A Guide to Binge Eating Disorder Recovery
Binge Eating Disorder (BED) recovery is absolutely possible. Recent statistics show that millions of people worldwide are impacted by BED, with its occurrence rates differing among different groups. In the United States, around 2.8% of adults are projected to encounter BED during their lifetime.
While women make up about 60% of diagnosed instances, it's crucial to acknowledge that BED doesn't discriminate based on gender, age, ethnicity, or economic status, affecting individuals across various demographics.
If you or someone you know is suffering from Binge Eating Disorder, use this guide as a way to understand recovery options and possibilities.
What is Binge Eating Disorder
BED is a serious mental health condition characterized by recurrent episodes of consuming large quantities of food, in a discreet period of time (i.e. 2 hours), often to the point of discomfort and distress.
There is typically a strong sense of urgency or loss of control while eating. Individuals with BED describe several common features of binge eating episodes:
Often the individual is eating quickly during a binge.
The binge is not typically a response to feeling hungry and the eating continues well beyond fullness.
People often engage in binges in secret.
People describe the binge experience as numbing or relieving – until it’s over.
There are often feelings of shame or disgust after a binge episode.
The Diagnosis of Binge Eating Disorder
The diagnosis of Binge Eating Disorder (BED) typically involves meeting specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, recurrent episodes of binge eating must occur, characterized by eating a significantly larger amount of food than most individuals would consume in a discrete period, coupled with a sense of lack of control overeating during the episode. Additionally, to meet the criteria for BED, the binge eating episodes must occur at least once a week for three months.
Individuals with BED typically experience marked distress in relation to their binge eating behavior and may exhibit three or more of the following symptoms: eating more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not physically hungry, eating alone due to embarrassment about the quantity of food consumed, and feeling disgusted, depressed, or guilty after overeating.
Criteria for diagnosis was developed to help healthcare professionals identify and treat individuals with BED, facilitating appropriate interventions and support. It’s important to note that people may not meet all of the diagnostic criteria for BED but professional intervention is still essential.
Struggling in Silence
Despite its prevalence, Binge Eating Disorder often remains undiagnosed or untreated, resulting in serious physical and psychological repercussions. Various common obstacles hinder individuals from getting help:
Overlooked Diagnosis
BED frequently eludes diagnosis within healthcare environments due to inadequate training among healthcare providers to identify its symptoms, which can differ from those of other eating disorders and may not manifest in weight changes.
Although established screening protocols could identify individuals with BED, healthcare systems seldom incorporate BED screenings into routine medical care.
Additionally, it's crucial to recognize that individuals with BED frequently avoid medical attention altogether due to past traumatic encounters with providers who emphasize body weight in a shaming and inappropriate way.
Isolation and Shame
People with BED often experience profound shame in relation to their behaviors, making them hesitant to disclose their challenges to healthcare providers, family members, or other potential sources of support. Cultural attitudes and stereotypes regarding weight, food, and body image contribute to feelings of embarrassment and self-blame.
There's a prevailing misconception that overeating reflects a lack of willpower or self-discipline, which can cause individuals with BED to internalize feelings of inadequacy or defeat, further compelling them to conceal their struggles.
The secretive nature of binge eating, in which people hide their behaviors and consume extreme quantities of food, exacerbates these feelings of shame and isolation.
Poor Access to Essential Care and Intervention
Access to specialized care (or any care at all, for that matter) presents a significant obstacle to recovery from binge eating. The shortage of treatment providers skilled in diagnosing and treating BED, especially in specific regions and healthcare systems, leads to prolonged wait periods for appointments and restricted access to evidence-based therapies like Cognitive-Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).
Furthermore, financial hurdles, such as exorbitant treatment expenses and inadequate insurance coverage for mental health services, may hinder individuals from obtaining the necessary care.
The Difference between Binge Eating Disorder and Emotional Eating
Binge Eating Disorder and emotional eating share many similarities, but they are not one and the same. Emotional eating refers to eating in response to emotional triggers, such as stress, sadness, boredom, or anxiety.
While emotional eating can involve overeating, it typically doesn’t involve the same degree of loss of control and quantity of food consumption that is seen in BED.
Additionally, emotional eating can occur sporadically, whereas BED involves more consistent and frequent binge eating episodes. BED is recognized as a distinct mental health disorder, whereas emotional eating is a behavior that can occur in individuals with or without a diagnosed eating disorder.
Emotional eating represents a vulnerability to developing a full blown, clinical eating disorder; crossing the line to a clinical disorder depends on the frequency of the episodes, the intensity and the level of distress involved.
Whether it meets criteria for a clinical condition or not, emotional eating can be highly upsetting and disruptive to one’s functioning and self-esteem. Anyone experiencing distress around their eating patterns or feelings in relation to food or their body, should be engaged promptly in treatment to help them stabilize and normalize their relationship with food.
What Causes Binge Eating Disorder?
BED is a complex condition influenced by a combination of genetic, biological, psychological, and environmental factors.
Genetic predisposition can play a role, as BED tends to run in families, suggesting a hereditary component. Studies have identified specific genes and genetic variations associated with increased susceptibility to BED, including those involved in appetite regulation and dopamine signaling pathways. While genetics play a role, environmental factors and individual experiences also interact with genetic predispositions to contribute to the development of BED
Neurobiological factors contribute to Binge Eating Disorder through alterations in brain chemistry and reward pathways. Research indicates abnormalities in neurotransmitter systems, including serotonin, dopamine, and opioids, which may dysregulate appetite control and impulse regulation.
Psychological factors, including low self-esteem, negative body image, and difficulty coping with emotions, can also increase the risk of developing BED.
Traumatic experiences, such as childhood trauma or abuse, can increase vulnerability to developing Binge Eating Disorder. Trauma disrupts emotional regulation and coping mechanisms, leading individuals in some cases, to turn to food as a means of soothing distressing emotions. Additionally, trauma survivors may use binge eating as a way to regain a sense of control or numb painful memories, further exacerbating their susceptibility to BED.
Sociocultural factors contribute to Binge Eating Disorder by promoting unrealistic body ideals, which can lead to body dissatisfaction and low self-esteem. Media portrayal of thinness as an ideal and easy access to highly palatable foods further exacerbate these pressures, fostering maladaptive eating behaviors like binge eating. Societal norms that equate food with comfort or reward also play a role, shaping attitudes towards eating and increasing vulnerability to BED.
Extensive dieting is known to be a gateway to Binge Eating Disorder. Restrictive approaches to eating often lead to feelings of deprivation and preoccupation with food, which can increase the likelihood of binge eating episodes as a response to perceived "forbidden" foods. Additionally, the cycle of dieting followed by overeating typically disrupts hunger and satiety cues, contributing to a loss of control around food intake and reinforcing binge eating patterns. Repeated cycles of dieting and binge eating habituate over time, locking the individual into these harmful patterns.
Treatment for Binge Eating Disorder
We can’t talk about Binge Eating Disorder without highlighting a leading evidence-based treatment for the condition. The primary evidence-based treatment for Binge Eating Disorder is Enhanced Cognitive-Behavioral Therapy (CBT-E), a form of behavioral therapy specifically adapted for eating disorders like BED. While CBT-E is the best course for treatment for the majority of individuals with BED, it’s not for everyone. It’s important to get in depth assessment of your condition by an expert to establish the ideal solution for you. DBT, for example, is another therapy that works well in some cases. Let’s break the two of these interventions down.
CBT for Binge Eating disorder
CBT-E for BED typically involves psychoeducation about binge eating, identifying triggers and patterns of binge eating behavior, challenging dysfunctional thoughts related to food and body image, and developing healthier coping strategies. CBT has been shown to reduce binge eating frequency, improve psychological well-being, and promote long-term recovery in individuals with BED.
One of the reasons why CBT-E is so effective for BED, is because it addresses the restrictive eating tendencies that have maintained the problematic behavior for years. Most people with BED will report at least some history of dieting or restrictive eating practices.
Further, many individuals with BED experience distress in relation to their body shape and weight. CBT-E attacks these issues (food restriction, restraint and over-valuation of shape and weight) head on.
DBT for Binge Eating disorder
Some folks with BED don’t have restricted eating. They actually approach each day with the intention to eat regular, satisfying, adequate meals; their binge eating problem is primarily related to emotion dysregulation. In other words, the primary trigger to their binge eating behavior is aversive emotions.
So, when they feel sad, lonely, bored or any negative emotion for that matter (sometimes even positive emotions, too), they turn to food as their means of coping and getting through. When this is the case—when binge eating primarily serves an emotion regulation function—we often recommend either Dialectical Behavior Therapy (with an adaptation for eating disorders) or DBT Solution for Emotional Eating. What DBT-ED and DBT Solution have in common, is their focus on establishing alternative means of coping with difficult emotions.
These potent treatments offer targeted skills to help people manage distress, regulate emotions, and increase mindfulness and self-awareness. Since DBT-ED and DBT Solution understand disordered eating, the skills they offer apply beautifully to common binge eating struggles.
Primary Tools for Reducing Binge Eating
CBT for BED highlights several critical interventions to help people break out of their binge eating cycles. Let’s focus on a few.
Regular Eating
In CBT-E, the principle of regular eating is a fundamental component of treatment. This principle emphasizes establishing structured and consistent eating patterns, including regular mealtimes and balanced meals, to help awaken hunger and fullness cues and reduce the likelihood of binge eating episodes.
By promoting regular eating, individuals with BED begin to normalize their relationship with food, regulate their appetite, and prevent extreme hunger or deprivation that may trigger binge eating behaviors. Regular eating also helps individuals develop a sense of predictability and control over their eating habits, supporting long-term recovery from BED.
Planning Ahead
Planning ahead involves proactively anticipating and preparing for potential triggers or challenges related to eating behaviors. This principle emphasizes the importance of knowing what is coming ahead and being prepared.
This means having food ready and available to you when you need it or being prepared with a coping plan for challenging situations and emotions that may come up.
Planning ahead includes identifying high-risk situations, such as social events or emotional stressors, and implementing coping skills or alternative behaviors to manage these triggers effectively. By engaging in proactive planning, individuals with BED can enhance their self-awareness, build resilience against urges to binge eat, and maintain progress toward recovery.
Increasing Self Awareness
CBT for BED reinforces self-monitoring as a crucial intervention in treatment. How can you change anything if you can’t see it clearly? To see (and ultimately change) patterns and triggers with clarity, treatment encourages keeping detailed records of eating behaviors, emotions, thoughts, and environmental triggers related to binge eating episodes.
By regularly tracking these factors, individuals with BED gain insight into their patterns and triggers of binge eating, which helps identify specific areas for intervention and behavior change. Self-monitoring also promotes self-awareness and accountability, empowering individuals to take an active role in their treatment and recovery process.
Additionally, self-monitoring allows for the evaluation of progress over time and provides valuable information for clinicians to tailor treatment strategies effectively.
Developing Skills for Coping
Emotions play a significant role in binge eating, as they can trigger or exacerbate episodes of binge eating. People often describe the binge experience as numbing, soothing, or distracting. The episode temporarily alleviates uncomfortable emotions or provides a sense of pleasure or distraction, reinforcing the association between emotions and eating.
Individuals with Binge Eating Disorder often report beginning with some kind of emotional distress followed by an escape into binge eating and then intense guilt, shame, or feelings of failure.
You can see how this vicious cycle can repeat indefinitely. A way out is to establish alternative methods for coping with the initial distress experience, so you are less likely to resort to binge eating as the primary mechanism of self-soothing.
Developing coping skills is essential when overcoming Binge Eating Disorder because it helps individuals address the underlying emotions, thoughts, and situations that contribute to binge eating episodes, empowering them to respond in healthier ways.
By learning and practicing coping skills, individuals with BED can build resilience, enhance emotional regulation, and reduce reliance on binge eating as a coping mechanism. These skills are crucial for long-term recovery, as they provide sustainable tools for navigating life's challenges and maintaining a balanced relationship with food and emotions.
Binge Eating Disorder Is Treatable
BED is a complex and challenging condition that affects millions of individuals worldwide. Despite its prevalence and significant impact on physical and mental health, BED often goes undiagnosed or untreated due to stigma, shame, and misconceptions surrounding eating disorders.
With increased awareness, access to evidence-based treatments like Enhanced CBT and support from healthcare professionals and loved ones, individuals with BED can recover fully. By addressing the underlying emotional, psychological, and behavioral factors driving binge eating, individuals can learn to develop healthier coping mechanisms, regulate their eating behaviors, and improve their overall well-being.
It's essential to recognize that recovery from BED is possible, and seeking help is the first step towards reclaiming control over one's relationship with food and emotions. Together, we can break the silence and stigma surrounding BED and support those on their path to healing and recovery. Book your free consult call today.
