Common questions I see in my practice: If I stuff myself at a birthday party or holiday celebration, do I have binge eating disorder? Isn't binge eating bulimia? If I stuff myself, does that mean I'm bulimic?
The answer to all three of those questions is no. While binge eating disorder (BED) shares some similarities with bulimia nervosa, they are not the same disorder. The key difference between binge eating disorder and bulimia nervosa is that individuals with BED do not purge to "make up" for the binge, while those with bulimia nervosa typically compensate for their binge by purging (e.g., vomiting, exercise, laxative use).
Furthermore, overeating is not the same thing as binge eating. If you "stuff" yourself on rare occasions like holidays or birthday parties, you are not a binge eater. To be diagnosed with binge eating disorder, you must experience at least one episode of binge eating per week, on average, for three months or more. A binge occurs when an individual eats an amount of food within a two-hour period that is unquestionably larger than most individuals would eat during a similar period under similar circumstances. In addition, as the binge eating episode is occurring, the individual feels like she cannot stop eating or control what or how much food she is consuming. As you can imagine, this feeling of being out of control causes much distress in those who suffer with binge eating disorder. (See: Common Misconceptions About Eating Disorders.)
How common is binge eating disorder?
Although BED is the most common eating disorder in the United States, the prevalence rate is only 1 to 5 percent of the population, depending on the age and gender of the population in question. Women are more likely to suffer than are men, with a 3.5 percent lifetime prevalence for women, and a 2 percent lifetime prevalence for men.
What causes binge eating disorder?
Since BED is a new diagnosis, researchers and therapists don't actually know much about how and why it starts. At this point, there are no "early warning signs" other than frequent binge eating, which the individual will likely try to hide evidence of. The disorder does appear to run in families and is equally common among individuals of all races, unlike most eating disorders. (Anorexia nervosa, for example, is much more prevalent in non-Latino whites than in other races.)
Researchers are beginning to examine biological differences between the brains of those with and without BED. Not surprisingly, given the similarities in diagnostic criteria with those suffering with bulimia nervosa, researchers are finding that those with BED and those with bulimia nervosa share the same reward mechanisms in their brains. (See: The Shocking New Way to Treat Binge Eating.)
When we do something that we really enjoy, certain areas of our brains "light up." This is caused by a rush of two neurochemicals: serotonin and dopamine. Individuals with BED or bulimia nervosa seem to experience this rush of serotonin and dopamine when they binge eat. Translation: Binge eating is very rewarding for their brains, much more so than it would be for someone who did not have BED or bulimia nervosa. We don't yet understand why this rush happens. But as BED and bulimia nervosa both run in families, there is likely a genetic reason for this reward mechanism.
What treatments are there for binge eating disorder?
Similar to treatments for anorexia nervosa and bulimia nervosa, treatments for binge eating disorder usually involve a dual approach: pharmaceutical drugs to help balance brain chemicals (dopamine and serotonin, in particular) and therapy to help the individual develop appropriate coping mechanisms (which shows relatively high levels of success at eliminating binge eating in the long term). New research out of the Baylor College of Medicine is exploring ways that other drugs currently being used to treat obesity may also help suppress binge eating disorder. However, it is too soon to tell how these drugs will work in the long run.
If you or a loved one currently suffer from binge eating disorder, please seek help from a qualified eating disorder specialist. Know that a combined treatment approach of pharmaceutical treatments in addition to therapeutic approaches will likely be your best bet. In the meantime, keep your ears open for more news about potential alternative treatments in near future.