BED research: What Do We Know?

Article Contributed By: Chelsea Fielder-Jenks, M.A., LPC-Intern | CFJCounseling.com

Since Binge Eating Disorder (BED) was first mentioned in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1987, research on BED has come a long way in a relatively short period of time. In fact, in 2013, BED was added to the latest, fifth edition, of the DSM as its own diagnosis.

This is thanks to, in large part, the growing amount of data that validates the disorder.

Thankfully, this body of research continues to grow along with the recognition of BED as a mental disorder. Here’s a recap of what we know so far:

Facts about BED

• The prevalence of BED is estimated to be approximately 1-5% of the general population.
• BED affects women slightly more often than men. Estimates indicate that about 60% of people struggling with binge eating disorder are female, 40% are male.
• Studies that have looked at ethnic differences in BED have not found any significant findings.
• People who struggle with BED can be of normal or heavier than average weight.
• BED is often associated with symptoms of depression. To a lesser degree, BED is associated with anxiety, substance-related disorders, and personality disorders.
• BED is associated with several health consequences, including: high blood pressure, high cholesterol levels, heart disease, diabetes mellitus, sleep apnea, gallbladder disease, and muscle and/or joint pain
• People who struggle with BED report a lower quality of life than those who do not struggle with BED.

What is BED?

• BED is characterized by repeated episodes of uncontrolled overeating, or eating more than the average person would eat in a short period of time.
• Binge eating often includes a feeling of lack of control over what is eaten, how much is eaten, or when and how to stop eating.
• Eating is often used to fill an emotional void or in an attempt to cover up or avoid feelings.
• People struggling with BED often express distress, shame, and guilt over their eating behaviors.
• There are also several behavioral indicators of BED including eating when not hungry, eating alone because of embarrassment over quantities consumed, eating until uncomfortably full.

What causes BED?

While the exact cause of BED is unknown, there are a variety of factors that are thought to influence the development of this disorder. These factors are:

• Biological: Twin and family studies estimate the heritability of BED symptoms at 41%-57%. Biological abnormalities, such as brain structure and hormonal irregularities or genetic mutations, which are linked to appetite and satiety, may be associated with compulsive eating and food addiction. Research has also found that binge-eating behaviors are more likely to occur in those individuals genetically predisposed to obesity.
• Psychological: A strong correlation has been established between depression and binge eating. Body dissatisfaction, low self-esteem, and difficulty coping with feelings can also contribute to BED. Many people with binge-eating disorder also have a history of dieting. Dieting may trigger an urge to binge eat, especially if you have low self-esteem and symptoms of depression.
• Social/Environmental: Traumatic experiences, such as a history of physical, sexual, or emotional abuse or emotional neglect, can increase the risk of binge eating. Social pressures to be thin, which are typically influenced through media, can trigger emotional eating. Persons subject to critical comments about their bodies or weight may be especially vulnerable to binge eating disorder. A family environment that is less supportive and cohesive, more controlling and conflict ridden, and less likely to express direct and open feeling may also contribute to BED.

BED Treatment

Due to the variety of factors that are involved in the cause of BED, it is important that they each be addressed when treating the disorder. This includes, but is not limited to, the following:
• • Biological: Medical and physical evaluation, laboratory blood/urine testing, nutrition/dietary counseling, medication management, treatment of coexisting medical conditions (diabetes, hypertension, hypo/hyperthyroidism)
  • Psychological: Psychotherapy, behavioral therapy, psychiatric assessment, understanding negative emotions, building adaptive coping skills
  • Social/Environmental: Identifying environmental triggers, family counseling, addressing stressful life events
• The major goals for treating BED are to reduce binge-eating episodes, improve emotional well-being and then, if necessary, weight-loss.
• Psychotherapy, medications, and behavioral weight-loss treatments are the most common treatments for BED.
• A multidisciplinary team including but not limited to a psychologist, psychiatrist, individual therapist, social worker, nutritionist, and/or primary care physician provides treatment.
• Care should be coordinated and provided by a health professional with expertise and experience in dealing with eating disorders.
• Treatment of BED is delivered in hospitals, residential treatment facilities, and private office settings.
• Levels of care consist of acute short-term inpatient care, partial inpatient care, intensive outpatient care (by day or evening), and outpatient care.

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