Definition

Binge eating disorder (BED) is a medical condition characterized by the excessive and rapid consumption of food. This condition persisted for over three months, occurring every week. 

BED is predominantly found in people who are obese. However, there are several health conditions, such as diabetes, hypertension, and chronic pain, that are comorbid and make BED worse.

Women are more susceptible to BED than males. The age at which this condition typically manifests is 23 years. Comorbid diseases, including anxiety disorders, mood disorders, impulse control disorders, and substance misuse disorders, frequently co-occur with BED conditions.

Causes

BED can occur due to several factors, such as psychological, social, cultural, and biological factors. It occurs because it is difficult to regulate the chemicals in the brain that regulate the desire to eat. Impaired emotional regulation and exercising emotional awareness are correlated with BED. Furthermore, these factors, plus the presence of interpersonal problems, can correlate with BED.

Risk factor

Some risk factors for BED include:

• Childhood obesity,
• Loss of control over eating in childhood
• adjustment disorder,
• drug abuse,
• Family history of weight problems and eating problems,
• Having family conflicts or having problems with parenting,
• Parental psychopathology,
• Physical and sexual harassment,
• Mental health disorders.
• Distortion in body image perception,
• Changes in gut microbiota

Symptoms

Weight gain is the most common complaint among BED patients. Obesity is one of the comorbidities that develop due to increased body weight.

The major symptoms of BED include eating excessively in a short period and being unable to stop eating even when full. Other symptoms felt may include:

• Eat when you're not hungry.
• Eat hastily during gatherings.
• Eating alone or in private,
• Overeating can leave you feeling miserable, guilty, humiliated, and disgusted.

People who experience this regularly are more likely to experience BED.

Diagnosis

To diagnose a patient with BED, your doctor will ask several questions, including:

• Age of initial occurrence of BED.
• The frequency of episodes of overeating
• The length of each binge-eating episode
• Feelings that emerge during a BED episode.
• Overeating is accompanied by compensatory behaviours such as vomiting, purging, and the use of laxatives.
• Comorbid disorders may include psychiatric issues, obesity, and diabetes.
• The onset of emotional disorders such as neglect and stress
• There is societal pressure.
• Emotional violence in infancy and physical and sexual abuse
• Restricted calorie intake or disturbed eating behaviour in childhood
• Suicidal ideation.
• A history of substance misuse.
• Distortion of body image perception
• There is a familial history of overeating.

Apart from that, an examination must be carried out to find out any comorbidities that may accompany BED in you. The checks carried out can take the form of:

• Checking and monitoring blood pressure and glucose levels regularly,
• Carry out an examination to look for signs of physical or sexual violence. This is only done if you are suspected of experiencing this.

Several tools can be used to turn on the BED, in the form of:

• Binge Eating Scale (BES),
• Three-factor eating questionnaire (TFEQ questionnaire),
• body shape questionnaire,
• Eating disorder screening (EDE),
• Structured clinical interviews for diagnosis of DSM disorders,
• Diet and weight questionnaires.

To diagnose BED, you will undergo many exams. The evaluations conducted encompass mental status, health status, and nutritional status.

The psychiatric status assessment includes an examination of psychiatric comorbidities, such as depression and substance misuse, as well as an evaluation of body shape and weight, self-image, and self-esteem.

As part of a person's medical history, their comorbidities and factors related to obesity and overweight are checked. This can include measuring their body mass index, waist circumference, hypertension, hyperlipidemia/cholesterol disease, diabetes mellitus, GERD, coronary heart disease, obstructive sleep apnea, and hypothyroidism.

Management

The treatment given to people with BED aims to reduce excess body weight, episodes of binge eating, and excessive anxiety about body shape and to manage psychiatric comorbid conditions (anxiety, substance abuse, and depression).

Your doctor may do several things to treat your BED, including psychotherapy, medication, and reducing weight.

• Psychotherapy. The primary recommended treatment for BED is psychotherapy. Medication has a less beneficial effect than psychotherapy. Dialectical behavioral therapy, CBT, interpersonal psychotherapy, and cognitive behavioral therapy are among the psychotherapies that are frequently used to treat BED.
• Medication is used as the main therapy if you have difficulty accessing psychotherapy and prefer to take medication. The main drugs used for psychotherapy are antidepressants. If this fails, your doctor may replace the drug with an antiepileptic drug or a drug used in ADHD patients.
• Reduce your weight. The majority of individuals with BED seek treatment to lose weight, not to treat the BED. Obese individuals with BED should all undergo a thorough evaluation of the condition. Behavioral interventions that emphasize dietary and lifestyle changes can aid in managing BED.
• Psychoeducational intervention. Psychological and educational help. It's important to teach people with BED about mental health. These are meant to help people with BED get better by giving them information about things that are related to their illness.

Complications

BED frequently coexists with obesity, which means it can result in issues like muscle pain, pain in the neck, shoulders, and lower back, disorders that affect health after BMI changes, high blood pressure, diabetes, asthma, high cholesterol, coronary heart disease, menstrual issues, metabolic syndrome, osteoarthritis, sleep apnea, hypoventilation obesity syndrome, gallbladder disease, and even cancer.

Prevention

To overcome BED, several things can be done, such as:

• Review your eating habits
• Eat regularly. Try not to eat late.
• Look for and determine the causes of BED that might happen to you
• Make a list of the foods you avoid, from the most to the least. This aims to reduce eating anxiety and prevent BED.
• Do activities or hobbies you enjoy. This can have a good effect on the BED behavior you experience.

When to see a doctor?

You can talk to a doctor if you think that you or someone in your family is having BED. Some people may find it hard to accept that they are dealing with BED. However, getting the right care from a doctor can stop harmful effects from happening in the future because of BED.