When you think about an eating disorder, you might think about restricting food, like in anorexia, or purging food, like in bulimia. But the most common eating disorder has nothing to do with either of those. It’s called binge eating. These days when we hear the word ‘binge,’ we mostly think of watching like 6 episodes of the Netflix show in one day. And If you’re less TV-inclined, maybe you think of binging on food. Say, on Thanksgiving. But what if you found yourself overeating like that multiple times a week? What if it felt like a cycle and it got really difficult to control?
This is what it’s like for people with a certain type of eating disorder. Even though it’s easily the most common eating disorder, chances are you’ve never heard of it. Binge Eating Disorder, or B.E.D., has as a primary symptom of frequent, seemingly uncontrollable food binges that create feelings of distress or guilt. If you’re thinking, “Yeah, I’ve gotten that extra-large pizza all for myself before, and I felt pretty terrible after,” you’re thinking more of over-indulgence than binging. Those with B.E.D. often eat even when they’re not hungry — even when continuing to eat is upsetting.
During a binge, they’ll eat a lot of food, super-fast, until it’s physically uncomfortable to eat any more. Binges are often planned in advance, with ‘special’ food purchases. Sufferers often try to hide their atypical eating by eating alone or hiding food they’ve purchased specifically for binging. But while the binges may be planned, when people are actually in the middle of a binging episode, it’s not uncommon for them to just zone out, then struggle to stop or even remember everything they’ve consumed. And even though it’s less likely to be on your radar than anorexia and bulimia, studies have shown that B.E.D. is over three times more common than anorexia and bulimia combined.
In one study, researchers asked nearly ten thousand Americans about their experiences with various mental health conditions. And they found that 3.5% of women and 2% of men had B.E.D. at some point in their lives. That’s a pretty massive number, and it doesn’t just make binge eating the most common eating disorder. It makes it more common than breast cancer, HIV, and schizophrenia. So, it’s something worth paying attention to. It was only officially recognized as a stand-alone eating disorder in 2013, so at this point, we don’t know everything about what causes B.E.D. But research seems to show that it has some genetic basis.
As one’s DNA doesn’t determine everything about mental health, genetics isn’t the only factor here. Stress may play a role, too. Some evidence for this comes from a study published in the journal Psychiatry Research. It compared 162 black and white American women with B.E.D. to the same number of women without it who matched their demographics. After interviewing these women, the study found that, across the board, those with B. E. D. had a lot more stressful events in the year before their symptoms began.
These triggering events could be anything from a passing comment about their body shape or weight, to work or school stress, abusive relationships, or major life changes. Outside of this study, research has also found that other psychological factors can contribute to binge eating too, such as anxiety, low self-esteem, obsessiveness, and perfectionism. But people can also be born with differences in their brains that make them more likely to develop B.E.D
For example, a systematic review analyzed 51 articles on binge eating and found that when compared to obese people without B.E.D., people with the disorder had stronger responses to food rewards, meaning food likely had more influence over them. They were also more impulsive, and many of the studies showed evidence that those with the disorder were more likely to act spontaneously, or even recklessly, in their day-to-day lives.
Brain imaging studies have also backed up these findings. For example, another study used brain scans to show that people with B.E.D. had less activity in the part of the brain that handles inhibitions. But really, that’s just one piece of the puzzle. There appear to be other things happening in the brains of those with binge eating disorder, and honestly, scientists haven’t quite gotten to the bottom of it yet. That doesn’t mean they don’t know how to treat this condition, though.
People seeking treatment are often prescribed a course of cognitive behavioral therapy, or CBT. This type of therapy aims to make people aware of how their behaviors are connected to harmful beliefs. And that awareness can help minimize behaviors like binge-eating. This approach is often effective, but those who need a little extra may be offered antidepressants to alleviate symptoms related to binge eating, like depression and anxiety — which can make therapy more effective. Like many other psychological conditions, B.E.D. is complex and there’s no silver bullet to treat it. But the more we learn about it, the faster we can get working on finding new and improved ways to recover.