph.D., LCSW, assistant professor at the University of North Carolina’s School of Social Work, calls “a great deal of emotionality.” Coping with BED’s emotional symptoms means learning the skills to “navigate these feelings and manage crisis events,” she tells SELF.
How is binge eating disorder diagnosed?
The first step toward a binge eating diagnosis is reaching out for help. Unfortunately, only about 28% of people with a binge eating disorder are currently receiving treatment, and only about 43% will seek treatment at some point in their lives, per the NEDA.
The secretive nature of eating disorders may be one reason people don’t get help, but there are other factors at play. For one, “since eating disorders have stereotypically been associated with the identities of white women, many Black women go undiagnosed and may not even receive the same referrals to eating disorder clinicians,” notes Dr. Goode, who has researched this problem extensively. In fact, the lack of diagnosis for eating disorders is more severe among Black women in the U.S., she says. But eating disorders affect all kinds of people, not just one race or gender.
Another factor is that doctors may focus only on weight loss or gain without ever discussing the possibility of an underlying eating disorder, which can actually worsen the problem.
For people who do reach out for help, the process of being diagnosed usually involves an interview with a health care professional. To guide the interview, a doctor or therapist might use an eating disorder questionnaire such as the Binge Eating Scale or Eating Disorder Examination. This tool has questions about symptoms, how often and how intense the episodes are, and when they happen. The American Psychiatric Association says people with a binge eating disorder binge at least once a week for a period of three months or longer.
There’s no specific lab test to confirm that you have an eating disorder, but your doctor will probably measure your body mass index, your waist circumference, and your blood pressure. You might also be screened for other health conditions that can sometimes develop due to binge eating disorders, like type 2 diabetes and gastroesophageal reflux disease (GERD).