What to Know About Binge Eating Disorder

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Note from Kat: My good friend T and I were talking about our various struggles, and I was surprised when she mentioned that she's struggled with binge eating disorder for a long time. As we talked more I had some misconceptions, so I asked if she would be willing to write about it for everyone here. HUGE, HUGE thanks to T for putting this together — it's a great guide if you're unfamiliar and/or curious about the disorder.

Readers, do any of you struggle with eating disorders in general or binge eating disorder in particular? What resources have you found to help you, and where are you in your journey right now?

T's Experience with Binge Eating Disorder

For elder millennials and young Gen-Xers, the unit on eating disorders was a big deal in high school health class. I still remember a lot of details from those particular classes — more than our 1990s-era lessons on smoking, drinking, AIDS, etc. (OK, I also can't unsee the grisly photos of STI symptoms blown up larger than life on the projector screen.)

We learned about the harmful (and fatal) effects of anorexia and bulimia, such as lanugo (I'll never forget that word!) and dental problems, and teachers explained that teenagers with anorexia restrict their eating to such an extreme degree because other aspects of their lives feel out of their control. (That's an oversimplification, but they really drilled that into our heads.)

The teachers didn't tell us anything about binge eating disorder (BED), and even today, the phrase “eating disorder” probably makes most people think of anorexia. Binge eating disorder didn't have a standalone diagnosis in the DSM until 2013; before that, it was part of “EDNOS: Eating Disorder Not Otherwise Specified.” A decade later, it's the most common eating disorder, but, as The New York Times explained earlier this year, it's “under-discussed and underrecognized by both the general public and those in the medical field, partly because many don’t know about the diagnosis or its potential severity.”

Especially because of that lack of awareness, I'm hoping that writing about my experiences can help readers with binge-eating issues by potentially prompting them to seek help — or at least be comforted in a small way by recognizing aspects of their own behavior. I also hope that readers with partners or family members who have BED can get some insight from what I've shared.

{related: office stress vs. your diet}

What Is Binge Eating Disorder?

Binge eating disorder goes far beyond simple overeating or “emotional eating.” BED does not mean going out to eat and eating a lot more than you planned (gotta discreetly undo that pants button, and maybe skip dessert), or the relatable “Whoops, I just finished a whole sleeve of Thin Mints while watching Netflix.”

BED is more along the lines of sitting (or standing at the counter) in your kitchen alone while shoveling food into your mouth on autopilot, not taking the time to savor it, but enjoying the dopamine boost. Maybe you weren't even hungry when you started.

When you're done, you suddenly realize the huge amount you just ate, leaving you feeling ashamed, not to mention gross physically. Then you hide the evidence — the food wrappers, etc. If it's bedtime, you may not even want to lie down right away, to avoid heartburn. Good times.

(Bonus: If you polished off food that your partner or kids were going to eat, you'll end up quickly buying more and replacing it before they notice, adding to the secrecy and shame.)

For a description on the more “professional” side, diagnostic criteria for BED include recurrent episodes of binge eating, at least once a week for three months, according to the National Eating Disorder Association (NEDA). The episodes are characterized by:

1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).

NEDA notes that the binge episodes are associated with key behaviors and feelings such as (1) “Eating large amounts of food when not feeling physically hungry,” (2) “Feeling disgusted with oneself, depressed, or very guilty afterward,” and (3) “Eating alone because of feeling embarrassed by how much one is eating.” (BED is not linked with purging like bulimia is, but it can develop into bulimia.)

The same NEDA webpage also gives a long list of warning signs and symptoms, a few of which are (1) “Feels lack of control over ability to stop eating [during binges],” (2) “Frequent checking in the mirror for perceived flaws in appearance,” and (3) “Disruption in normal eating behaviors, including eating throughout the day with no planned mealtimes; skipping meals or taking small portions of food at regular meals; engaging in sporadic fasting or repetitive dieting.” Check, check, and check.

{related: how to eat healthy while working from home}

How Can You Get Diagnosed with Binge Eating Disorder?

If you check out that webpage from NEDA, or a similar list like this one from The Cleveland Clinic, and everything — or almost everything — rings true, I recommend printing it out, checking off every symptom/characteristic that applies to you, and bringing it to a doctor or therapist. With it right in front of you both in black and white, you may find it easier to talk about, and depending on the provider, they may even take you more seriously.

If you speak to a therapist and don't have much luck, try your primary care doctor, or vice versa.

I'm in my 40s, and I've had issues with general emotional eating for almost 20 years. I'm not sure when my behavior “officially” developed into BED, but for many years on and off, I've definitely “qualified.” I've never been officially diagnosed, but reading the BED criteria gives me the feeling of “Yep, that is me exactly.”

Frustratingly, a few of my former therapists didn't seem to take my concerns seriously, probably in part because the person sitting in front of them was (usually) a reasonable weight. (At my highest, I was about 30 lbs. more than I am now.) I'm thinking it's safe to assume that some (many?) mental health providers unfamiliar with BED have a particular image in mind — a person who weighs, say, 200–300+ pounds.

In fact, it's common to have weight fluctuations with BED; it's not always a case of gaining more and more weight, because of the binge-and-restrict cycle. You worry about gaining weight after you've been bingeing, so you restrict your food and stay “good” for a while, maybe losing some pounds… and then you're triggered by something and “give in” and start bingeing again, and so on, ad nauseum (ha, no pun intended).

Comorbidities are also common with binge eating. Research has found that some mental health conditions are associated with BED, such as anxiety, mood disorders, substance abuse, and PTSD, and that about 30% of people with BED have a history of ADHD. *raises hand*

{related: the best ways to relax after a stressful day}

Recovering from Binge Eating Disorder

While of course substance abuse and alcohol abuse are incredibly hard to recover from, stopping binge eating brings its own complication. If you want to never drink again, that's something that (in theory) you can one day accomplish, and abstain for the rest of your life. If you want to stop bingeing, however, the object of your “addiction” is inescapable. You have to eat food for the rest of your life, after all.

For example, if you live with someone who always happens to have your trigger foods in the house, it would be unfair, not to mention embarrassing, to say, “Hey, please don’t buy ice cream sandwiches anymore, because I can’t control myself when they’re in the freezer.” (When you have the compulsion to binge, you sometimes don't care WHOSE food it is — and afterward, you pile on more guilt.)

That aside, here are some things that may help you cope with BED:

1. Work with a therapist: With the Psychology Today therapist directory, you can filter by issue, such as “eating disorders.” Many experts recommend cognitive behavior therapy (CBT) for BED.

2. Try a self-help book (or two): I just checked my Amazon order history and found that I bought, um, FIVE binge-eating self-help books from 2014–2018. They didn't “work” (the ones I actually read, that is), but they've gotten really good reviews, and they might work for you! If you'd prefer a book that doesn't focus on losing weight, read summaries and reviews carefully.

• Breaking Free from Emotional Eating by Geneen Roth
• Never Binge Again by Glenn Livingston, PhD
• Reclaiming Yourself from Binge Eating by Leora Fulvio
• Eat What You Love, Love What You Eat by Michelle Ma, MD, and Kari Anderson DBH, LPC
• How to Have Your Cake and Your Skinny Jeans Too (ugh, that title) by Josie Spinardi

3. Connect with people with BED online: The subreddit r/BingeEatingDisorder is a good place to start, and it has strict rules to support the well-being of its 70,000+ members.

4. Plan a week of meals ahead of time: This will reduce the number of food decisions you'll have to make during the week (avoiding decision fatigue!) and provide healthy structure. A dietitian can help, and The Academy of Nutrition and Dietetics has an online directory with telehealth and in-person providers.

5. Sorry to sound like an ad, but: Ask your doctor about Vyvanse (lisdexamfetamine). Vyvanse is expensive (although a generic is now available), but you can get a savings card from the manufacturer. Note: When I took Vyvanse for ADHD (it didn't do much for my binge eating), I used a savings card with our high-deductible plan, and it was still $300+ per month. *sad trombone noise*

6. Don't keep trigger foods in the house: This has helped me the most, and I really wish I could do it more, but for one, because of my teenager, there's always ice cream, chips, etc., around.

7. Postpone your binges: If you really want to eat a particular food that you know you will trigger a binge (whether the food is in your house or you have to go buy it), tell yourself, “Not today. I can have it tomorrow.” It's easier to avoid a trigger food by telling yourself you can have it in the future rather than creating an absolute. (It's the same strategy as stopping yourself from immediately buying something online by leaving it in your cart.)

8. Try affirmations: Avoid potentially harmful ones like “Nothing tastes as good as skinny feels” in favor of one of these 100 (!) options. Even if you're not an affirmations person (I'm not), you might find one or two you can tolerate and try. (I'd love to be able find a good substitute for “Hey, self, life is really hard lately, so you deserve this huge amount of sugary food right this minute!”)

9. Create small barriers: If you've you've had a filling dinner, brush your teeth. (Waiting 30 mins. is better for your teeth for some foods, so it's a trade-off.) It presents a cue that you're done eating for the day. Also, when you get home from work, put on pajamas, so that if you later want to go out and buy food for a binge, you'll have to get dressed again first. (I know, I know: delivery.)

{related: open thread: on drinking too much, jobs that encourage drinking, and drinking because of job-related stress}

How to Get Immediate Help for Eating Disorders

ANAD (National Association of Anorexia Nervosa and Associated Disorders) has a free helpline available from Monday through Friday, 9 a.m. to 9 p.m. CST: 1-888-375-7767

NEDA (National Eating Disorder Association) ended its helpline in June 2023, unfortunately, but suggests several other resources.

MEDA (Multi-Service Eating Disorders Association) has an online Recovery Community. If you create a free account, each month you get access to the online library and all forums, and at least seven recovery tools, four webinars, and three meditations.

988 Suicide & Crisis Lifeline is free and available 24/7.

2023 Update: Here's a suggestion from a reader: Overeaters Anonymous

2024 Update: T followed up with Kat to let us know that she has been formally diagnosed with binge eating disorder and is getting treatment.