Binge eating disorder

BES, eating disorder

Experts speak of binge eating disorder (BED) when people repeatedly eat unusually large amounts of food in an uncontrolled manner. This usually leads to a cycle of eating, shame and anger because of the binge eating, which is sometimes compensated for by eating again. A binge eating disorder usually leads to overweight or obesity. However, there are also people of normal weight who suffer from binge eating disorder.

What is a binge eating disorder?

Everyone sometimes eats more than is good for them. The situation is completely different in the case of binge eating disorder. Those affected eat large quantities of food in a very short time. Most of the time they are also alone. While eating, they have the feeling that they cannot stop (loss of control experience). Afterwards, those affected often feel ashamed of their behavior. Because their stomach is completely full, they also feel unwell. In contrast to bulimia, however, those affected by binge eating disorder do not try to expel the contents of their stomach by vomiting, taking purgatives or balancing out their weight through excessive exercise. However, a binge eating disorder can develop into bulimia. The term binge eating disorder comes from the English words “binge” (binge, excess) and “eating” (food). Sometimes phases without symptoms alternate with phases of frequent binge eating.

According to the International Classification (ICD 11, DSM V), several factors must come together for us to diagnose a binge eating disorder: The binge eating episodes happen at least once a week over a period of three months. Those affected suffer from these seizures, but do not try to “undo” this through compensatory measures. In addition, binge eating must be accompanied by at least three of these symptoms:

  • Those affected eat much faster than normal.
  • They eat alone so that other people don’t wonder about the large amount of food.
  • They consume very large amounts of food, even if they do not feel hungry.
  • Those affected then suffer from an unpleasant feeling of fullness.
  • After eating, those affected are depressed or feel disgusted by the excessive amount of food they have eaten.

Frequency and age

Binge eating disorder often develops in young adulthood. However, it can also occur later in life. Overall, around two percent of all people develop the disease in the course of their lives. Among people between the ages of 20 and 30, up to four percent are affected, women slightly more often than men. Obese people suffer more frequently than average from binge eating disorder – between 15 and 30 percent of them have this condition.

Binge eating disorder: causes and risk factors

It is always a combination of different factors that lead to a binge eating disorder. Often, but not in all cases, those affected try to lose weight with a diet beforehand. The avoidance of certain foods then leads to a ravenous appetite. The following factors can also play a role in triggering an eating disorder:

  • low self-esteem: those affected are dissatisfied with their lives and themselves, want to please others, feel overwhelmed by school or working life or have problems with the transition to adult life.
  • Dissatisfaction with your own body: Perfect-looking people are often shown in (social) media – often enough artificially embellished. This can lead to people being dissatisfied with their normal body. Disparaging comments from other people can exacerbate the problem.
  • Stress: If you feel very tense, frustrated or sad (after a loss, for example), you may be prone to binge eating.

Many people with a binge eating disorder try to obtain pleasant feelings by eating. At first, the food usually creates positive sensations. But then those affected can no longer stop and continue to eat, even when their hunger has long since been satisfied.

In many cases, binge eating disorder also occurs together with other mental illnesses:

It is then usually unclear whether the eating disorder was present first or whether it is a consequence of the other mental illness. Both diseases are then treated in one therapy.

Binge eating disorder is difficult to recognize – prognosis

For outsiders, a binge eating disorder is often barely recognizable because those affected usually eat alone in secret. Between binges, they often hold back on eating.

Although therapy requires perseverance, it can lead to a significantly improved quality of life in the long term. The earlier the eating disorder is treated, the better the chances of recovery. Without treatment, the symptoms threaten to become chronic, and other mental illnesses can also develop.

Binge eating disorder: clarification in our consultation hours

During the assessment interview, we will ask you how such eating attacks usually occur and how often they happen. Your feelings will play a major role in this:

  • What do you feel before, during and after such an eating binge?
  • Do you often think about food?
  • What eating habits do you know from your family?
  • Are you happy with your body?
  • Are you happy with your weight?
  • Are you under stress?
  • Do you play sport?

We will also want to know if you take laxatives or vomit after meals.

If necessary, we will carry out a physical examination in the endocrinology department to check that there are no physical causes for the binge eating. It is also examined whether the overeating has caused any consequential damage, for example to the cardiovascular system or blood sugar levels(diabetes mellitus).

To the consultation

Self-help groups

The exchange with people who are affected by the same disease can be a great support in coping with the disease. Advice on finding a suitable self-help group is available from Selbsthilfe Zürich. Self-Help Zurich and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.

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