Binge Eating Disorder Symptoms, Signs, and Causes

Binge eating disorder is an eating disorder characterized by periods of extreme overeating, but not followed by purging behaviors, as in bulimia. Binge eating disorder can occur alone or in association with abnormalities of the brain's hypothalamus gland, Prader-Willi disorder, or other medical conditions. It can contribute to high blood pressure, weight gain, diabetes, and heart disease. Treatment may include therapy, dietary education and advice, and medication.

The main symptom of binge eating disorder is binge eating, accompanied by an inability to control the binges, and guilt and/or distress because of these eating episodes. Other signs and symptoms of binge eating disorder are not specific, but are related to the consequences of binge eating and may include:

• Weight gain
• Being overweight
• High cholesterol
• High blood sugar levels (hyperglycemia)

Binge eating disorder is more than just eating too much. Binge eating disorder is a serious condition characterized by uncontrollable eating, significant distress, and often results in weight gain. Although binge eating disorder can be diagnosed in people with normal weight, almost all individuals with binge eating disorder who are seeking treatment are overweight or obese. People suffering with binge eating disorder may feel ashamed and try to hide their symptoms. Eating episodes are usually done secretly to avoid having other people know what is going on. Unfortunately, this can make people reluctant to seek help or treatment so they continue to struggle alone.

The exact causes of binge eating disorder are unknown. Like other eating disorders, binge eating disorder seems to result from a combination of genetic, biological, and psychological factors. Each of these areas can affect a person's:

• Childhood development
• Exposure to trauma
• How their families dealt with food
• Physical appearance (and ideals of attractiveness)
• Support system

Genetic Effects

Because binge eating disorder has been accepted as a formal diagnosis only recently, few studies have investigated genes associated with the disorder. However, some studies suggest that there may run in families, but the genes causing this have not been identified. More studies including larger numbers of families will need to be done for specific genes to be identified.

Biological Factors

Certain brain chemicals (neurotransmitters) and brain regions may be affected in binge eating disorder.

Dopamine is another neurotransmitter related to appetitive behaviors and the reward pathways in the brain. Appetitive behaviors are the actions taken to seek pleasurable or rewarding experiences -- including sex, food, or drugs --, which activate the reward pathways. The reward pathways are involved with triggering positive feelings in response to positive and pleasurable activities but also in response to the use of many addictive drugs including heroin, cocaine, and alcohol. Eating disorders, particularly binge eating disorder, may be considered a "food addiction" and involve these dopamine pathways.

Psychological Factors

Personality traits such as impulsivity, impulsive decision-making, stress reactivity, harm avoidance, perfectionism, and other personality traits are common in patients with eating disorders. As mentioned previously, certain personality types seem to be more commonly associated with binge eating disorder.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria requires the following for a diagnosis of binge eating disorder.

The binge-eating episodes are associated with at least three of the following:

1. Eating much more rapidly than normal
2. Eating until feeling uncomfortably full
3. Eating large amounts of food when not feeling physically hungry
4. Eating alone because of feeling embarrassed by how much one is eating
5. Feeling disgusted with oneself, depressed, or very guilty afterward
6. People have marked distress regarding binge eating.
7. The binge eating occurs, on average, at least once a week for three months.

The number of binge eating episodes per week defines the severity of binge eating disorder:

• Mild: One to three episodes per week
• Moderate: Four to seven episodes per week
• Severe: Eight to 13 episodes per week
• Exxtreme: Fourteen or more episodes per week.

Eating disorders are serious health conditions that can be both physically and emotionally destructive. It is important for people who struggle with binge eating disorder to recognize that it is a real medical condition and that there are treatments that can help. Early diagnosis and intervention may improve recovery. Eating disorders can become chronic, debilitating, and even life-threatening conditions without appropriate treatment.

When one begins to notice that disordered eating habits are affecting one's life, happiness, and ability to concentrate, it is important to talk to somebody about what's going on. Seek professional help from a primary care provider, a psychiatrist, or other behavioral health provider. If someone you know is showing signs of binge eating disorder, let them know you are concerned and want to help. You may offer to help them find medical advice.