DEAR MAYO CLINIC: What is binge eating disorder? I’ve heard of anorexia and bulimia. But I’d never heard binge eating described as a disorder until my nephew was diagnosed with it. How is it treated?
ANSWER: Binge eating disorder is a serious health problem that involves eating unusually large amounts of food in a distinct span of time, such as over a two-hour period. During a binge, people who have this disorder feel unable to control or stop their eating. Treatment for binge eating disorder focuses on changing a person’s behaviors and attitudes about eating and weight. In some cases, medication also can help.
As you mention, many people are familiar with anorexia and bulimia. Anorexia is an eating disorder characterized by an abnormally low body weight, intense fear of gaining weight and a distorted perception of weight. Although it’s probably the most well-known type of eating disorder, anorexia is the least common. Bulimia is an eating disorder in which people eat large amounts of food and then try to prevent weight gain in unhealthy ways, such as by inducing vomiting, misusing laxatives, fasting, or exercising excessively.
Binge eating disorder, which affects about 3% of the U.S. adult population, is more common but less well-known than the other two. It involves eating large amounts of food during a time period that lasts two hours or less. People who have binge eating disorder often eat rapidly during these episodes, and they eat even if they are not hungry. The bingeing frequently happens alone or in secret. After bingeing, people with binge eating disorder may feel depressed, upset, ashamed, or guilty about their eating.
If left untreated, eating disorders can lead to serious and even life-threatening health problems. Research has shown that among all psychiatric disorders, eating disorders have the highest mortality rate. It is crucial to identify eating disorders, so they can be appropriately treated.
Diagnosing binge eating disorder is a significant challenge. Many people who have it are skilled at hiding their binge eating from others. Stereotypes about the kind of person affected by eating disorders often hinder diagnosis, too. Many people think young women who appear to be average weight or underweight are the only ones who deal with eating disorders. That’s simply not true.
About 10 million men in the U.S. suffer from eating disorders, as do many people who are overweight or obese. Most do not seek help. That’s dangerous because the long-term health risks of eating disorders can be severe.
One in five people who have anorexia die as a result of the disease. Although the mortality rate is lower for bulimia and binge eating disorder, the complications from those conditions also can be severe. They include anxiety, depression, heart problems, and gastrointestinal disorders. These eating disorders also can result in a poor quality of life and social isolation, as well as raise the risk for substance abuse disorders and suicide.
The lack of accurate diagnosis of binge eating disorder is particularly disheartening because once it is identified, binge eating disorder often can be treated successfully. In some situations, certain medications can curb binge eating and reduce symptoms. But the cornerstone of effective treatment for binge eating disorder is cognitive behavioral therapy.
Cognitive behavioral therapy is a type of talk therapy that involves learning techniques that help people cope with issues that can trigger binge eating episodes, such as hunger; negative thoughts about eating, weight, and shape; depressed mood; and interpersonal challenges. This therapy can provide patients with a better sense of control over their behavior and help them regulate their eating patterns.
If you think you might have an eating disorder, or if you suspect a loved one does, seek help. Eating disorders are serious health problems that require medical care. Talk to your healthcare provider or a mental health professional. Effective treatment is available to help overcome an eating disorder. — Leslie Sim, PhD, Psychology, Mayo Clinic, Rochester, Minnesota