What Is Compulsive (Binge) Eating?

As the COVID-19 pandemic spread around the world, doctors and psychiatrists predicted that it would cause a global mental health crisis. In July 2020, the International Journal of Eating Disorders drew attention to another consequence of COVID-19: a rise in eating disorders such as anorexia, bulimia, and binge eating. A study found that people with binge eating disorder and bulimia were experiencing increases in their binge eating episodes and their urges to binge. Some felt the need to stockpile food due to potential shortages in the food supply, or not being able to find a certain type or brand of food. Many were anxious about staying at home or changes to their exercise routines.

A year into the pandemic, health professionals had their fear confirmed: eating disorders were, indeed, on the rise. At the Michigan Medicine center in Ann Arbor, Michigan, the number of hospital admissions among adolescents with eating disorders more than doubled during the first twelve months of COVID-19. School closures, cancelled extracurricular activities, and social isolation were cited as factors that may have worsened or triggered symptoms for students.

Achieving a healthy relationship with food can be tricky even for the most health-conscious individuals. However, when a relationship with food becomes so unhealthy that it interferes with basic daily functioning, it is likely an eating disorder—a potentially life-threatening medical illness. Eating disorders have both a physical and emotional component. Millions of people are or have been affected by an eating disorder in their lifetime.

There are different kinds of eating disorders. They can involve a dangerously low intake of food, a dangerously high intake, or other abnormal eating habits. The three major types are anorexia nervosa, bulimia nervosa, and binge eating disorder (also known as BED). Binge eating disorder—characterized by consuming large amounts of food frequently and feeling unable to stop—often results in obesity, which, in turn, can lead to major health risks including diabetes, high blood pressure, and heart disease. However, with the proper treatment and support, many have overcome binge eating disorder to develop a healthy relationship with food and with themselves.

Binge eating disorder is one of the newest eating disorders formally recognized in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). According to the National Eating Disorder Association (NEDA), binge eating disorder is more than three times more common than anorexia and bulimia combined. Research suggests that between 0.2 percent and 3.5 percent of girls and women and 0.9 percent and 2.0 percent of boys and men will develop binge eating disorder. Unlike other eating disorders that tend to impact girls and women more than boys and men, approximately 40 percent of those with binge eating disorder are male. Canada’s National Initiative for Eating Disorders (NIED) estimates that about one million Canadians have a diagnosis of an eating disorder such as binge eating, anorexia, or bulimia.

About Binge Eating Disorder

Binge eating disorder, also known as compulsive overeating, is different from occasional bingeing—eating a large amount of food once in a while, such as on holidays or special occasions. People with binge eating disorder regularly—at least once a week—consume much more food than their bodies can use and don’t stop even when they feel full. Unlike people with bulimia, people with binge eating disorder do not get rid of the food, or purge, after they have eaten. Binge eating usually results in weight gain and, often, obesity.

Although some distinguish between binge eating and food addiction, the two conditions are often related. Much in the way that alcoholics are addicted to alcohol, binge eaters are addicted to, or hooked on, food. Their lives are controlled by thoughts of what, when, and how much they will eat. They feel so guilty about their lack of self-control about food that they often eat alone or hide their food and eat it secretly. They eat whether or not they are hungry. They often eat large amounts of sweets and high-calorie foods and may find it hard to stop until they feel uncomfortably full. These episodes are usually followed by feelings of shame, disgust, sadness, or other negative emotions.

The Definition of Binge Eating Disorder

Doctors and psychiatrists rely on the Diagnostic and Statistical Manual of Mental Disorders (frequently known as the DSM) for the definitions they use in diagnosing conditions. According to the fifth edition of the DSM, the official diagnostic criteria for binge eating disorder includes:

• Repeated episodes of binge eating. (An episode of binge eating is characterized by eating, within a period of time, an amount of food that is definitely larger than most people would eat during a similar period of time, and feeling like you can’t stop eating or control how much you’re eating.)

• The binge eating episodes are associated with three (or more) of the following: eating much more rapidly than normal; eating until you feel uncomfortably full; eating large amounts of food when you are not physically hungry; eating alone because you feel embarrassed by how much you are eating; or feeling disgusted with yourself, depressed, or very guilty afterward.

• The binge eating occurs, on average, at least once a week for three months.

• The binge eating is not associated with the repeated use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa. (Compensatory behaviors are things that are meant to “un-do” eating and consuming calories.)

How Is Binge Eating Disorder Different from Other Eating Disorders?

As with binge eating disorder, other eating disorders involve some kind of extreme emotional reaction to food. The two best-known eating disorders are anorexia nervosa and bulimia nervosa. Anorexia is a condition in which a person believes they are overweight and refuses to eat in order to lose excessive amounts of weight. Bulimia is when a person binges, or eats large amounts of food in a short period of time, and then purges, or gets rid of all the food by self-induced vomiting; abuse of laxatives, diet pills, and/or diuretics; or fasting.

Compulsive exercise (also sometimes called exercise addiction) is also considered a serious eating disorder–related problem. This is when a person constantly exercises to get rid of calories. This behavior is also known as exercise bulimia, because the person is using exercise to purge food from the body. Another eating disorder where people take healthy behaviors to unhealthy extremes is orthorexia nervosa. According to NEDA, people who suffer from orthorexia nervosa develop an unhealthy obsession with healthy or “clean” eating to the point that it becomes detrimental to their health.

The cause of eating disorders remains unknown. There are often social or environmental factors that might trigger an eating disorder and possibly a genetic or biological basis as well. Depression or anxiety might also increase the risk of developing an eating disorder. While any or all of these might play a role, there does not seem to be a sole cause.

Who Does Binge Eating Affect?

Most teenage girls and many teenage boys have probably been unhappy with their body once in a while. It is nearly impossible to live in a culture obsessed with fitness and thinness without having a negative body image at least occasionally. However, teens who suffer from binge eating are never free of these bad feelings.

Binge eating disorder is the most common of all eating disorders. Both boys or men and girls or women can be affected. Of the adults affected by binge eating disorder, about 40 percent are men and 60 percent are women.

Behavioral and Emotional Signs of Binge Eating

Most people overeat now and then, and that’s typical. But if you often eat until you are overstuffed, or you eat large amounts of food when you are not really hungry or it’s not a regular mealtime, you may be a binge eater.

A binge eating disorder left untreated can lead to serious health problems, as well as psychological problems. It is important to determine as early as possible whether you have a problem. The earlier you identify the problem, the sooner you can get treatment. There are numerous behavioral and emotional indicators of binge eating disorder. The following are some of the most common signs.

Eating When You’re Not Hungry

Experts note that there are two types of hunger: physical and emotional. Physical hunger is the slight discomfort or burning feeling you get in your stomach when it is empty and in need of food. This is a natural and healthy signal that lets you know when it’s time to eat. Emotional hunger, on the other hand, has little to do with the body’s physical needs. When people experience emotional hunger, they eat to try to fill an emptiness they feel in their hearts and minds.

Because binge eaters have learned to eat in response to their emotional needs instead of their physical needs, they often reach a point at which they are no longer able to experience and recognize real hunger. With the messages between the brain and the stomach short-circuited, binge eaters continue to think that they are hungry even after eating too much. Overeating often leads to weight gain, and weight gain usually leads to more of the same painful feelings that caused the person to turn to food in the first place.

Consuming Large Amounts of Food

Binge eaters often turn to food as a way to cope. They consume large volumes of food in a relatively short period—around two hours or so. They usually eat quickly and consume a large quantity of high-calorie foods. Bingeing episodes occur regularly—at least once a week and often more. These episodes frequently accompany feelings of extreme emotions, such as anger or fear.

For binge eaters, these episodes reflect a compulsion. They feel powerless to stop or control what they are doing.

Hiding Food

Secretive snackers eat late at night or hide food away and eat it when no one is looking. They may eat just a little bit at a time, so that their family and friends don’t notice the missing food. They hide their eating because they are too ashamed to let other people see what they are doing. Eating secretly also makes them feel more powerful and in control over at least one aspect of their lives.

Eating Frequently Throughout the Day

Someone who grazes eats constantly––snacking on candy bars between classes, munching cookies in the locker room, or eating at home while talking to friends on the phone. Male athletes often graze when trying to bulk up in order to make a sports team. Other boys may cheer them on, encouraging the grazing behavior.

People who graze don’t act as though they are ashamed of overeating, because they do it in front of people. But inside, they may not feel good about what they’re doing. They often suffer from low self-esteem and use food to gain attention and acceptance.

Dieting Frequently

Binge eaters often go on and off diets, repeatedly losing and gaining back large amounts of weight. Binge eating may even begin after a major diet. Many times, binge eaters may experience no weight loss after dieting. They may try crash diets, diet pills, or other diet trends. However, these are often ineffective. Part of the problem is that diets do not address the psychological component of binge eating disorder. Another factor is that the hunger caused by a strict diet may prompt food cravings or an impulse to overeat.

Negative Feelings

Binge eaters are often plagued by negative emotions. Many experience feelings of shame and guilt—disgust for their bodies or eating habits or guilt about viewing eating as one of their only pleasures in life. Many judge themselves as “good” or “bad” according to the foods they eat or the size they are. Many binge eaters also feel a lack of self-control over their eating. Some become sad, upset, or even depressed. They may avoid friends or family out of embarrassment over their binge eating. Eating alone or hiding food is another common response.

Binge eating is something people may do in response to a problem, such as a parent’s alcoholism or stress at school. Because they can’t talk about their problems with their friends or deal with them alone, they use bingeing as a way to escape the fear, tension, stress, or anger they feel. All they can think about is eating.

The relief that binge eaters feel while bingeing is only temporary, though, and many may not experience any satisfaction, regardless of how much they consume. Afterward, they may feel guilty about what they have eaten. They eventually criticize and blame themselves. It can be a vicious cycle in which binge eaters turn back to food to relieve their feelings of guilt or shame. And, unfortunately, when they stop eating, their stressful situation hasn’t gone away.