Binge eating disorder

Binge eating is an eating disorder where a person feels they have to overeat through regular binges.

People who binge eat consume very large amounts of food over a short period of time, even when they’re not hungry.

Binges are often planned in advance and can involve the person buying ‘special’ binge foods.

In some cases, people describe themselves as being in a ‘dazed’ state during a binge – particularly binges during the night – and can’t remember what they ate.

People who binge eat feel they have no control over their eating. They often binge in private because they feel embarrassed, guilty or disgusted with their behaviour after they’ve finished eating.

Episodes of binge eating sometimes alternate with periods where the person cuts down on the amount of food they eat. This can lead to a vicious cycle that’s difficult to break, where blood sugar levels rise and fall rapidly. Your blood sugar level affects how hungry you feel and how much energy your body has. When the levels go up and down quickly, this sends false messages to the brain and causes cravings for food when your body doesn't need it.

How common is it?

Anyone can be affected by binge eating. It’s estimated that there’s around a 1 in 30 to 1 in 50 chance of a person developing binge eating disorder at some point during their life.

It’s most common for the condition to develop in young adults. It can take a long time for people to feel able to seek help.

Many people occasionally overeat – this doesn't necessarily mean you have binge eating disorder. However, if you’re worried about your eating habits, the best thing to do is talk to your GP.

Treating binge eating disorder

Binge eating disorder can be treated using a number of talking therapies, including guided self-help and cognitive behavioural therapy for eating disorders (CBT-ED).

Learn more about talking therapy

Learn more about self-help therapies

These treatments can help you overcome the psychological issues associated with your binge eating, but they won't usually have a significant impact on your weight.

If you’re worried you have binge eating disorder, the first step is to go to your GP for a medical check-up and advice on how to get treatment.

Find a local GP using Scotland's Service Directory

The main sign of binge eating disorder is if someone is bingeing on a regular basis. There are a number of signs that an episode of overeating is actually a binge, including:

• you eat much faster than normal
• you eat until you feel uncomfortably full
• you eat a large amount of food when you are not hungry
• you eat alone or secretly due to being embarrassed about the amount of food you are consuming
• you have feelings of guilt, shame or disgust afterwards

If you feel like you have to purge what you’ve eaten after a binge in order to avoid gaining weight, you may have symptoms of bulimia.

If binges don’t happen regularly, and your weight is very low, you may have symptoms of anorexia.

Treating binge eating disorder

The main type of psychological treatment for binge eating disorder is guided self-help. Guided self-help is where you work through information and activities on your own, and have regular support sessions with a professional (usually a psychologist). These activities can include filling out worksheets, keeping a food diary and meal plan, and writing about difficult thoughts and feelings.

Another treatment is cognitive behavioural therapy (CBT), either individually or as part of a group. CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. If problems in your life are causing you to binge eat, CBT helps you to reduce bingeing and identify the underlying issues so you’re less likely to binge in the future.

Learn more about talking therapies

Medication

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may be used alongside guided self-help or talking therapies to treat binge eating disorder. The SSRI usually recommended to treat binge eating disorder is called fluoxetine (brand name Prozac).

As with any antidepressant, an SSRI will usually take several weeks before it starts to work. You’ll usually be started on a low dose, which is then gradually increased as your body adjusts to the medicine.

When you start taking an SSRI, see your GP after 2, 4, 6 and 12 weeks to check your progress and to see if you’re responding to the medicine. Not everyone responds well to antidepressant medicines, so it's important your progress is carefully monitored.

Very few drugs are recommended for children and young people below the age of 18. It’s also best not to take SSRIs if you have epilepsy or a family history of heart, liver or kidney disease.

It's not clear what causes binge eating, but, like many eating disorders, it's seen as a way of coping with feelings of unhappiness and low self-esteem.

Psychological factors

Many people who develop binge eating disorder share certain patterns of thinking and behaving that may make them more likely to develop the condition. These include:

• a tendency towards depression and anxiety
• finding it difficult to handle stress, anger, boredom or loneliness
• low self-esteem and a lack of confidence
• feeling dissatisfied with your body and under pressure to be thin
• frequently worrying and feeling scared or doubtful about the future
• finding it hard to express feelings
• experiencing unwanted thoughts, images or urges that make them feel they have to behave in certain ways

Binge eating is often a way of coping with distress, and the above factors can make it harder for someone to cope with distress in a healthy way.

Environmental factors

Environmental factors are parts of the world around a person, and events happening in their life, that can affect their mental wellbeing in a variety of ways.

Stressful life changes – for example, moving house, the breakdown of a relationship, going to college or university, or a bereavement – can make a person more likely to start binge eating as a way of coping.

Culture and society may also play a part. People of all ages are exposed to a wide range of media messages promoting the idea that only certain body shapes are desirable, and that not having the ‘ideal’ body is something to be ashamed of. Even health advice that’s intended to be helpful can have a focus on the risks of being overweight, which can add to feelings of pressure and low self-esteem.

Other environmental factors that can contribute towards binge eating disorder include:

• pressure and stress at school, such as exams or bullying – particularly if someone is bullied about body weight or shape
• having a family that places high value on body shape, and praises or rewards weight loss
• difficult family relationships
• stressful or traumatic events in your past

Biological and genetic factors

The risk of developing binge eating disorder is thought to be greater in people with a family history of eating disorders. This suggests that genetics could contribute to developing binge eating disorder.

As with other mental health conditions, like depression, people with binge eating disorder might have some differences in the way their brains work compared to people who don’t have the condition. These differences may affect the part of the brain that’s linked to appetite and body image.

Long term physical effects of binge eating

Binge eating often leads to weight gain. Being overweight or obese can put you at risk of a number of physical health problems, some of which can be life threatening.
These include:

• high cholesterol and high blood pressure
• diabetes
• osteoarthritis
• some types of cancer, such as breast cancer and bowel cancer

If you think you might have a binge eating problem, it’s important to know that there’s help available. You can get support to tackle both the physical and mental effects of binge eating.

If you have eating problems or think you may have binge eating disorder, it’s important to seek help as soon as possible. You could start by:

• talking to someone you trust, such as a friend or member of your family
• going to see your GP – you may find it helpful to bring someone with you for support

Helping someone else

If someone close to you is showing signs of binge eating disorder, you can offer help and support.

You could try talking to them about how they feel, and encourage them to think about getting help. Try not to put pressure on them or be critical of them, as this could make things worse. You could also offer to help by going with the person to see their GP.

If you’d like to get some advice on how to help, a healthcare professional, such as your own GP, can provide information on:

• the treatments available
• how you can support them during their treatment

Sources of support

A leading charity for people with eating disorders is Beat, which has a range of information on the help and support available for people with eating disorders, and their friends and families.

There are a number of self-help books that you may find useful, for example Overcoming Binge Eating by Christopher Fairburn. Your GP and care team can recommend helpful resources.