What is binge eating?

Binge eating disorder accounts for around 22% of eating disorders in the UK alone, yet many people aren’t aware of the severity, symptoms, and impact on your quality of life this condition can have. Only one in four people suffering from binge eating disorder currently seek or receive help and treatment, despite it being the most commonly experienced eating disorder.

Binge eating disorder is a mental illness. It’s characterised by regular episodes of binge eating, during which a person eats an excessive amount of food in either a short period of time, or over an extended grazing period. During these episodes, the sufferer feels out of control and unable to stop eating, even when they’re not hungry or well beyond the point of feeling comfortably full. These binges can be really distressing, and are often carried out in secret or alone, leading to intense feelings of shame, guilt, self-loathing and low self-esteem and mood following a binge.

For some, however, they may not identify with the binge eating disorder condition, but instead struggle with periodic binge eating episodes. The experience of binge eating ranges in severity for different people, but if it’s impacting your quality of life or your physical or mental health, know that you deserve support and recovery is possible.

The difference between overeating and binge eating

Almost all of us overeat from time to time beyond the point of feeling full, whether it’s in social settings or alone, by accident or intentionally because the food is right in front of us, we find the food on offer too tempting or pleasurable to resist, we’re feeling bored or distracted, or in need of “comfort” from our food choices. This experience is normal and part of being human, and while it may trigger feelings of guilt for some, it’s not an ongoing, all-consuming experience occurring frequently and causing extreme distress.

However binge eating disorder (BED) is a serious mental illness. For someone with BED, the excessive eating episodes feel completely out of their control, and occur frequently, resulting in embarrassment, shame and guilt, as well as weight gain a lot of the time. The compulsion which drives these binges feels irresistible and overwhelming, meaning they’re powerless against the intense urge to continue eating well past fullness. The lack of control and the resulting feelings of shame are highly distressing, and can significantly interfere with a person’s quality of life, relationships, ability to socialise, and general physical and mental health too.

Signs and Symptoms

While many people struggling with BED are overweight or struggling with weight gain, others are able to maintain a normal weight, so diagnosis may not be as straight-forward as relying on physical symptoms. Warning signs which may indicate BED include:

• Eating copious amounts of food within a certain time frame (either a really short window of time, or over a couple of hours)

• Feeling out of control around food and eating

• Eating beyond the point of excessive fullness regularly

• Eating extremely quickly during episodes

• Eating in secret often

• Experiencing guilt, shame, self-loathing or disgust around eating behaviours

• Regularly embarking on diets or attempts to stop bingeing, only to fall back into the binge cycle

• Unpredictable eating patterns

• Compulsively eating food available to you, even if you don’t enjoy the food

• Feeling numb or dissociating during binge episodes

• Avoiding social settings or occasions, especially when they involve eating

• Spending excessive amounts of money on food

• Low self-esteem 

• Shame around physical appearance

• Eating excessive amounts of “forbidden” foods uncontrollably

• Eating even when not physically hungry

• Sensitivity to any comments about body shape/size or appearance

• Worry about weight gain following a binge

People struggling with BED may not exhibit all of the above symptoms, just as someone experiencing some of these traits may not necessarily have BED, however they’re red flags to consider your behaviours around food and eating, and ask yourself whether something deeper is going on for you. 

Another important thing to note is, unlike with bulimia and some other eating disorders, though BED leads to excessive guilt and shame following a binge episode, it normally doesn’t lead to compensatory behaviours such as purging, excessive exercise or use of laxatives. Often, sufferers will struggle with the mental and emotional backlash of a binge, but will try to eat more normally or “healthfully”, yet in doing so they restrict their food choices and intake, leading to further binges down the track.

BED ranges in severity, based on how often a person is bingeing during a given week. Some people may struggle with binge eating symptoms or occasions, yet not experience the extent of the accompanying mental illness.

Underlying causes and contributing factors

While there’s no single cause of BED we can pinpoint, we do know that genetics, biological factors, whether you’ve been dieting over a long period of time, and psychological trauma or other mental illnesses increase your risk of the condition.

BED can present itself at any age, though it most commonly occurs in someone’s late teens or early 20s. Interestingly, almost 40% of sufferers are men, so it’s not a gender-specific condition.

If your parents, siblings or other family members have struggled with an eating disorder, this may increase your risk of BED, as does long-term dieting or restricting energy intake during the day. Depression, anxiety, low self-esteem, heightened stress and poor body image can also increase your chances of developing BED.

Top tips for preventing or treating binge eating

The rest of this article will mostly address people who experience less severe cases of binge eating. Remember, if you’re really struggling with feeling out of control and having regular bingeing episodes, seek professional support and treatment immediately. And, even if you only occasionally struggle with binge eating, know that you deserve help and support too, and you may wish to seek assistance beyond these tips.

Treatment of BED aims to both reduce binge episodes, but also to create positive eating habits and a healthy relationship with food and your body. It focuses on reducing shame and guilt after binges, and improving body image, self-worth, and addressing any other mental health conditions you may be experiencing, so you can reclaim control over your eating habits and behaviours.=

Stop dieting and restricting food.

It’s important to recognise that people who struggle with severe dieting are 18 times more likely to experience binge eating. This is because the physiological and psychological impact of restricting food and energy on both the body and mind often triggers a scarcity response. On a physical level, if your body is being starved of nutrients and energy and is often subject to hunger, it tends to overcompensate and increase physical hunger, causing you to overeat and binge. It’s almost like stretching an elastic as far as it will go, and watching it fling back in the opposite direction - restriction and deprivation of food will lead your body to go to the other extreme in an attempt to prevent the lack of energy, fuel and food from occurring again. Similarly, on a psychological level, when you forbid yourself from eating a certain food, or you don’t allow yourself to get enough energy from your food, your mind becomes all the more fixated on the “banned” food or food group. Eventually, the cravings become so intense, you inevitably give into them - not because of a lack of willpower, but because of the physical and physiological drivers to eat the food - triggering feelings of failure, self-blame and weakness for many people. These emotions can lead to an “all or nothing” mentality around food, meaning if you give in to your cravings and eat the forbidden foods once, you are often likely to “throw in the towel” altogether, and instead of eating one row of chocolate, you’re more vulnerable to eating the entire block. The all-or-nothing approach is a key driver of binge eating episodes, whereby you gorge on all the foods you’ve been avoiding in a way that feels chaotic and uncontrollable.

Restriction and dieting of any kind sends a message to your body that it’s unsafe and can’t rely on a consistent, adequate supply of food. Your body can’t determine how real or big of a threat this restriction is, so it triggers a survival response, where your body slows down its metabolism and conserves energy (often storing it as fat for later use in case it’s not being well-fed), and all your thoughts become food-oriented, making you crave and obsess over these restricted foods more so than ever, to the point where you’re helpless against the temptation they present. The survival mechanism also increases your likelihood of overeating, as your body is trying to protect itself from scarcity in the future, and often leads to bingeing on high-sugar, high-fat, palatable foods like chocolate, cakes, pastries, pizza and sweets to provide quick, readily-accessible energy to your wanting body.

So, in order to prevent this restriction-bingeing cycle, it’s critical to eat regular, balanced, satiating meals to stop this physical and physiological starvation response in its tracks. This may look different for everyone - you may prefer to eat six smaller meals, more regularly throughout the day. Or, others will find three large meals plus snacks works for them. Whatever helps your body feel assured and safe in the fact it has a consistent, adequate supply of food, energy and nutrients coming in in the near future is critical to avoiding (or at least reducing) these bingeing episodes. Aim to include a source of protein, healthy fats, fibre and complex carbohydrates at each meal, and try to get protein into each of your snacks as well.

Address food insecurity or food-related trauma.

If you’ve ever experienced food scarcity or insecurity as a child, or at any point during your life, you may find yourself vulnerable to the same survival response we just discussed. For example, people who have endured financial hardships during life and found themselves unable to afford particular (or adequate) foods are at an increased risk of BED. They may be more likely to hoard food too, particularly foods they previously didn’t have access to or considered “forbidden” foods.

It’s important to work through this mentality in a therapeutic setting under the guidance of a professional. Which leads us to number three…

Work through the underlying causes.

Several forms of therapy and coaching can help you address what is leading to these binge eating episodes for you. There are various support groups or health professionals who can help you get to the root cause in order to challenge core beliefs keeping you stuck in these damaging patterns. Some commonly used forms of therapy to combat BED include:

• Cognitive behavioural therapy, which aims to give you coping strategies to tolerate and overcome “difficult” emotions, rather than resorting to bingeing to numb or avoid these. It aims to replace unhealthy beliefs and behaviours with more healthy, positive ones.

• Interpersonal psychotherapy, which focuses on improving your relationships with others, and how you interact and relate to others. It can be useful if your bingeing is tied to difficult relationships in your life, or feelings of isolation and loneliness in your existing relationships.

• Dialectical behaviour therapy, which helps you discover behavioural skills to allow you to handle stress, emotions, relationship challenges and other obstacles in life which may otherwise trigger bingeing.

There are also many other types of therapy or forms of support which can help you on your recovery journey, or equip you with tools to help manage and prevent binge eating moving forwards.

Ensure your own needs are being met.

All too often, binge eating episodes can occur as a result of your needs not being met consistently. For many, food offers a way of “self-soothing”, at least temporarily. While some people turn to drugs or alcohol or similar to “numb” difficult emotions, or avoid dealing with the reality that they’re feeling abandoned or uncared for by themselves or by others, many people turn to food for this purpose, increasing the chances of a binge episode.

Unmet needs can be emotional, psychological, social, spiritual, physical, professional, the list goes on. They can include feeling unheard or unseen by the people you love, feeling unfulfilled in your work, living in a stressful or unpredictable situation, feeling out of control in regards to the future, experiencing social isolation or a lack of connection, or even experiencing anxiety or depression. While food may provide a band-aid, temporary relief to these feelings and emotions, a binge episode often worsens them in time, thanks to the inevitable guilt, shame and self-loathing that come after a binge episode. So it’s important to develop alternative coping strategies which address the route of the problem, teach you how to meet your needs or ask others to meet your needs, and allow you to sit in and process your emotions without the need to numb or avoid them entirely.

Be safe in the knowledge that feelings come and go, they’re not permanent. While you may be feeling lonely, isolated, dejected, uncared for, sad, or experiencing any of the numerous “negative” emotions, learning to simply recognise and name an emotion, and allow it to pass without holding onto it and causing yourself further suffering is key. The fact is, an emotion typically lasts for 90 seconds - it’s the stories around our emotions which we tell ourselves which leave us feeling “stuck” in these difficult emotions. So recognising a feeling, without attaching yourself to it, means you can move beyond these emotional challenges more easily without reverting to food to avoid it in the first place. If this sounds complicated, working with the ETPHD team or a professional on strategies to help you do this is a great place to start.

Foster positive body image.

Recognising that body image is not based on how your body actually looks is fundamental. While you may fall into the trap of believing that “when your body looks like this, then you’ll be happy with it and have a positive body image,” this is completely false. When you achieve your “goal” body, dress size, weight, or whatever metric you’ve set for yourself, you’re not likely to experience any improvements to your body image whatsoever - in fact, often the opposite occurs. 

The truth is, body image is not tied to your body’s physical appearance. Body image is about how you feel about and within your body. Anyone, regardless of their shape and size, can develop a positive body image, by:

• Developing a sense of self and self-worth away from your appearance and body. What other personality traits, skills, hobbies and passions can you invest time and energy into building on? How can you appreciate yourself for who you are, and what you have to offer, that isn’t based on how you look?

• Be grateful for your body. Focus on what your body can do, rather than how it looks. Your body allows you to hug your loved ones, to breathe and laugh, to move in ways that feel empowering and energising. Be grateful every day for these abilities.

• Reduce your exposure to diet culture. Stop clicking on articles about fat loss and fad diets. What you consume from the media and people around you is just as important as what you consume in terms of diet when it comes to mental health!

• Similarly, ditch comparison culture. Unfollow social media profiles you notice you compare yourself and your body against. Set your own goals and standards, and don’t measure your successes and achievements (or appearance!) against anyone else’s.

• Move your body in ways that feel good. Don’t exercise to burn off food you’ve eaten, or to earn your next meal. Don’t choose movement styles that burn the most calories. Choose what feels most energising and enjoyable for you! Whatever that’s a gentle nature walk, a yoga flow, Pilates or boxing, tune into your body and your needs, and honour these without question. Exercise should never be a form of punishment for your body, it should be a celebration of what you can do.

There are many other strategies to help improve your body image, but recognising that body image isn’t actually tied to your appearance is a critical first step. Once you’re aware of this, you can recognise those harsh, critical thoughts and inner dialogues around your body and appearance, and you can begin to challenge and rewrite these cruel thoughts, replacing them with affirming, respectful, self-loving thoughts instead.

Be compassionate towards yourself.

Remember, healing and creating a positive body image and relationship with food can be a long process! Allow yourself the space and time to move through difficult emotions and challenges that arise along the way, and reach out for help and support from professionals and loved ones whenever you need it.

BED is a mental illness, and one that you deserve help in healing. It’s not going to vanish overnight. It requires work, effort and investment to overcome, but it can absolutely be done. Keep in mind why you’re working to overcome binge eating - stay aligned with your values, and the life you want to be living. And allow this to motivate you through the more difficult moments.

And in the meantime, show yourself the love, kindness and care you deserve. Be patient with yourself. Know that you’re tackling some challenging issues right now, and it’s okay if it feels hard. Sometimes, things that seem like they should be “easy”, like learning to meet your own needs, are the most difficult of all. So know that you’re doing the best you can, and progress (and consistency) is always more important than perfection.

Listen to episode 170 of the ETPHD team podcast here, where Emilia, Roslyn and Bekka discuss taking a nutritional and psychotherapeutic approach to overcoming binge eating.

Get in touch if you’re looking for support or guidance on how you can improve your health and fitness in 2023, or work on improving your relationship with food and exercise.