Binge eating disorder: cause, symptoms, diagnosis, and treatment.

Year after year, people suffering from eating disorders are increasing. Sadly, according to the data, 9% of the world population already has no clue how to get rid of unhealthy, overeating disorders [1].

Moreover, these eating disorders are not just a situation where people tend to overeat and feel discomfort, but binge eating disorders have their place among the deadliest mental illnesses. This is a matter of concern, and on a serious note, we need to examine ourselves for any signs and symptoms of an eating disorder to rectify at the initial stage and treat it.

This article will provide the available information related to the binge eating disorder signs and symptoms, cause, and treatment, thus may guide to rectifying and treating the disorder with small lifestyle changes with or without medications.

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What is a binge eating disorder (BED)?

Binge eating disorder is a condition in which people frequently consume unnecessarily large amounts of food, which significantly affects a person’s emotional and physical health. Nevertheless, BED is different for obese since, as compared to obese without BED, they consume more calories, reported more significant functional impairment, poor quality of life, and a higher level of psychiatric comorbidity in the studies conducted by Wilson 2011. Some studies suggest it has a neurological and psychopathic basis, which increases impulsivity, compulsivity, decreased reward sensitivity, and attentional biases toward food [3, 12].

Symptoms of binge eating disorder

The direct relation between binge eating and obesity is reflected among the population, as most binge eaters are obese or overweight. But it’s not necessary that if you are skinny, you can’t suffer from BED. All those having the following emotional and behavioral symptoms should be alert.

• Eat unnecessarily any time large amount of food.
• Unable to control eating behavior, i.e., stop yourself from eating.
• Eating rapidly and eating until uncomfortable.
• Developing behavior of eating alone or in secret again and again
• Feeling depressed, ashamed, guilty, or unhappy about your eating.
• Frequently dieting, possibly without weight loss.

How to Diagnose Binge eating disorder?

There is a vast difference between overeating and binge eating disorders. Mainly, binge eating disorder falls under mental health conditions; thus, for diagnosis, one should use the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM) [4].

The following criteria for diagnosis of binge eating disorder can be used:

• Binge eating disorders can be characterized by two different categories.

1. Eating an ample amount of food that most people generally eat within 2 hours, i.e., in a discrete period.
2. A sense of lack of control during binge eating, i.e., whatsoever the person can’t stop eating or control the portion of food eaten [5].

• If you suspect or fall in the above categories, you can self-assess by asking the following question. If the answer to most questions is ‘YES,’ then it’s an alarming sign and high time to consult the physician.

1. Do you feel out of control when you’re eating?
2. Do you think about food all the time?
3. Do you eat in secret?
4. Do you eat until you feel sick?
5. Do you eat to escape worries, relieve stress, or comfort yourself?
6. Do you feel disgusted or ashamed after eating?
7. Do you feel powerless to stop binge eating, even though you want to?

The above information is adapted from http://www.helpguide.org/mental/binge_eating_ disorder.htm.

Cause of Binge eating

The root cause of binge eating is still not understood; however, it is suspected that the cause could be one or a combination of the following factors:

Extreme concern about body size and image:

Its always observed that obesity and a condition where the individual is unable to stop binge eating have a direct positive connection. Petribu et al. 2006 investigation revealed that obese individual with Binge eating disorder (BED) was more prone to depression than obese without BED [6]. Another reason for binge eating is that people have a negative perspective on their body image; therefore, to attain perfect shape, they fall for a crash diet, unhealthy eating methods, and continuous fasting weeks.

Genetics:

Research has shown that genes related to dopamine, serotonin, and brain-derived neurotrophic factors (BDNF) significantly affect compulsive eating disorders or binge eating. For instance, Dopaminergic neural pathways are related to non-homeostatic feeding behavior and food reinforcement. Although findings do not support the relationship, however, compared to others, obese adults with Binge eating disorder were more likely to have dopamine receptor gene DRD2 polymorphism [8, 9].

Emotional eater:

There are pieces of evidence that negative emotions motivate people to eat; therefore, to overcome the emotional imbalance, individuals start eating in an uncontrolled manner, termed as emotional eating, which helps them reduce negative emotions. The episode starts with occasional snacking or consuming a small amount of food to gradually reach the point of binge eating a large amount of food [10]. Nonetheless, problems don’t only arise because of uncontrolled eating but also because the eating patterns in the patients get disrupted [10].

Other psychological problems:

Its commonly noticed that most of the people with symptoms of food binge have some or other psychological disorder, like phobias, depression, post-traumatic stress disorder, anxiety, etc. [11]

Binge eating disorders treatments

Around 2% of people in the world develop an abnormal way of eating wherein they eat more than they are supposed to, more rapidly than they want to, etc., followed by hours of being uncomfortably full. Although it does not look so serious in the beginning, it does lead to serious problems in the long run. Thus, treatment to stop binge eating in the initial stages, whether through self-control and willpower with or without medication or solely by binge eating medication with the help of a practitioner, is advisable.

Psychological Treatment

Self-help treatments:

Under randomized clinical trials (RCTs), self-help treatments like bibliotherapy (use of certain reading materials as therapeutic adjuvants), Cognitive Behavior Therapy-guided Self-help were concluded to be positive [12]. Cognitive behavioral therapy may help to overcome the stimulus of binge eating by leading to a better sense of control over your eating behavior.

weight loss therapy

weight loss therapy may work with patients having low self-esteem, negative body image, and obesity. The diet plans and exercise gradually mold binge-eating people towards healthy lifestyle changes with healthy weight loss of approximately 0.5 kg per week [14].

Interpersonal psychotherapy

Interpersonal psychotherapy (IPT) helps by identifying the specific problem causing binge eating, acknowledging it, and making constructive changes over 12-16 weeks to overcome the emotional trauma hence the binge eating disorder [15].

This therapy session can be organized along with a group or one-to-one in the presence of the trained therapist. These sessions help people to cope with several types of binging problems, specifically those with lower self-esteem [14].

There are several other psychological treatments available that can be opted for by different binge eating disorder patients, such as body image intervention, self-compensation training, behavioral activation therapy, etc.

Medications for binge eating disorder

Various research proves that antidepressants are effective in reducing binge eating disorders but have no effect on weight gain due to binging.

Another effective medication available is 4 types of anti-obesity medication, i.e., the serotonin-releasing agent d-fenfluramine; the lipase inhibitor orlistat; the selective cannabinoid receptor subtype 1 antagonist rimonabant; and the SNRI sibutramine [17, 18, 19]. Unfortunately, except for lipase inhibitors, orlistat other three drugs are removed from the market for safety concerns.

Other medications effective against binge eating disorder are anti-craving or anti-addiction medications, armodafinil, and cataplexy medications sodium oxybate [16, 20]. All the medication mentioned is for knowledge purposes and should only be consumed if advised by the physician.

Conclusion

At first, although binge eating disorder might look like a frequent snaking, it gets worse and leads to serious health issues. The cause of BED could be many, like low self-esteem, body image, weight, genetics, or psychological trauma; it’s important to rectify the problem and take specific measures based on the diagnosis. The safest way is to consult the physician as soon as an individual notices the symptoms of binge eating since a growing number of treatments are available, let that be psychological and pharmacological treatments for Binge eating disorder. Be alert and wise to take the proper steps at the right time.

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