Atypical Binge Eating Disorder: Signs and Symptoms

Contributor: Leigh Bell, BA, writer for Eating Disorder Hope

Binge-eating disorder, or BED, received full recognition as an eating disorder in 2013 when the American Psychiatric Association released the 5th edition of the Diagnostic and Statistical Manual, basically the encyclopedia of mental-illness diagnoses used by clinicians and insurance companies.

BED is now a separate diagnosis, rather than its previous place as a subcategory of Eating Disorder Not Otherwise Specified (EDNOS), or an atypical eating disorder. This is important because insurance companies will argue coverage for treatment of EDNOS.

It’s also important because many people with BED say the illness is stigmatized and frequently misunderstood, according to the National Eating Disorder Association. [1]

“Greater public awareness that BED is a real diagnosis—and should not be conflated with occasional overeating—is needed in order to ensure that every person suffering from BED has the opportunity to access resources, treatment, and support for recovery,” the association reports.

The Statistics Surrounding BED

BED is the most common eating disorder in the United States, where about 3.5% of women and 2% of men have the illness. However, a recent study of 46,351 men and women ages 18 to 65 published in The International Journal of Eating Disorders, found roughly 11% of women and 7.5% of men struggle with binge eating. [2]

Unlike people struggling with anorexia and bulimia, of whom about 10% are male, BED affects both sexes almost equally. About 40% of the estimated 10 million Americans who binge eat are men, according to the Binge Eating Disorder Association.

The eating disorder is defined by recurrent, persistent episodes of binge eating – consuming unusually large amounts of food beyond fullness – without compensatory behaviors, like purging.

Characteristics of BED

BED has three main characteristics listed in the DSM-5:

1. Recurrent episodes of binge eating occurring at least once a week for three months
2. Eating a larger amount of food than normal during a short time frame (any two-hour period)
3. Lack of control over eating during the binge episode (feeling you can’t stop eating or control what or how much you are eating)

Binge eating episodes are associated with three or more of the following:

• Eating until feeling uncomfortably full
• Eating large amounts of food when not physically hungry
• Eating much more rapidly than normal
• Eating alone out of embarrassment over quantity eaten
• Feeling disgusted, depressed, ashamed, or guilty after overeating

Still remaining an atypical BED is bingeing but less frequently or for shorter periods of time.

Now that BED is separate diagnosis in the DSM-5, treatment may be more accessible for individuals suffering from it. Effective evidence-based treatments for BED include cognitive behavioral therapy, or CBT, among other therapies, and pharmacological treatments.

In fact, the Federal Drug Administration approved last year the first drug for BED. The drug Vyvnase was originally and continues to be used to treat Attention-Deficit-Hyperactivity-Disorder, ADHD.

Only one other medication, fluoxetine, which is known commercially as Prozac, is approved for the treatment of eating disorders, specifically bulimia nervosa.

Physical Complications of BED

Most people who are obese do not have BED, but 2 out of 3 with BED are obese, which can cause serious problems, such as:

• Type 2 diabetes
• High blood pressure
• High blood cholesterol
• Gallbladder disease
• Heart disease
• Certain cancers
• Osteoarthritis
• Joint and muscle pain
• Gastrointestinal problems
• Depression
• Anxiety
• Sleep apnea
• PCOS (polycystic ovary syndrome)

Therefore, it’s important to prevent BED and intervene early in diagnosed cases of the illness.

Binge-eating disorder represents a public health problem at least equal to bulimia nervosa, but fewer than half of people with the illness seek treatment for it. [3] Getting help can even be more difficult for men, who may be embarrassed they’re dealing with a disorder society often deems a “woman’s one.”

Help is necessary, however, not only because of the physical effects of BED but also the emotional ones. People with BED have a significantly lower perceived quality of life and health compared to obese people without BED, and these negative feelings seem related to severe eating impulsiveness. [4]

As with most eating disorders, no one can specifically say what causes BED, but we do realize several factors collide in its development. These include: [5]

• Depression. As many as half of all people with binge eating disorder are depressed or have been depressed in the past.
• Dieting. Some people binge after skipping meals, not eating enough food each day, or avoiding certain kinds of food.
• Coping skills. Studies suggest that people with binge eating may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.
• Biology: Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Research also suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family.

Community Discussion – Share your thoughts here!

Have you or your loved one suffered with Binge Eating Disorder, what impact have the DSM5 changes made to treatment and recovery?

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About the Author: Leigh Bell holds a Bachelor of Arts in English with minors in Creative Writing and French from Loyola Marymount University in Los Angeles. She is a published author, journalist with 15 years of experience, and a recipient of the Rosalynn Carter Fellowship for Mental Health Journalism. Leigh is recovered from a near-fatal, decade-long battle with anorexia and the mother of three young, rambunctious children.

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References:

[1]: Binge Eating Disorder | National Eating Disorders Association. (n.d.). Retrieved January, 12, 2016.
[2]: Ross, C. (2012, October 2). Binge eating in men, Psychology Today. Retrieved January 12, 2016.
[3]: Kessler, R. C. et al. (2013). The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biological Psychiatry, 73(9), 904-914
[4]: Amianto F, Ottone L, Abbate Daga G, Fassino S. (2015). Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC Psychiatry, 15:1.
[5]: Binge eating disorder fact sheet | womenshealth.gov. (2012, July 16). Retrieved January 12, 2016.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on March 8, 2016
Published on EatingDisorderHope.com