In the six months after her parents' divorce, 13-year-old Caroline (not her real name) gained more than 20 pounds. Feeling sad and alone, she consoled herself with food -- and lots of it. Day after day, she was binge eating.
"I remember the night my dad left, I went into the kitchen and devoured a dozen glazed doughnuts and a quart of milk," Caroline said. "Still feeling hungry (but really sad), I took a bag of chips up to my room and ate them in the dark while sitting on my bed, crying."
Unlike people with bulimia, Caroline didn't vomit or use laxatives to purge her system. She just continued to binge eat to soothe her sadness and anxiety.
What Causes Binge-Eating Disorder?
Binge-eating is one of the most common eating disorders. People with binge-eating disorder eat large amounts of food at one sitting at least two days a week for six months. Their binges also have three of these five characteristics:
- Eating faster than normal
- Eating until uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of embarrassment
- Feeling disgusted, depressed, or very guilty after overeating
Approximately 4 million people in the United States have binge-eating disorder, binging without purging. They eat compulsively -- sometimes thousands of calories at one sitting -- until they feel stuffed. Most people with binge-eating disorder are either overweight or obese, defined as being 20% to 30% above their desirable weight. They often have a history of weight problems and weight fluctuations.
No one knows for sure what causes binge eating disorder, but there are several factors that may contribute.
- Genetics and biology seem to play a role. Binge eating tends to run in families.
- Researchers are actively studying how abnormalities in levels of certain neurochemicals in the brain can contribute to binge eating.
- Individual psychology may also play a role. About 50% of people with binge eating disorder suffer from depression, and it's thought that negative emotions -- like anxiety, shame, and guilt -- contribute to out-of-control eating behaviors.
- Sometimes, a traumatic event can trigger binge-eating disorder.
What Are the Signs of Binge-Eating Disorder?
People with binge-eating disorder may miss school, parties, or social events so they can binge eat. At home, a binge eater may take food to their room, lock the door, and eat alone. Binge eaters may hide food under beds or in closets so no one knows they are binging. Some binge eaters are ashamed of their behavior and suffer tremendous guilt.
Family members or friends might notice the binge eater eating enormous amounts of food, even after finishing a large meal. During the binge, the person might eat very quickly, without even knowing what they ate. Those with binge-eating disorder also may have odd eating habits, such as eating food directly from a can or taking food from the garbage and eating it.
How Is Binge-Eating Disorder Treated?
Binge-eating disorder is best treated with a combination of approaches.
- Psychotherapy, such as cognitive behavioral therapy and insight-oriented therapy, can help people learn to recognize the thoughts and feelings that trigger binge eating.
- Group therapy may help relieve feelings of shame about symptoms.
- Self-help strategies such as keeping a journal and meditation can help people identify and tolerate difficult feelings and mood states that may lead to binge eating.
- Nutritional counseling helps educate people about healthy food choices and, more importantly, about how to recognize the difference between physical hunger and emotional hunger.
- Certain medications such as antidepressants may be used to treat symptoms of depression.
- For some people, medications can help regulate the urge to binge eat.
Can Binge-Eating Disorder Harm My Health?
Binge-eating leads to obesity, which is a major public health problem. Some 97 million Americans (65% of the population) are overweight, and half of them are obese. Many experts believe that binge eating and overeating "bad fats" (saturated and trans fats), carbohydrates (such as white bread and pastries), and sugar is largely responsible for this epidemic.
As with other eating disorders, binge eaters have a greater risk of serious illnesses. They include heart disease, stroke, diabetes, gallbladder disease, and some types of cancer.
When Should I Get Help for Binge Eating?
If you feel sad, anxious, or depressed and eat enormous amounts of food to soothe your emotional state, talk with your health care professional about binge eating. Even if you don't have these feelings, but are 20% or more over a normal weight, your doctor may have some ways to help you control your eating and lose the excess weight. Obesity can lead to serious medical problems.