Are Binge Eating Disorder and Obesity Related?

Binge eating disorder (BED) is a serious mental health condition, but it manifests in a number of physical ways, with binge eating behavior having a number of common effects on the body.

Binge eating disorder can occur in people with all body weights, shapes, and sizes, though there’s a strong misconception that the disorder is connected to “obesity.” In fact, “obesity” is not a reliable medical term nor an indicator of overall health, making this association problematic and potentially dangerous.

Still, BED may lead to weight gain over time and certain associated health risks if not properly treated. So while it’s important to understand the causes and effects of binge eating disorder, it’s equally important to understand why “obesity” should not be considered one of them.

What is Binge Eating Disorder?

Binge eating disorder is a mental health condition involving recurrent binge eating episodes, where an excessive amount of food is consumed within a relatively short period of time. These episodes are marked by a sense of a loss of control over how much or what is eaten. [1]

According to the Diagnostic and Statistical Manual for Mental Disorders (DSM), the official record of all recognized mental health conditions, binge eating episodes are also characterized by at least three of the following traits: [1]

Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone, due to embarrassment over eating habits
Feeling disgusted or guilty after periods of overeating

In order to be officially considered part of BED, binge eating frequency must occur at least one day a week, for at least three months. [1] But in any case, these eating behaviors commonly feel distressing or disruptive to someone’s daily life. [5]

BED can affect individuals of all ages, including children, adolescents, and adults. [2][3] Still, research suggests that the average onset of binge eating is typically sometime during adolescence, with the highest prevalence occurring around age 16-17. [4]

Common Causes of Binge Eating Disorder

While the causes of BED are not well understood, research has identified some common factors that may increase a person’s risk of developing the disorder.

It’s important to note that while these factors may increase a person’s risk of developing BED, not everyone who experiences them will develop the disorder.

Brain Changes

Studies indicate that individuals with BED may experience structural and functional changes in their brain, leading to an intensified response to food and diminished self-control.

In particular, research suggests that brain parts associated with reward processing and impulse control may be altered in people with binge eating disorder. [8]

Genetics

People with BED may have an inherited sensitivity to dopamine, a brain chemical responsible for feelings of reward and pleasure. Studies have also found strong evidence that the disorder is heritable, meaning it can be passed down in families. [9][10]

Co-Occurring Disorders

Binge eating disorder is often associated with other mental health disorders, including: [6]

Depression
Anxiety disorders
Bipolar disorder
Substance use disorder

Other potential risk factors include a history of dieting or calorie restriction, especially if simultaneously struggling with depression.

What is Obesity?

“Obesity” is a term commonly used to describe people in larger bodies, and it’s often associated, directly or not, with health problems like diabetes, heart disease, stroke, and more. But when it’s understood in that way, the idea of “obesity” is also misleading, stigmatizing, and potentially harmful.

In reality, “obesity” is just a term. It has nothing to do with health and should be decoupled from the concept. People can be healthy at any size, and finding health at every size is entirely possible.

Obesity and the Body Mass Index

The idea of “obesity” as a medical term started gaining traction when the word was used in conjunction with the body mass index (BMI), a common tool used in the medical world that is also being increasingly scrutinized.

Broadly, someone’s BMI is a ratio of their height to weight. The number is compared to a chart (index) of “average” ratios to determine where someone lies along the overall spectrum, with results being designated by one of several categories, including: [7]

Obese: BMI of 30 or higher
Overweight: BMI of 25-29.9
Healthy/normal: BMI of 18.5-24.9
Underweight: BMI of 18.5 or lower

While still commonly used—and a highly-considered factor in everything from health insurance rates to personal health recommendations—the BMI is not a good indicator of someone’s health. Among the problems involved with relying on the number, the BMI does not represent an accurate measure of someone’s body weight composition or distribution, making it a poor indicator of metabolic health, which often plays a much larger role in someone’s overall health. [6]

Unfortunately, even as the BMI is seeing more resistance to its use as a diagnostic tool, the ideas it’s created around “obesity” remain deeply embedded in both popular culture and the medical field. For example, someone with a BMI categorized as “obese” may be advised to lose a certain amount of weight, even if they show no signs of medical concerns.

These ideas can have very real and negative impacts on someone’s mental, physical, and emotional health, which are generally more problematic than any health concerns caused by body weight alone.

The Connection Between Binge Eating and Obesity

Since “obesity” is not a true medical condition, binge eating disorder is not necessarily connected to “obesity.” However, aspects of BED may put people at risk of gaining weight in a way that is not good for their overall health.

Studies have shown that binge eating episodes are often triggered by, or involve, the consumption of so-called “hyper-palatable food”—generally, food that is rich in sugar, salt, and fat. [13] And eating these macronutrients in unbalanced proportions can potentially lead to health issues and concerns.

Individuals in larger bodies also tend to experience a lower quality of life in terms of their social and interpersonal relationships and mental health. [12] Unfortunately, this seems to be the case whether or not the individual is in good physical health.

This can, in turn, potentially exacerbate the symptoms of BED. Stress and low self-esteem are two major drivers of binge eating behaviors. The fear of being judged or criticized can also lead to feelings of isolation and depression, further fueling the cycle of binge eating and potential subsequent weight gain.

Obesity and the Health at Every Size Movement

Feeling good and being healthy have nothing to do with physical weight. The Health at Every Size (HAES) movement is helping to promote this truth.

The concept stands apart from the idea that weight loss is always a practical and positive goal that will prolong life, and “obesity” is always a problem and a health risk. Instead, it asks individuals to embrace ideas like body acceptance, intuitive eating, and joyful—or, at least, neutral—movement. [11]

The idea is to stop framing health in terms of weight, which can make someone in a larger body susceptible to feeling ostracized or at risk of feeling like a “failure” if they don’t reach certain body weight goals. Instead, HAES takes a bigger picture approach, giving equal measure to physical, mental, and emotional health and understanding how all three work together to elevate someone’s overall health, regardless of their body weight, shape, or size.

Long-term, HAES also hopes to work against certain biases, including in the medical world, where “obesity” is still considered a valid measure of someone’s health, or at least used as a diagnostic tool for recommending treatments, regardless of someone’s actual physical health. As the philosophy spreads, it can hopefully help do away with misleading questions like “how are binge eating disorder and obesity related?”

Finding Help for Disordered Eating

If you are struggling with disordered eating, it’s important to know that help is available. Many resources, including therapy, support groups, and online resources, can assist you on your recovery journey.

Consulting with a healthcare professional who specializes in eating disorders is often the best way to find help. They can diagnose you and develop a personalized treatment plan to address your specific needs.

There are also many online resources available to those struggling with disordered eating. Websites such as Within Health offer a wealth of information, including articles, forums, and online support groups.

These resources can be particularly helpful for those who cannot access in-person treatment due to cost or location. Remember that recovery is possible, and seeking help is the first step to a healthier, happier life.

Resources

Berkman MD, Brownley KA, Peat CM. (2015). DSM-IV and DSM-5 diagnostic criteria for binge-eating disorder. National Library of Medicine. Accessed September 2023.
Brownley KA, Berkman ND, Peat CM, Lohr KN, Cullen KE, Bann CM, & Bulik CM. (2016). Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis. Annals of Internal Medicine; 165(6):409–420.
Bohon C. (2019). Binge Eating Disorder in Children and Adolescents. Child and Adolescent Psychiatric Clinics of North America; 28<(4):549–555.
Marzilli E, Cerniglia L, & Cimino S. (2018). A narrative review of binge eating disorder in adolescence: prevalence, impact, and psychological treatment strategies. Adolescent Health, Medicine and Therapeutics; 9:17–30.
Iqbal A, & Rehman A. (2022). Binge Eating Disorder. StatPearls Publishing. Accessed September 2023.
Shmerling R. (2023, May 5). How useful is the body mass index (BMI)? Harvard Health Publishing. Accessed September 2023.
Assessing Your Weight. Centers for Disease Control. Accessed September 2023.
Bakalar JL, Shank LM, Vannucci A, Radin RM, & Tanofsky-Kraff M. (2015). Recent Advances in Developmental and Risk Factor Research on Eating Disorders. Current Psychiatry Reports; 17(6):42.
Davis C. (2015). The epidemiology and genetics of binge eating disorder (BED). CNS spectrums; 20(6):522–529.
ulik CM, Sullivan PF, & Kendler KS. (2003). Genetic and environmental contributions to obesity and binge eating. (3):293–298.
Penney TL, Kirk SF. (2015). The Health at Every Size paradigm and obesity: missing empirical evidence may help push the reframing obesity debate forward. American Journal of Public Health; 105(5):e38–e42.
Perez M, Warren CS. (2012). The Relationship Between Quality of Life, Binge-Eating Disorder, and Obesity Status in an Ethnically Diverse Sample. Obesity: A Research Journal; 20(4):879-885.
Bjorlie K, Forbush KT, Chapa DAN, Richson BN, Johnson SN, & Fazzino TL. (2022). Hyper-palatable food consumption during binge-eating episodes: A comparison of intake during binge eating and restricting. The International Journal of Eating Disorders; 55(5):688–696.

We at EatingDisorderHope.com 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.Published March 25, 2024 on EatingDisorderHope.com