It’s common for people to overeat once in a while. This can be especially true over holidays when it’s hard to turn down another portion of a favorite food. But there’s a big difference between overeating on occasion and binge eating.

Binge eating is where you eat an amount that’s definitely larger than what most people would eat in a similar situation and period of time. It can seem like there’s a loss of control and you may be unable to stop, even if you’re not hungry. Binge eating is often followed by feelings of guilt or shame.

If you or a loved one frequently binge eats, it may be binge eating disorder (BED). Binge eating disorder is a serious mental health condition that can affect all aspects of health and life, and it’s best to get help for binge eating disorder as soon as possible.

Below, we share more information about the symptoms, causes and possible treatments of binge eating disorder.

What is binge eating disorder?

Binge eating disorder is used to describe binge eating that’s frequent or ongoing. People may binge eat as a way to deal with or avoid difficult emotions or for comfort and soothing. Binge eating disorder really isn’t about food.

Binge eating may be considered binge eating disorder if binge eating occurs, on average, at least once a week for three months. But not everyone with binge eating disorder experiences it in the same way. For some people, it might only last for several months, while for others, it may go away and come back, or go on for years if it’s not treated.

Signs and symptoms of binge eating disorder

You can’t look at someone and know if they have binge eating disorder. People with binge eating disorder can be very good at hiding it. However, possible symptoms include:

• Eating an unusually large amount of food in a short amount of time – A person with binge eating disorder eats more food than most people would eat in a similar situation.
• Eating faster than usual – During a binge episode, a person may eat very rapidly.
• Eating that feels out of control – A person may feel out of control while eating and can’t stop eating once they start.
• Eating when not hungry – They may start eating when they’re not hungry and continue to eat, even after they’re full. They may eat so much that they become sick to their stomach afterwards.
• Eating alone – People who binge typically binge alone. They might do it when everyone is sleeping or when they’re home alone or in the car.
• Gaining weight – If someone you care about seems to be eating normally but gaining large amounts of weight, they may have binge eating disorder, especially if they also have signs of depression and anxiety. But not everyone with binge eating disorder gains a noticeable amount of weight.
• Hiding the “evidence” – Someone with binge eating disorder may hide the evidence of overeating. You may find food wrappers under the bed or empty boxes stuffed in the closet, or notice that large amounts of food are missing.
• Feelings of guilt or shame after overeating – Almost all individuals struggling with binge eating disorder report feeling depressed and filled with shame or guilt after binges. To avoid those feelings, they may binge again, repeating another cycle.
• Unhappiness with weight or shape – People with binge eating disorder can be of average weight or overweight. But most are unhappy about their body size or shape, even if they’re at a healthy weight.
• Yo-yo dieting – Shame or embarrassment about binge-eating behaviors (and weight gain) can lead to periods in which a person tries to severely cut back how much they eat. But starting and stopping diets frequently is more likely to increase the urge to binge eat and lead to an ongoing cycle of periods of binge eating followed by periods of dieting.

Binge eating vs. bingeing behaviors

Binge eating can also be a symptom of other eating disorders, including bulimia nervosa and anorexia nervosa. The difference is that people with binge eating disorder don’t use compensatory behaviors after overeating to make up for the food they ate. Compensatory behaviors include throwing up, using laxatives or diuretics, restrictive eating and over-exercising.

A person with binge eating disorder might try to diet or eat less at mealtimes to make up for overeating. But for people with binge eating disorder, restricting food intake often leads to more bingeing.

Getting an eating disorder assessment is the only way to know for sure if you or a loved one has binge eating disorder or another type of eating disorder. All eating disorders are serious, so it’s best to see a doctor as soon as possible.

Causes of binge eating disorder are not entirely clear

We don’t know the exact cause of binge eating disorders. It’s likely a combination of factors, including:

• Mental health conditions – People with binge eating disorder are more likely to have other mental health problems, such as depression, anxiety, post-traumatic stress disorder (PTSD) and ADHD. Binge eating can be used as a coping mechanism by those with mental health concerns. When the calming effect sets in, emotional pain goes away for a while.
• Family history – You're more likely to have binge eating disorder if someone in your family had an eating disorder.
• History of dieting – Many people say that their binge eating disorder started with a diet. A diet is any form of food restriction. The more people restrict, the more likely they are to binge. And the more they binge, the more weight they may gain. Which puts increased pressure to restrict, repeating the cycle.

Who gets binge eating disorder

Binge eating disorder is one of the most common eating disorders, affecting nearly 3% of the U.S. population. Anyone may develop binge eating disorder. Adults with a history of dieting or another mental health condition are at a higher risk. It often begins in the late teens or early 20s, but younger children can have binge eating disorder, too.

Binge eating disorder comes with serious health risks

Binge eating disorder can seriously affect your physical and mental health. People with binge eating disorder are more likely to experience depression, isolation, anxiety and substance abuse. These mental health problems can make it hard to be effective at work or keep up with personal relationships. They may even lead to thoughts of suicide. Physical health risks tend to be those related to weight gain and include type 2 diabetes, high blood pressure and cardiovascular disease.

The sooner a person gets treatment, the sooner we can start to address behaviors that could lead to worsening health.

How is binge eating disorder diagnosed

If you think you or a loved one has binge eating disorder, the first step is an eating disorder assessment. During the appointment, your doctor will ask questions to see if your symptoms meet the diagnostic criteria for binge eating disorder.

They’ll ask you about eating behaviors, mental health, lifestyle and medications. It can be helpful to track symptoms and typical eating habits for three or four days before your appointment.

Your doctor may also recommend additional tests to see if binge eating disorder has affected your health. These tests could include a physical exam, lab work or a sleep study.

Diagnostic criteria for binge eating disorder

The following are the diagnostic criteria for binge eating disorder from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), which is the encyclopedia of mental health diagnosis:

• Recurrent and persistent episodes of binge eating
• Episodes including three (or more) of the following:
  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty after overeating
• Marked distress regarding binge eating
• Absence of regular compensatory behaviors (such as purging)

It’s best to get help, even if you or your loved one don’t meet this specific criteria. Eating disorders take many different forms, and the first step is an eating disorder assessment.

Binge eating disorder treatment

The first step in binge eating disorder treatment is addressing bingeing and developing more consistent eating patterns – it’s not about losing weight.

People receiving treatment for binge eating disorder are supported by a team that includes a therapist and a dietitian. The therapist helps patients identify and plan for the emotions and triggers that cause binge eating behaviors. A dietitian can help you understand the nutrition your body needs and help improve your relationship with food.

Since binge eating disorder is a medical condition, many insurance companies cover some or all of the cost of eating disorder recovery. To learn what your insurance company covers, contact Member Services by calling the number on the back of your insurance card.

Cognitive behavioral therapy for binge eating disorder

The main treatment for binge eating disorder is cognitive behavioral therapy (also called psychotherapy), which can be delivered in individual therapy or group therapy. This type of therapy helps a person to first understand the factors leading them to engage in binge eating, and then to learn and practice skills to help them get out of the binge eating cycle.

Binge eating can be triggered by many factors, including inconsistent eating patterns, guilt, shame, relationship challenges, poor self-image and mental health concerns like depression. People may also have a history of bullying, trauma or abuse, and memories can trigger binge eating. Cognitive behavioral therapy helps people to acknowledge those feelings when they arise and identify interventions to help until the urge to binge is in the past.

So, let’s talk about what a person may think or do when they’re presented with their favorite cake. A person with binge eating disorder may have harmful, untrue thoughts like, “I don’t deserve to eat that cake,” and “I’m ugly, fat and stupid, and I’ll always be this way so I might as well eat the entire cake.”

The question is how to stop these thoughts and keep them from leading to binge eating. For many people, the best way to interrupt an urge to binge eat is to get away from their negative thoughts – for example, by calling a friend, watching fun videos, going for a walk or reading a few chapters of a book.

Medications for binge eating disorders

Medications are sometimes used as part of binge eating disorder treatment if a person has severe symptoms or the doctor feels that medications may make it easier for a person to practice the skills they’ve learned through cognitive behavioral therapy. But they shouldn’t be the main treatment for binge eating disorder and may not be used right away.

While medications can be helpful in reducing binge eating behaviors, they can also make it harder for people to manage binge eating disorder over the long term.

When people take these medications, they may not have the urge to binge eat. As a result, they don’t understand the factors driving the binge or have the chance to learn and practice the skills that can help break the binge eating cycle. So, when they stop taking the medication, binge eating behaviors can return.

Medications that doctors use to treat binge eating disorders include:

• Vyvanse (Lisdexamfetamine dimesylate) – This is the only medication approved by the U.S. Food and Drug Administration to treat moderate to severe binge eating disorder, and only in adults. Because it's a stimulant, this medicine can be habit-forming if misused.
• Ozempic (semaglutide) – tudies show that this diabetes medication may help people with binge eating disorder gain better control over their eating habits, and reduce the frequency and intensity of binge eating episodes.
• Antidepressants – Since boosting your mood can help avoid binges, these medications are sometimes used as part of binge eating disorder treatment.
• Topamax (Topiramate) – This anti-seizure medication is shown to reduce the urge to binge eat, but it has the potential to cause serious side effects like memory problems.

Recovering from binge eating disorder takes time and support

Recovery takes ongoing work and commitment. There’s no set pace, and it’s not always a linear process. Many people experience setbacks, especially in times of stress. It’s important to view recovery as a process instead of a set goal.

People who are in recovery are often most successful if they surround themselves with the support of friends, family and others who are also in recovery from binge eating disorder – both as part of formal support groups and in personal, supportive relationships.

When children and adolescents are treated for binge eating disorder, it’s very important for adults or caregivers to be part of the process.

Learn more about binge eating disorder on the Melrose Heals podcast

The Melrose Heals podcasts on eating disorders explores, discusses and understands these conditions. Learn more about binge eating disorder and recovery in the following episodes:

Do you think you or a loved one has binge eating disorder? Start healing today

Binge eating disorder isn’t a choice – it’s a mental health condition. If you or a loved one is struggling with binge eating disorder, call Melrose Center at 952-993-6200 to schedule an eating disorder assessment.
When treating our patients, we educate them on binge eating disorders and help them figure out the role that binge eating plays in their life. What does it offer or help them manage? And how can they break the binge eating cycle.

At Melrose Center, we use individual and evidence-based group programming to support patients during recovery. Adult patients start with a 17-week binge eating program that includes a weekly virtual small group session led by a therapist and dietitian. After completing this program, patients are able to join the binge eating relapse program. Patients also have regular individual therapy and dietitian appointments throughout the process.

Melrose can also help children and adolescents who are 10 years old or older. For these younger patients, binge eating disorder starts with individual sessions. Parents and caretakers will also learn how to support the child through recovery.

Binge eating doesn’t need to control or define your life. Recovery is possible, and getting treatment and support from Melrose Center can make it happen.