Binge-eating disorder

Binge-eating disorder is a serious condition. It always involves feeling like you're not able to stop eating. It also often involves eating much larger than usual amounts of food.

Almost everyone overeats on occasion, such as having seconds or thirds of a holiday meal. But regularly feeling that eating is out of control and eating an unusually large amount of food may be symptoms of binge-eating disorder.

People who have binge-eating disorder often feel embarrassed or ashamed about eating binges. People with the disorder often go through periods of trying to restrict or severely cut back on their eating as a result. But this instead may increase urges to eat and lead to a cycle of ongoing binge eating. Treatment for binge-eating disorder can help people feel more in control and balanced with their eating.

If you have binge-eating disorder, you may be overweight or obese, or you may be at a healthy weight. Most people with binge-eating disorder feel upset about their body size or shape no matter what the number on the scale is.

Symptoms of binge-eating disorder vary but can include:

• Feeling that you don't have control over your eating behavior, for example, you can't stop once you start.
• Often eating much larger than usual amounts of food in a specific amount of time, such as over a two-hour period.
• Eating even when you're full or not hungry.
• Eating very fast during eating binges.
• Eating until you're uncomfortably full.
• Often eating alone or in secret.
• Feeling depressed, disgusted, ashamed, guilty or upset about your eating.

A person with bulimia nervosa, another eating disorder, may binge and then vomit, use laxatives or exercise excessively to get rid of extra calories. This is not the case with binge-eating disorder. If you have binge-eating disorder, you may try to diet or eat less food at mealtimes to compensate. But restricting your diet may simply lead to more binge eating.

How much eating binges affect your mood and ability to function in daily life gives an idea of how serious the condition is for you. Binge-eating disorder can vary over time. The condition may be short-lived, may go away and come back, or may continue for years if left untreated.

When to see a doctor

If you have any symptoms of binge-eating disorder, get medical help as soon as possible. Talk with your healthcare professional or a mental health professional about your symptoms and feelings.

If you're embarrassed by your eating and are worried about talking to your healthcare professional, start by talking with someone you trust about what you're going through. A friend, family member, teacher or faith leader can encourage and support you in taking the first steps to successful treatment of binge-eating disorder.

Talking with a professional with specialty training in eating disorders or reaching out to an organization specializing in eating disorders might be a good place to find support from someone who understands what you're going through.

Helping a loved one who has symptoms

Someone who has binge-eating disorder may become an expert at hiding behavior. This is usually because of feelings of shame and embarrassment about the symptoms. Hiding symptoms can make it hard for others to notice the problem. If you think a loved one may have symptoms of binge-eating disorder, have an open and honest talk about your concerns, but remember to approach the topic with sensitivity. Eating disorders are mental health conditions, and the behaviors are not the fault or choice of the person with this condition.

Give encouragement and support. Offer to help your loved one find a healthcare professional or mental health professional with experience in treating eating disorders. You may help make an appointment. You might even offer to go along.

The causes of binge-eating disorder are not known. But certain genes, how your body works, long-term dieting and the presence of other mental health conditions increase your risk.

Binge-eating disorder is more common in women than in men. People of any age can have binge-eating disorder, but it often begins in the late teens or early 20s.

Factors that can raise your risk of having binge-eating disorder include:

• Family history. You're much more likely to have an eating disorder if your parents or siblings have — or had — an eating disorder. This may point to genes passed down in your family that increase the risk of having an eating disorder.
• Dieting. Many people with binge-eating disorder have a history of dieting. Dieting or limiting calories throughout the day may trigger an urge to binge eat.
• Mental health conditions. Many people who have binge-eating disorder feel negatively about themselves and their skills and accomplishments. Triggers for bingeing can include stress, poor body self-image and certain foods. Certain situations also can be triggers, for example, being at a party, having downtime or driving in your car.

Mental health conditions and physical problems can happen from binge eating. Complications from binge-eating disorder may include:

• Not feeling comfortable or able to enjoy your life.
• Problems functioning at work, in your personal life or in social situations.
• Isolating or feeling isolated from others socially.
• Weight gain.
• Medical conditions related to weight gain. These may include joint problems, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD), poor nutrition and some sleep-related breathing disorders.

Mental health conditions that are often linked with binge-eating disorder include:

• Depression.
• Anxiety.
• Substance use disorders.
• Suicidal thoughts and behavior.

If you have a child with binge-eating behaviors:

• Model body acceptance, regardless of body shape or size. Make it clear that dieting or restricting food is not healthy unless there's a diagnosed food allergy.
• Talk with your child's healthcare professional about any concerns. The healthcare professional may be in a good position to identify early symptoms of an eating disorder and help get expert treatment right away. The professional also can recommend helpful resources you can use to support your child.

To diagnose binge-eating disorder, your healthcare professional may recommend a mental health evaluation. This includes talking about your feelings and eating habits with a mental health professional. Look for a mental health professional with expertise in treating eating disorders.

Your healthcare professional also may want you to have other tests to check for health problems that can be caused by binge-eating disorder. These may include high cholesterol, high blood pressure, heart problems, diabetes, GERD, poor nutrition, electrolyte imbalances and some sleep-related breathing disorders. Tests may include:

• A physical exam. With your permission, the exam may include getting your weight.
• Blood and urine tests.
• A visit with a sleep disorder specialist.

The goal for treatment of binge-eating disorder is to have healthy, regular eating habits. Because binge eating often involves shame, poor body self-image and other negative emotions, treatment also addresses these and related mental health conditions, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating.

Treatment of binge-eating disorder may be done by a team of specialists. The team can include doctors and other healthcare professionals, mental health professionals, and dietitians, all with experience in eating disorders.

Talk therapy

Talk therapy, also called psychotherapy, can help you learn how to exchange unhealthy habits for healthy ones and reduce binge eating. Talk therapy may be in individual or group sessions. Examples of types of talk therapy that can help binge-eating disorder include:

• Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge eating, such as negative feelings about your body or a depressed mood. CBT also may give you a better sense of control over your behavior and help you gain healthy-eating patterns. A form of CBT called enhanced CBT (CBT-E) is specifically designed to treat eating disorders.
• Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating.
• Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.

Medications

Lisdexamfetamine dimesylate (Vyvanse) is a medicine for attention-deficit/hyperactivity disorder (ADHD). This is the first medicine approved by the U.S. Food and Drug Administration to treat moderate to severe binge-eating disorder, but only in adults. Because it's a stimulant, this medicine can be habit-forming and misused. Common side effects include dry mouth and problems sleeping, but more-serious side effects can happen.

Examples of other types of medicine that may help reduce symptoms of binge-eating disorder include certain medicines used to control seizures and certain antidepressants.

Along with getting professional help, you can take these self-care steps as part of your treatment plan:

• Stay with your treatment. Don't skip therapy sessions. If you have a meal plan, do your best to stay with it. Don't let setbacks keep you from continuing treatment.
• Stay away from dieting. Trying to diet can trigger more binge eating, leading to a vicious cycle that's hard to break.
• Eat regularly. For example, eat every 2 to 3 hours to try to break the restrict-then-binge cycle.
• Plan ahead for triggering situations. Being around certain foods can trigger eating binges for some people. Plan what to do when you're around foods that are tempting.
• Get the right nutrients. Just because you may be eating a lot during binges doesn't mean you're eating the kinds of food that have all the nutrients you need. Ask your healthcare professional if you need to adjust your diet to get essential vitamins and minerals.
• Stay connected. Don't isolate yourself from caring family members and friends who want to see you get healthy. Surround yourself with people who have your best interests at heart.
• Get active. Ask your healthcare professional what kind of physical activity is best for you.

Most dietary supplements and herbal products designed to lessen the appetite or aid in weight loss are not effective and may be misused by people with eating disorders. Natural doesn't always mean safe. Some weight-loss supplements or herbs can have serious side effects and dangerously interact with other medicines.

Before you use any dietary supplements or herbs, talk about the possible benefits and risks with your healthcare professional.

Living with an eating disorder can be difficult. Here are some tips to help you cope:

• Treat yourself with care. Living with and treating an eating disorder is very hard. Often other people don't understand what you're going through. Be kind to yourself, even if you're not successful with the treatment plan right away. Try to find communities where people are able to support your efforts.
• Identify situations that may trigger problem eating behavior. Identifying these triggers can help you develop a plan of action to deal with them.
• Look for positive role models. Find role models who don't accidentally add to your body dissatisfaction and pressure to eat in unhealthy ways. Remind yourself that the models, actors and influencers showcased in the media or on social media often don't represent healthy, realistic bodies.
• Look for a trusted relative or friend. Find someone you can talk with about what's going on.
• Find healthy ways to take care of yourself. Do something just for fun or to relax, such as yoga, meditation or a walk.
• Consider writing in a journal about your feelings and behaviors. Journaling can make you more aware of your feelings and actions, and how they're related.
• Visit trusted internet sites. Examples of organizations that offer support for people affected by eating disorders include the National Eating Disorders Association (NEDA). Families Empowered And Supporting Treatment for Eating Disorders (F.E.A.S.T.) offers support to families.

Get support

If you have binge-eating disorder, you and your family may find support groups helpful for encouragement, hope and advice on coping. Support group members can understand what you're going through because they've been there themselves. Ask your healthcare professional or mental health professional about finding a group in your area.

Here's some information to help you get ready for your appointment. Think about asking a family member or friend to go with you. Someone who goes with you can help you remember key points and, with your permission, give extra information about your situation.

What you can do

Before your appointment make a list of:

• Symptoms. Include any that may not seem related to the reason for your appointment.
• Key personal information. Include any major stresses or recent life changes.
• All medicines you're taking. Include any herbs, vitamins or other supplements, and the doses.
• A typical day's eating. Make a list of what you eat over a few days to help your healthcare professional or mental health professional understand your eating habits.
• Questions to ask your healthcare professional or mental health professional.

Questions to ask may include:

• What treatments are available, and which do you suggest?
• If medicine is a part of treatment, is a generic drug available?
• Are there any brochures or other printed material I can have? What websites do you recommend?

Feel free to ask other questions during your appointment.

What to expect from your doctor

Your healthcare professional or mental health professional is likely to ask you questions, such as:

• What does your typical daily food intake look like?
• Do you eat much larger than usual amounts of food or eat until you're uncomfortably full?
• Do you feel that your eating is out of control?
• Have you tried to lose weight? If so, how?
• Do you think about food often?
• Do you eat even when you're full or not hungry?
• Do you ever eat in secret?
• Do you feel depressed, ashamed or guilty about your eating?
• Do you ever make yourself vomit to get rid of food you've eaten?
• Are you concerned about your weight?
• Are you physically active? What types of physical activity or exercise do you do and how often?

Be ready to answer questions so you have time to discuss what's is most important to you.