What is binge eating disorder?
Binge Eating Disorder (BED) is the most common eating disorder, affecting about 3% of the general population. It is characterized by recurrent episodes in which the person consumes large amounts of food in a short period of time, with an intense sense of loss of control, but without the compensatory behaviors typical of bulimia (vomiting, laxatives, excessive exercise).
After the binge, the person experiences deep feelings of guilt, shame, self-disgust and intense emotional distress. Often, this emotional distress ends up triggering another binge, creating a vicious cycle that is hard to break without professional help.
Despite being the most common eating disorder, for many years it was overlooked and was not recognized as a separate disorder until 2013, with the publication of the DSM-5. As a psychologist specialized in eating disorders, I often see how shame and guilt prevent many people from seeking the help they need.
Symptoms of binge eating disorder
According to the diagnostic criteria, a binge eating episode is characterized by:
- Eating an amount of food greater than what most people would eat in the same time and circumstances
- A sense of loss of control during the episode (being unable to stop eating or unable to control what or how much is eaten)
In addition, binges are associated with three or more of the following indicators:
- Eating much faster than usual
- Eating until feeling uncomfortably full
- Eating large amounts without being hungry
- Eating alone out of shame at the amount being eaten
- Feeling disgusted, depressed or very guilty after the binge
For diagnosis, episodes must occur at least once a week for three months.
Emotional eating: the link between emotions and binges
Food as an emotional regulator
In binge eating disorder, food works as an emotional regulation mechanism. Foods rich in sugar and fat activate the brain's reward system (releasing dopamine), providing temporary relief from stress, sadness, anxiety or boredom. Over time, the brain learns to associate eating with emotional relief, creating an automatic pattern that is hard to break.
Common emotional triggers
Binges rarely happen "for no reason." The most common triggers include: work or family stress, loneliness, boredom, interpersonal conflict, anxiety, sadness, feelings of inadequacy, and paradoxically, excessive food restriction (very restrictive diets increase the risk of bingeing).
Causes of binge eating disorder
- Biological: alterations in the neurotransmitters that regulate hunger, satiety and reward. Genetic predisposition (family studies show a heritability of 40-60%).
- Psychological: difficulty regulating emotions, low self-esteem, impulsivity, perfectionism, severe self-criticism. Traumatic experiences are an important risk factor.
- Cultural: diet culture and weight pressure feed the restriction-binge cycle. Paradoxically, very restrictive diets are one of the main risk factors for developing binge eating disorder.
When the disorder is connected to traumatic experiences, treatment with EMDR can be especially effective in addressing the emotional roots of binges.
Health consequences
Binge eating disorder can have significant impacts on health:
- Physical: overweight or obesity, type 2 diabetes, high blood pressure, high cholesterol, sleep apnea, joint problems, metabolic syndrome.
- Psychological: depression, anxiety, low self-esteem, social isolation, suicidal ideation in the most severe cases.
- Social: avoidance of social situations involving food, impact on interpersonal relationships, weight discrimination.
Treatment of binge eating disorder
Cognitive-behavioral therapy (CBT)
CBT is the first-line treatment for binge eating disorder. It helps identify the emotional patterns that trigger binges, develop alternative emotional regulation skills and modify distorted beliefs about food and body. The goal is not to diet, but to normalize the relationship with eating.
EMDR for associated trauma
When binges are linked to painful past experiences, EMDR makes it possible to process these memories and reduce the need to use food as a mechanism of emotional protection.
Mindful eating
Mindful eating techniques help reconnect with the body's hunger and satiety cues, eat with full awareness and enjoy food without guilt or anxiety.
It is not a matter of willpower
If you are struggling with binge eating, I want you to know something fundamental: it is not your fault and it is not a matter of willpower. Binge eating disorder is a real mental health condition that requires appropriate professional treatment. I offer a free informational session where we can talk about your situation in confidence.