Uncontrolled Eating Disorder: What is Binge Eating Disorder?

By Cristiano Antonino On Mar 17, 2023

About Binge eating disorder (BED): sufferers experience recurring situations in which they consume large amounts of food in a relatively short time, losing control over what and how much they are eating

Binge Eating Disorder: what it is and what it consists of

Binge eating is one of the most widespread eating disorders of our time and is accompanied by often chronic depressive states.

Compulsive hyperphagic crises, a manifestation of psychological distress, are followed by feelings of guilt and shame and, in most cases, lead the sufferer to eat alone or in secret.

When binge eating episodes are recurrent, at least once a week, for a period of at least three consecutive months, a diagnosis of Uncontrolled Eating Disorder is made.

Unlike bulimic disorder, Binge Eating Disorder (BED) sufferers do not systematically engage in compensatory behaviours to control their weight, such as vomiting, laxative abuse, fasting or excessive exercise.

Instead, it is typical to compulsively and methodically experience these eating excesses, usually followed by a great sense of discouragement and inadequacy.

Who suffers from Binge Eating Disorder

Currently, Binge Eating Disorder is considered a widespread eating disorder and is believed to affect 2-3% of the general adult population.

Its prevalence increases in parallel with the degree of overweight.

Studies carried out on the Italian population show that the disorder is prevalent in obese individuals and that in those who intend to undergo bariatric surgery, the disorder would even exceed 50%.

Uncontrolled Eating Disorder is mainly suffered by women

However, of all the eating-related psychiatric disorders, such as anorexia and bulimia, Binge Eating Disorder also has a high incidence in men.

This disorder is believed to strike most between the ages of 20 and 30, although retrospective investigations have revealed that the loss of control over food begins well before the age of 20.

This time lag between onset and diagnosis may partly explain the tendency for the disorder to become chronic.

Symptoms of uncontrolled eating disorder

The most striking symptom is the hyperphagic crisis, which, on a psychological level, is associated with a low mood, low self-esteem and bodily dissipation.

Moreover, those suffering from Uncontrolled Eating Disorder run the risk of developing over time the typical complications of obesity such as:

diabetes;
sleep apnoea;
cardiovascular diseases;
malignant neoplasms.

Excessive weight and psychological distress then lead to difficulties in interpersonal relationships and problems in social relationships that can lead to progressive isolation.

The psychological implications, together with the medical complications, lead to a significant deterioration in the quality of life of sufferers.

The Causes

On the triggering causes of Binge Eating Disorder, the multifactorial theory is often cited in the literature, which includes factors

genetic;
neuroendocrine;
developmental;
affective;
social.

There are not many studies on genetic influences in Binge Eating Disorder, but some data indicate that the prevalence of the disorder is higher in individuals who have at least one first-degree relative suffering from the same disorder.

Among the social factors, a difficult childhood, including the presence of depressive disorders in the parents, a tendency to obesity and repeated exposure to negative comments about food and body perception seem to play a key role.

In the pathogenesis of binge eating, hormones could play an important role, but also context and social factors; subjects with a low cultural level are more affected.

Diagnosis

First of all, a correct diagnosis must be made.

It is important that in the assessment of every obese patient, the possible presence of an Uncontrolled Eating Disorder is carefully investigated, because the subject not only tends to mask it out of discomfort or guilt, but sometimes is not even fully aware of the presence of dysfunctional eating behaviour.

Diagnosis is the responsibility of the specialist centres for DCA or obesity, to which one should turn for a correct diagnostic framework and a targeted therapeutic approach.

Diagnostic criteria for Binge Eating Disorder according to the DSM-5

In order to get a more precise picture of the disorder, the diagnostic criteria for Binge Eating Disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are given below:

Recurrent binge episodes. A binge episode is characterised by both of the following aspects
eating, in a defined period of time (e.g. a 2-hour period), significantly more food than most individuals would eat in the same time and under similar circumstances;
feeling of losing control during the episode (e.g. feeling unable to stop eating or to control what or how much one is eating).

Binge eating episodes are associated with 3 (or more) of the following aspects:

eating much faster than normal
eating to the point of feeling unpleasantly full
eating large amounts of food even if one does not feel physically hungry;
eating alone because of embarrassment about how much one is eating;
feeling disgusted with oneself, depressed or very guilty after the episode.

Marked uneasiness about binge eating is present.

The binge occurs, on average, at least once a week for 3 months.

Binge-eating is not associated with the systematic enactment of inappropriate compensatory behaviour, as in bulimia nervosa, and does not occur exclusively in bulimia nervosa or anorexia nervosa.

Psychometric tests such as the Binge Eating Scale are also used in the diagnosis of BED.

The BES (Gormally et. al, 1982) is a scale that measures the severity of the symptom on a behavioural level and examines the feelings that accompany the episode.

It analyses in particular the sense of loss of control and the sense of guilt.

How it is treated

The primary goal of treatment is the interruption of binge eating, unhealthy eating behaviour.

Focusing exclusively on weight loss risks triggering a counterproductive vicious circle.

In fact, dieting, especially if rigid, increases hunger, tends to trigger binges, in a deleterious alternation of weight loss and weight regain that over time aggravates the condition of obesity.

This tendency is even more frequent in patients with Uncontrolled Eating Disorder who have greater difficulty in adhering to diets and greater ease of relapse.

According to current guidelines, the best therapeutic-rehabilitation treatment for obesity and BED must be conducted by a multidisciplinary team of integrated specialists consisting of: