As part of this trilogy on eating disorders, we have addressed anorexia nervosa (See the article: Eating Disorders: Anorexia Nervosa), as well as bulimia nervosa (See the article: Eating Disorders: Bulimia Nervosa).
The third part of this series focuses on binge eating disorder, a less known yet more common eating disorder. In Quebec, approximately 192,000 people are affected by binge eating disorder. In Montreal, 3.8% of the population would suffer from this disorder, compared to 1% for anorexia and 2% for bulimia.
It was only recently, in 2013, that this disorder was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a distinct entity, which likely explains why it is still not well known.
Here is the final part of this series: binge eating disorder.
Definition of binge eating disorder
Along with anorexia and bulimia, binge eating disorder is one of the three main eating behavior disorders recognized by the DSM-5. This disorder affects about 3.5% of women and 2% of men. Unlike anorexia and bulimia, most people with binge eating disorder are overweight or obese. Moreover, these individuals are generally older and more often men.
Warning signs of binge eating disorder
Some signs that may alert to the presence of binge eating disorder in an individual include:
- Changes in body weight
- Dressing in multiple layers of clothing or wearing clothes aimed at hiding body shape, even when the temperature does not warrant it
- Signs of binge eating, such as disappearance of food or secret food hoarding
- Feelings of guilt and anxiety about eating or food
Symptoms of binge eating disorder
Binge eating disorder is characterized by recurrent episodes of binge eating, where individuals consume large amounts of food in a short period. These episodes are accompanied by a feeling of loss of control. Unlike people with bulimia nervosa, individuals with binge eating disorder do not engage in compensatory behaviors to eliminate excess food, such as abuse of diuretics or laxatives, intensive physical activity, or fasting. Individuals with binge eating disorder may also experience depression and be preoccupied with their weight and body.
Diagnosis of binge eating disorder
The criteria for diagnosing binge eating disorder include:
- Binge eating episodes occurring on average at least once a week over a period of three months
- A feeling of loss of control over eating
Additionally, at least three of the following criteria must be present:
- Eating more rapidly than normal
- Eating until uncomfortably full
- Eating large amounts of food without feeling physically hungry
- Eating alone due to shame about the amount of food consumed
- Feeling disgusted, guilty, or depressed after overeating
Treatment of binge eating disorder
The main treatment for binge eating disorder is cognitive behavioral therapy. This therapy can help control binge episodes in the long term but does not have a significant effect on weight. Treatment may sometimes include interpersonal psychotherapy, as well as the prescription of certain medications, such as selective serotonin reuptake inhibitors (SSRIs) or drugs aimed at inducing weight loss.
Nutritional approach for binge eating disorder
A dietitian may also be involved in the treatment of binge eating disorder. As with other eating behavior disorders, their role includes teaching the basics of normal eating, which may include planning three regular meals a day, consuming appropriate portions, etc. Similar to the treatment of bulimia nervosa, the initial goal of treating binge eating disorder is also to maintain body weight. Indeed, it may be preferable to wait until individuals have normalized their eating behavior before undertaking weight loss strategies to avoid risking exacerbating binge eating.
To conclude this trilogy:
Seeking help, or even becoming aware of an eating disorder, is often very difficult. According to Dr. Mimi Israel, head of the psychiatry department at the Douglas Institute and associate professor in the Department of Psychiatry at McGill University, individuals with an eating disorder cannot be forced to seek help. First, they must be helped to recognize their discomfort and the negative consequences it entails (e.g., fatigue, etc.). It must be done calmly and respectfully, as it is a process that involves trust. Afterwards, they can be encouraged to seek help.
For help requests:
A nonprofit community organization, Anorexia and Bulimia Quebec (ANEB Quebec), provides assistance to people directly or indirectly affected by an eating disorder.
References
- http://test.opdq.org/reinventez-vos-habitudes-alimentaires/lhyperphagie-boulimique/
- https://www.merckmanuals.com/fr-ca/accueil/troubles-mentaux/troubles-des-conduites-alimentaires/trouble-hyperphagie-boulimique
- https://www.merckmanuals.com/fr-ca/professional/troubles-psychiatriques/troubles-du-comportement-alimentaire/hyperphagie-boulimique
- https://www.merckmanuals.com/fr-ca/accueil/les-faits-en-bref-troubles-mentaux/troubles-des-conduites-alimentaires/trouble-hyperphagie-boulimique
- https://nedic.ca/eating-disorders-treatment/binge-eating-disorder/
- https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
- Coughlin, Janelle W., et al. Modern Nutrition in Health and Disease, by A. Catharine Ross, Wolters Kluwer/Lippincott Williams & Wilkins, 2014, pp. 1324–1325.
- https://quebec.huffingtonpost.ca/entry/troubles-alimentaires-demandes-aide-aneb_qc_60185fdac5b63b0fb2836d08
Article written by:
Marie-Noël Marsan, written in 2021.