”It Was About a 12-Pound Turkey”

Understanding Binge Eating Disorder (BED), the most common eating disorder.

Posted Sep 07, 2015

Gene Han/Flickr (Creative Common)
Source: Gene Han/Flickr (Creative Common)

It was about a 12-pound Turkey.” The words rung in my ears as I listened to her story.

My last binge was two days ago. I was making dinner for my family. I pulled the turkey out of the oven and tasted it to see whether it was cooked. As soon as I put the first bite in my mouth, I knew I was in trouble. I kept eating and eating and eating. I just couldn't stop. Before I knew it I had eaten the entire turkey—in less than half of an hour. I quickly cleaned up the kitchen and threw a pizza in the oven before my family got home because I was so embarrassed. I didn't want anyone to know. It was just too humiliating. And I felt so gross.”

I will never forget my first conversation with a person struggling with Binge Eating Disorder. The pain, anxiety, and shame in this woman’s voice as she described her eating behavior was palpable. Like most people with eating disorders, I was one of the only people she had ever told about her eating behavior and body image.

The truth is that Binge Eating Disorder (commonly referred to as BED) is a highly misunderstood and underdiagnosed disorder. This is, in part, because BED was not a diagnosable eating disorder until 2013, with the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). It is also because BED is often confused with general overeating and obesity, which is highly stigmatized in medical arenas that might otherwise provide help ().

Yet, research suggests that BED is more common than anorexia or bulimia nervosa combined (Hudson et al., 2007). In a nationally representative sample of almost 3,000 English-speaking adults, Hudson and colleagues (2007) found that 2% of men and 3.5% of women met criteria for BED during their lifetime. This is much higher than the lifetime prevalence estimates for anorexia nervosa (affecting .5-1% of the population) and bulimia nervosa (affecting about 1.5% of the population).

In addition, BED is associated with a great deal of guilt, shame, distress, and embarrassment, which can dramatically influence a person’s quality of life (). Consequently, it is critical for the public and medical professionals to more accurately identify and talk about BED.

Here are three things you need to know about BED:

1. What is Binge Eating Disorder?
The most obvious defining characteristic of BED is frequent binge eating behavior. Specifically, binge eating is defined as eating unusually large amounts of food in a short amount of time (e.g., within a 2 hour period) while feeling unable to stop eating. In addition, during binge eating episodes, people often eat much more rapidly than normal; eat until they feel uncomfortably full; eat when they are not physically hungry; eat alone because of embarrassment; and feel disgusted, depressed, or very guilty after eating. This binge eating behavior is highly distressing and occurs, on average, at least once a week during a three-month period.

2. Are all people with BED overweight or obese?
Unlike some other eating disorders (e.g., anorexia nervosa, bulimia nervosa), individuals with BED do not engage in behavior to prevent weight gain following binges. For example, individuals do not vomit, use diuretics, engage in excessive exercise, or fast after binge eating. As a result, about half of people with BED are obese (body mass index greater than 30) and another 35% are overweight (body mass index between 25-30). Only about 20% of individuals with BED are of average weight (Hudson et al., 2007). Consequently, although not all individuals with BED are overweight, all are at risk for becoming overweight due to the large amount of calories consumed during binges.

3. Are there effective treatments for people with BED?
There are highly effective treatments for BED. Various psychotherapies, including interpersonal therapy and cognitive behavioral therapy, show positive outcomes in clinical research trials (see Wilfley et al., 2002; Grilo, Masheb, & Crosby, 2012). In addition, the first medication to treat BED was recently approved by the FDA called Vyvanse

The Naked Truth is this: Many people with BED are never adequately assessed or diagnosed. As accurate information about BED is better understood among health care professionals and the public, more people struggling in silence with eating and body image issues will have access to care. Please spread the word.

Eating Disorder Resources
There are many excellent resources for people with eating disorders, practitioners, and loved ones alike. These include the American Psychiatric Association (http://www.psychiatry.org/eating-disorders); the National Eating Disorders Association (http://www.nationaleatingdisorders.org); the Binge Eating Disorder Association (http://bedaonline.com); and the Alliance for Eating Disorder Awareness (www.allianceforeatingdisorders.com).

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Copyright Cortney S. Warren, Ph.D.