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Binge Eating Disorder Treatment and Diagnosis

Binge Eating Disorder Definition

Binge eating disorder is characterized by distinct overeating episodes called binges.  Typically binges involve consuming unusually large amounts of food for a single meal. Calories may range from 3,000 to 15,000 or more.  This is accompanied by a “feeling” of being out of control, or feeling compelled to do it. Anticipating a binge can involve positive feelings such as excitement or relief. Likewise the binge itself can be a temporary respite from negative emotions. But, for many, the times before and during binges can also consist of negative emotions, similar to those that follow the binge. Binges are often followed by feelings of shame, embarrassment (although usually binge eaters engage in the behavior alone), guilt, anxiety, etc.  

Characteristics of Binge Eating Disorder Population

Many binge eaters are obese or at least overweight as frequent binges almost always lead to steep weight increases. Those suffering with binge eating disorder are more likely to also be experiencing other emotional or behavioral problems when compared to obese individuals without the disorder, e.g., ocd or major depression.

Binge Eating Disorder Diagnosis

The American Psychiatric Association includes Binge Eating Disorder in the Appendix as a syndrome in need of further study.  It may be the most common eating disorder in the US, with estimates as high as 4%.  But, currently it is not included as an Axis I disorder.  A diagnosis of Eating Disorder Not Otherwise Specified can be given when appropriate.  It is likely that the next version of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders will likely include Binge Eating Disorder, given the attention obesity is receiving.  

Binge Eating Disorder Causes

There is not consensus regarding the etiology of binge eating disorder.  There is a great likelihood that genes and other biological factors, such as neurotransmitters or hormones play a role, but the amounts of influence are yet to be determined.  In addition various situational and behavioral events are likely involved.  Periods of calorie restriction (typical dieting), stress, interpersonal strife, and deficiencies in modulating emotions and other behavioral coping strategies put people at greater risk of developing the disorder.  Binge episodes can be triggered by various situational, emotional, or interpersonal variables.  Some of the most common include boredom, anger, anxiety, stress, loneliness, rejection, disappointment, etc.

Binge Eating Disorder Treatment

Despite the lack of consensus on the precise diagnostic characteristics, there is agreement that binge eating can be treated.  Cognitive behavioral therapy and Interpersonal Therapy are believed to be efficacious.  During therapy many clients will experience a reduction in binges, weight, as well as anxiety and other emotional symptoms, and an improvement in relationships.