As a society, we use the word “binge” in connection to a wide variety of experiences with food. It is often used flippantly when describing eating a chocolate bar or a piece of cake.
But in the case of binge eating disorder, the word has a very different meaning. And is part of a very different experience.
It’s not simply a case of having occasional times of eating past the point of fullness. It’s the regular experience of losing control when eating and having your relationship with food completely change over time.
Food can be adversarial, where you try your best to avoid it. But can also be the thing that is turned to, often unintentionally, as a way to deal with difficult feelings or situations.
But what’s so upsetting and maddening is the powerlessness that you begin to feel around food. No matter how much willpower you apply or how many times you tell yourself “never again,” it reoccurs.
Even with the shame, guilt, disgust and physical discomfort you experience in the aftermath of a binge, this still isn’t enough to prevent it from happening again.
But if this has been your experience so far, I want to assure you that this isn’t a permanent situation. Full recovery from binge eating disorder is possible and something I have helped many clients achieve.
So as part of this article, I want to describe what binge eating disorder is, what are the reasons that it occurs, some of the misconceptions about it, and how to get the support that you need so binge eating disorder is a thing of the past.
Binge Eating Disorder, often shortened to BED, is an eating disorder that is characterised by instances of losing control and eating a large volume of food.
Binge Eating Disorder is diagnosed using the DSM-5, which is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. To receive a diagnosis, you need to meet the following criteria:
With binge eating disorder and the clients I’ve worked with, there is a mix up between what is the driver and what is the symptom. Or mistaking the symptom for where the problem really lies.
For example, everyone believes that the binges are the problem. That if I can simply stop the binges, by learning how to control myself to do so, then the problem will be fixed.
But binge eating is actually the symptom.
The real driver is restriction, dieting or the dieting mentality. Eating larger amounts of food is the body’s response to restriction.
This is known as the diet/binge cycle. Where you restrict or diet, it then becomes too much and you have a binge. You feel terrible and decide you need to restrict/diet again. And the cycle continues. (For a real-life example of what this is like and how it progresses, check out this podcast).
Now, a common response to this information is, “but I’m not restricting.” And given the world we live in, this makes sense.
Restriction has become so encouraged and normalised, that we’ve stopped even thinking of it as restriction. Restrictive practices are rebranded and sold as “health-promoting” or “biohacking”. They even take on a moralistic tone, where you are a good and virtuous person for pursuing them. Diet culture is so ubiquitous that we don’t even see it.
So what does restriction look like? Here is a non-exhaustive list of examples:
There are also three different types of restriction:
Physical Restriction
This is where your food intake is actually restricted in some way, which could be any of the options above.
Impending Physical Restriction
This is planning for future restriction.
You are approaching a meal and are planning all the ways you’re going to reduce your intake and all the things you’re not allowed to eat.
You’re making yourself food in advance and telling yourself that this is the only thing you’re allowed to eat.
You’re eating breakfast while telling yourself that today you’re only allowed to have a salad for lunch.
You’re reading a health blog online talking about the health benefits of Keto or intermittent fasting and you tell yourself that starting Monday, this is how you’re going to eat.
Basically, it is all the ways that you’re letting your body know that some form of restriction is on the horizon or just around the corner.
Mental Restriction
This is where you are physically eating a food, while simultaneously telling yourself you’re not allowed it.
For example, you are eating cake or chips or a pasta dish, but even while consuming it, you’re telling yourself that you shouldn’t be. Mentally, this food is being restricted.
Typically, clients do all three of these, not just one.
They are using MyFitnessPal to track calories, are avoiding carbs and making sure not to add any oils to their food.
They have a list of “good” and “bad” foods and go out of their way not to deviate from the good side of the equation.
When the inevitable happens and they find themselves eating the wrong food or in the wrong amount, they’re scalding themselves at the same time as “breaking the rules,” lamenting how they’re undoing all their hard work.
When someone can consistently restrict or diet, this is seen as a good thing. It’s often only when binge eating starts that it’s now recognised as a problem. But not because of the restriction, because of the binges.
Interestingly, this is often when someone wants to get help and becomes a client. That it’s the binges that have made them see that something needs to change.
Restriction is at the core of binge eating disorder. I’ve created this whole podcast on restriction that goes through this in detail. If you prefer to read as opposed to listening, you can see the transcript here.
One of the most common problems with dieting and restriction is that it messes up one’s ability to feel hunger. While hunger is often thought of as a growling stomach or an empty feeling in the stomach, there are many other symptoms associated with hunger.
But the vast majority of these symptoms can be chalked up to some other reason outside of hunger. And even with what would be considered obvious hunger symptoms, like an empty feeling in the stomach, it can become so common (but ignored) that it also gets disconnected from hunger.
The mind and the beliefs we have can also interfere with this too.
If you eat something and feel hungry two hours later you rationalise that you can’t possibly be hungry as you recently ate.
Or you had a binge in the evening. Any feeling of hunger the next day is written off as something else. Because, how can you be hungry if you ate “so much” last night?
So, while the definition of binge eating disorder contains this idea of eating when not physically hungry, what I discover with clients is that they are hungry, they just haven’t been hearing the hunger signals. And at the point of finally eating, they are overly hungry, even if it doesn’t feel that way to them.
I’ve written a whole article on hunger because it is so misunderstood, which you can check out here.
One of the defining features of binge eating disorder is a loss of control. This can be the feeling that once you start eating, the flood gates open and out of nowhere your eating just continues on.
Other components of the diagnostic criteria also add to this sense of loss of control. Eating at a faster pace than usual, ending the meal at an uncomfortable fullness, feeling guilty or disgusted with the amount that was consumed.
If you were really in control, none of this would have happened. So, if this outcome has occurred, then you obviously weren’t at the wheel, you were simply a passenger as this played out.
In this article, I go through all the reasons why someone can experience the feeling of “I can’t stop eating”. If you want to understand all the potential reasons, check out that article.
But when I think of the reason for binge eating disorder for the vast majority of clients, it’s a combination of two factors.
The first is a failure to adequately recognise hunger and starting meals from a place of being much hungrier than they at first realise. Which I’ve already gone through above.
The second is to do with rules around food and feeling like some rule has been broken or some line has been crossed.
For example, you are eating your lunch or dinner. The type and amount of food you are eating is based on what you deem is appropriate for this meal.
What is an “appropriate food” isn’t about what you genuinely feel like or sounds satisfying, but rather about what is “healthy” or “low calorie” or “allowed”.
And the amount isn’t about what your body physically needs, it’s an arbitrary portion size, based on what you believe “should” be enough.
It might be while eating the meal, it might be after finishing up, but at some point, you get this feeling that this hasn’t or isn’t hitting the spot. Thoughts about other foods begin to creep in. If this is happening before the meal is over, often your eating speed increases.
At some point, you “give in”. You find yourself eating more of the same “appropriate food”. Or, often, this is the point that you start eating the more “forbidden food” that has started to dance around in your mind.
And it is this act, of crossing some imaginary line, that makes the differences. A rule has been broken and it is this occurrence, more than anything else, that then triggers the “binge”. Crossing this threshold sets off the disinhibition that leads to more eating.
Now, it can feel like the binge was inevitable before the crossing of this line. That the eating pace had already increased. That you were already thinking about food.
But if there wasn’t a line in the sand about what was an appropriate amount or an appropriate type of food, when thoughts about other food arose, this would be a neutral experience. You’d register that you are still hungry or are wanting something else and you’d gladly get that food for yourself.
But that’s not what happens. You do reach for the food but it’s not a neutral experience, it comes along with judgements, emotions and beliefs. It is the supposed transgression that transforms this into a binge.
In this article, I talk more about expectations and judgements and the role that they play in binges.
Another complicating factor with binge eating disorder is related to weight. And I say complicating because I regularly see the reason given for wanting to stop binge eating is to manage one’s weight.
This can be eating disorder providers using this language, where the “benefit” of treatment is weight loss. Recovery is being sold as a “weight loss strategy.”
But this can be coming from the sufferer too. Where the biggest concern about binge eating is weight gain. That, if I keep this up, what’s going to happen to my weight?
Much like restriction, concerns and fears about weight are typically driving binge eating disorder. Often the two go hand in hand, with weight concerns leading to the restriction and then the inevitable binge eating.
It’s important to note that weight, size or appearance are not part of the diagnostic criteria for binge eating disorder.
But one of the diagnostic criteria for binge eating disorder is “marked distress regarding binge eating is present.” And the important word here is “distress”.
Now in the diagnostic criteria, it’s talking about distress because of binge eating. But this should actually be distress more generally, not solely because of binge eating. Because the real problem with binge eating isn’t the weight gain, it is the distress.
The distress someone feels because they believe they’ve eaten more than some arbitrary amount or have eaten particular foods that they deemed “bad” and that they’ve broken some rule.
The distress someone feels because they think about their size or shape or appearance and how much this is connected to their self-worth and self-esteem.
The distress someone feels because of the difficulty of life and its many challenges. How excruciating it can be to sit with feelings or to navigate uncomfortable situations.
When distress happens (from whatever source), if restriction is present, a binge will likely occur at some point. Restriction keeps food front of mind and, while it’s counter-intuitive, it makes it the most likely method for dealing with difficult circumstances.
Distress is the real issue and figuring out healthy coping skills to get past this distress is the goal. And these strategies therefore can’t be “dieting” or intentional weight loss, because that’s just offering more of what’s already been tried (often for years and decades).
Binge eating disorder is the most commonly diagnosed eating disorder. Which, at least from a biological perspective, makes senses. When the body receives inadequate amounts of food, the rebound effect is to make up for this shortfall.
We evolved when food wasn’t in so easy supply and having a hardwired drive for food was crucial to our survival.
But I also feel that the reason for the higher occurrence of diagnosis for binge eating disorder is down to society’s biases about weight and health.
For example, with anorexia nervosa, there are different subtypes of the disease. There is one subtype that involves bingeing and purging. There is another subtype where someone is not at a low body weight.
But because of biases around weight and the stereotypical view we have of anorexia, many people will receive a diagnosis of binge eating disorder when anorexia would be the more accurate diagnosis. And the only reason they aren’t receiving that diagnosis is that they aren’t in an emaciated body.
Another example is bulimia nervosa. While the stereotypical view of bulimia is someone who eats a meal and then throws up, this is only one type of purging. Purging can also include compensatory exercise, fasting or restricting.
But we live in a world where exercise is seen as good. So, it’s very easy for compensatory exercise to be ignored and seen as simply “health-promoting”.
We are also regularly told that foods are “addictive,” so we all need to be using some form of control. And that intermittent fasting is a longevity hack.
And considering that a key facet of binge eating disorder is the diet/binge cycle, how can we not see that dieting is the same as restriction, meaning that this is a form of purging.
So again, many people are receiving a diagnosis of binge eating disorder when the more accurate diagnosis would be bulimia.
Now, in many ways, this is simply semantics. The goal of treatment, irrespective of which type of eating disorder, is largely the same. And that’s because eating disorders are all largely the same, it’s just that the reaction to restriction and deprivation can affect people in different ways.
For some, the restriction leads to more restriction. For others, it leads to binges that end in a purge. While for others it ends in a binge but no purge (or at least a purge that’s not recognised as a purge).
But the reason I’m mentioning this is that for many providers, eating disorders are thought about and treated differently. And for binge eating disorder, often the “treatment” is tantamount to a diet. Because weight is seen as the problem, when it is the distress that is the real issue.
Or some providers put a weight limit on recovery for all eating disorders. That for even for someone suffering from anorexia, once they have hit a “normal weight” they shouldn’t gain anymore. So again, at this stage, they are put on a diet.
I’m mentioning this is to hammer home the point that the solution for any eating disorder, including binge eating disorder, can’t include restriction.
It can’t have a focus on making sure weight doesn’t go above some arbitrary amount that is deemed “healthy”.
Or that getting someone to a drop to a specific weight is what is going to make them happy and stop the disorder (which, sadly, is the goal and aim of treatment for binge eating disorder with some providers).
As I’ve mentioned already, restriction is at the heart of binge eating disorder. But people don’t fear restriction, they fear the binge.
Which means it can feel challenging to let go of restriction. Because if the binges are happening when you’re already trying to slam on the brake, what’s going to happen when you remove the brake completely?
The same is also true with any form of restriction. Whether that be someone who has received a diagnosis of anorexia or someone who participates in chronic dieting.
The fear is that if I don’t restrict, then I’ll develop binge eating disorder. Or that I’ve always been a binge eater, I’ve just had things under control. And without that control, my true nature is going to show itself.
Well, the reality is, when you first stop restricting, you are going to be hungrier. And as more food comes in and is allowed, this can continue to increase.
And this happens for both physiological and psychological reasons.
Physiologically the body is in energy debt. There is repair that needs to happen and calories are the currency that pays for this repair. Which is true irrespective of your size. Just because you may not be in an emaciated body, doesn’t mean that malnourishment hasn’t occurred.
Psychologically the body also has to get used to allowance. For so long when food finally became available, the impulse was to get in as much as possible. And a big part of this is because true allowance has never occurred. Even when more food was being consumed it was happening alongside mental restriction and planning future restriction.
But with time, this changes.
The body receives the energy that it needs to meet the day-to-day requirements plus the additional amount required to pay off the debt that has accrued.
And psychologically, the body learns that it is allowed the foods that it desires, in the quantity that it desires, and that this isn’t going to be taken away from it again.
In essence, you and your body learn to trust one another. And through this process, the body is allowed to autoregulate, which it has always been able to do, but just wasn’t allowed to.
When reading the above I imagine that two thoughts are occurring at once.
The first is that this makes a lot of sense and explains why the binges have been occurring. You might not be the full way there with this and there may be some level of ambivalence. But there are probably some light bulb moments or understanding things you hadn’t realised before.
The second is that, even if it makes sense, this feels incredibly scary. What’s being suggested is the complete opposite of the impulse for how to deal with the situation. Your thinking is that binges require more control and the removal of specific foods. That even if restriction is the problem and allowance is the solution, how do I even do that? What would that look like?
There is no one answer to that question. Different approaches and order of changes work for different people. This is why I like helping people to follow out what works best for them.
Binge eating disorder is not permanent. Like all eating disorders, full recovery is possible. And what makes this infinitely more likely and much less scary is to not go it alone.
If you’re experiencing bingeing episodes or have been diagnosed with binge eating disorder and would like to recover, even if you feel ambivalent, I’d love to help.
I’m a leading expert and advocate for full recovery. I’ve been working with clients for over 15 years and understand what needs to happen to recover.
I truly believe that you can reach a place where the eating disorder is a thing of the past and I want to help you get there. If you want to fully recover and drastically increase the quality of your life, I’d love to help.
Want to get a FREE online course created specifically for those wanting full recovery? Discover the first 5 steps to take in your eating disorder recovery. This course shows you how to take action and the exact step-by-step process. To get instant access, click the button below.
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