Binge Eating Disorder: Signs, Impact on Mental Health, & Binge Eating Treatment Options

Binge eating disorder (BED) is the most common eating disorder in the United States. In fact, approximately 2.8 million Americans struggle with BED, which includes 3.5% of women, 2% of men, and 1.6% of adolescents.¹

Many people with BED also live with depression, anxiety, post-traumatic stress disorder (PTSD), or other psychiatric conditions that fuel the binge-distress cycle. Therefore, recognizing the signs of binge eating disorder could mean that many people can receive the treatment they need before mental health symptoms worsen.

If binge eating disorder or a co-occurring mental health condition is affecting your well-being, mental health support could help you regain control over your life. This page can also work as a useful guide to understanding BED, as it covers:

What binge eating disorder is
How BED differs from overeating
The signs and symptoms of BED
BED underlying causes and risk factors
The most effective treatment options available

What Is Binge Eating Disorder?

Binge eating disorder is a recognized mental-health diagnosis. In general, people with BED have recurrent episodes of eating large amounts of food in a short period. They also feel they can’t control their eating patterns while they’re happening.

To be more specific, a binge episode means that within a short window of up to two hours, a person eats an amount of food larger than most people would eat under similar circumstances.²

These episodes typically cause distress and get in the way of life. However, they are not followed by regular “purging” compensatory behaviors, like vomiting, using laxatives, fasting, or doing excessive exercise.

The severity of BED is measured by the number of binge episodes:³

Mild BED: 1-3 episodes per week
Moderate BED: 4-7 episodes per week
Severe BED: 8-13 episodes per week
Extreme BED: 14+ episodes per week

Many people struggle to understand the difference between binge eating disorder vs. overeating, which is why we cover what makes them distinct from each other in the following section.

Binge Eating Disorder vs. Overeating

Overeating is something nearly all of us do from time to time. For example, holidays, buffets, or nights out may cause you to knowingly eat more than needed. Yet, while you may feel stuffed or regretful afterward, you were still in control of your eating.

In contrast, BED is a psychiatric diagnosis defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The core difference between the two is the loss of control (LOC) during eating that’s seen in BED. With a loss of control, people typically feel unable to regulate how much they’re eating once a binge begins, regardless of hunger or fullness cues.

Yes, occasional overeating can contribute to gradual weight gain if habitual. But, in contrast, BED is strongly associated with obesity, type 2 diabetes, cardiovascular disease, and psychiatric comorbidities such as depression and anxiety.⁴Being able to recognize the symptoms of binge eating disorder can help you better understand if this is something you should seek support for.

Signs and Symptoms of Binge Eating Disorder

BED can leave its traces on both the body and the mind.

The physical signs of BED often stem from repeated episodes of overeating and the body’s response to them. These include:⁵

Fluctuating weight
Frequent bloating, stomach cramps, acid reflux, or constipation
Lack of satiety cues
Fatigue and sluggishness

Emotional and psychological signs reflect the core driving forces of the disorder, and include:

Feeling unable to stop eating during a binge when already full
Eating alone or hiding food to avoid others noticing
Intense guilt, shame, and disgust after binge episodes
Avoiding social events that involve food
Withdrawing from relationships
Mood swings and depression

Causes and Risk Factors of Binge Eating Disorder

The causes of binge eating disorder can be complex and vary from person to person. However, the most recognized contributing factors include genetics, pre-existing mental health conditions, dieting habits, and childhood adversity.

Twin and family studies suggest that BED is moderately heritable, with estimates that around 41-57% of the risk of developing it is tied to inherited traits.⁶ Specifically, genes involved in dopamine regulation, our brain’s reward system, are suspected to be the main cause of the disorder since binge eating provides short-term pleasure that reinforces the cycle.

High rates of depression, anxiety, and low self-esteem are found in people with BED, with research showing that these conditions often predate the onset of binge eating. When conditions such as these are present, people may use food as a way to numb, distract, or cope with negative emotions.⁷

Repeated cycles of strict dieting and restriction can also increase vulnerability to binges. When the body feels deprived, the brain ramps up food cravings, making loss of control more likely. Studies confirm that restrained eaters are at greater risk of binge episodes, which suggests that the “I’ll just cut out carbs forever” approach could backfire in quite dramatic ways.⁸

Finally, many people with BED report childhood adversity, such as bullying about weight, neglect, or abuse. Add the sociocultural pressure to be thin (which can lead to body dissatisfaction) to this adversity, and you may have a fertile ground for disordered eating to develop.

Impact of Binge Eating Disorder on Mental Health

Uncontrolled binge eating can take a toll on both physical and mental health. This is because it has a strong impact on the way people think, feel, and interact with others. In fact, quality-of-life studies find that people with BED report lower physical and mental health functioning in comparison to the general population.¹²

We explore these impacts in the following sections.

Emotional and Psychological Impact of BED

Clinical studies show strong, consistent comorbidity between BED and mood and anxiety disorders.⁹

After a binge, people frequently report intense disgust about their behaviour and body. This emotional fallout can reduce help-seeking (as people may hide binges) and worsen isolation. This is often why there’s a higher risk of suicide ideation and attempts among eating-disorder populations.¹⁰

Cognitive Impact of BED

Studies report poorer performance in attention, inhibitory control, decision-making, and other executive functions in many people with BED compared with the general population.¹¹

This effect may come down to how BED typically causes hyper-responsivity in reward circuits of the brain to food cues. It can also reduce activity in prefrontal regions involved in impulse control, especially when people are exposed to highly palatable foods. Due to these reasons, patients commonly report brain fog, poor concentration, and memory difficulties during periods of frequent bingeing.

Social Impact of BED

Because binges are often performed in secret and are followed by shame, people may withdraw from meals with friends and avoid any social event that involves food. They may also lie to loved ones about eating habits.

This avoidance may damage friendships and romantic relationships and reduce social support, which removes one of the best buffers against relapse.

Also, people with BED may frequently experience both weight stigma and moral stigma (being judged as “lazy” or lacking self-control). This stigma can create barriers to accurate diagnosis and treatment, potentially worsening outcomes.

Binge Eating Disorder and Physical Health Risks

Due to the nature of the disorder, around two-thirds of people with BED are either overweight or obese.¹³ Binge episodes involve large amounts of high-calorie, ultra-processed foods consumed in short periods. Such an eating pattern can disrupt normal metabolism and contribute to a cluster of medical problems commonly seen in metabolic syndrome, including:

Type 2 diabetes
High blood pressure
Abnormal cholesterol levels

Frequent binge episodes also stress the cardiovascular system as they may lower good cholesterol and worsen hypertension. Plus, regular binges can also trigger acid reflux (GERD), stomach distension, constipation, or irritable bowel-like symptoms.

BED is also strongly linked to sleep apnea, particularly in people with obesity. Poor sleep then often worsens hunger hormones and makes cravings stronger the next day, becoming a vicious cycle.

Further, women with BED are at higher risk of polycystic ovary syndrome (PCOS), which can further destabilize metabolism and menstrual cycles. Men may also experience testosterone-related issues, including reduced fertility and sexual dysfunction.¹⁴

Finally, carrying excess weight gained through binge cycles strains joints, leading to higher rates of osteoarthritis, back pain, and mobility problems. Add in poor nutrition quality during binges, and bone health may also suffer over time.

How Is Binge Eating Disorder Diagnosed?

If you think you might have BED, it’s a good idea to go to your primary care provider or a mental health specialist for what’s called a “clinical interview.” This is a structured conversation in which a clinician asks you questions about your eating habits.

Your healthcare provider may also order blood tests to check blood sugar, cholesterol, and thyroid function. Sometimes a physical exam is included to see if there are related health issues, like high blood pressure or weight-related complications.

You may be diagnosed with BED if you meet the following criteria:

Recurrent binge eating episodes with loss of control
Binge episodes include at least three of the following: eating quickly, eating until uncomfortably full, eating when not hungry, eating alone due to shame, or feeling guilty or disgusted after
Marked distress about binge eating
Bingeing occurs at least once a week for three months
Eating is not associated with regular compensatory behaviors (for example, purging or excessive exercise)

Binge Eating Treatment Options

Treating binge eating disorder typically requires a holistic approach. Therefore, most treatment plans combine therapy to address thought patterns and emotions, nutritional counseling to rebuild a healthy relationship with food, and, when needed, medication to manage symptoms.

The following sections cover some of the most evidence-based approaches for managing BED.

Psychotherapy

The first-line treatment for BED is psychotherapy, specifically cognitive behavioral therapy (CBT).¹⁵ CBT helps you recognize the triggers that fuel binge eating and teaches healthier coping strategies. It is the most effective therapy for reducing binge episodes.

Interpersonal therapy (IPT) is another promising therapy that focuses on improving relationships and addressing interpersonal conflicts that drive binge eating.

There’s also dialectical behavior therapy (DBT), which was originally researched for borderline personality disorder but has now been adapted for BED.¹⁶ DBT helps with emotional regulation, so it works best for people who binge in response to stress or negative emotions.

Medication

Medication isn’t always necessary for BED, but it is helpful when psychotherapy alone doesn’t fully control binge episodes.

Lisdexamfetamine dimesylate (Vyvanse) is the first FDA-approved drug for BED.¹⁷ It can reduce the number of binge days per week by affecting dopamine and norepinephrine levels in the brain.

Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline have also been studied for treating BED. While originally used for depression, they may help reduce binge frequency and improve mood in BED.¹⁸

Topiramate, an anticonvulsant, has also shown promise in reducing binge episodes and promoting weight loss, but its use is limited due to side effects.

Nutrition

Nutritional counseling typically plays a central role in recovery from BED. A registered dietitian can help you establish structured eating patterns with three balanced meals and snacks at regular times.

Nutritional therapy may also help break the cycle of restrictive dieting followed by bingeing. Dietitians use approaches like intuitive eating and meal planning to rebuild a healthier relationship with food.

In addition, the diet will likely be adjusted to address health issues like high blood pressure, high cholesterol, or diabetes, which are common in BED.

Care for Binge Eating at Mission Connection

At Mission Connection, we recognize that binge eating disorder is often intertwined with other mental health challenges like depression, anxiety, stress, and past trauma. While we don’t directly treat eating disorders, our licensed therapists can focus on targeting the co-occurring mental health issues that usually drive the cycle of binge eating.

You’ll receive a thorough evaluation that assesses the extent of your disorder, followed by a tailored treatment plan that addresses your unique needs. We also offer flexible treatment settings, from inpatient programs to outpatient services and secure online therapy for those who need support that fits into daily life.

If binge eating is taking a toll on your life, reach out to us today. Our team can help you regain control of your life and move forward with confidence.

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