Binge eating disorder is a serious illness where people consume large quantities of food over a short period of time. This is accompanied by a loss of control to stop eating without using purging methods, such as self-induced vomiting.

The particular causes of binge eating disorder are unknown. However, a combination of multiple risk factors can increase a person’s susceptibility to binge eating disorder including age, family history, psychological issues, and dieting.

Signs and symptoms that are related to binge eating disorder divide into behavioral symptoms of binge eating and compulsive overeating, and emotional symptoms. Behavioral symptoms of binge eating and compulsive overeating may be manifested in continuity to eat even after feeling full, hide food to eat it secretly without others noticing, and eating normally in the presence of other people while devouring food when alone. Emotional symptoms include eating to relieve stress or tension, embarrassment over consuming large quantities of food, feeling numb while bingeing, not feeling full regardless of the amount eaten, and feeling depressed.

A psychological evaluation conducted by a doctor that includes discussing a person’s eating habits is helpful in providing a diagnosis. Other tests that provide a clear idea about any related complications include physical exam, blood and urine tests, and a sleep disorder center consultation.

The diagnostic criteria for binge eating is set by the Diagnostic and Statistical Manual of Mental Disorders and includes recurrent episodes of eating an abnormally large amount of food, lack of control during bingeing, and anxiety towards the person’s own  binge eating.

Changes in most eating disorders occur in lesions and the left orbitofrontal cortex responsible for controlling decision making. These changes lead to an increased insula volume, which is a brain lobe. Binge eating disorder may also be linked with decreased white matter in the medial temporal lobe, in addition to the parietal lobe.

There are many methods commonly used to treat patients with binge eating disorder including psychotherapy, medications such as antidepressants, the anticonvulsant topiramate, lisdexamfetamine dimesylate, and losing weight.

Some physical and psychiatric complications may be related with binge eating disorder, such as obesity and its related problems, such as heart disease, type 2 diabetes, bad quality of life, social isolation depression, and anxiety.

With proper treatment, binge eating disorder has a high recovery rate. As reported in a study in an American journal, Biological Psychiatry, it was found that 3.5% of women and 2.0% of men had binge eating disorder during their life.

Binge eating disorder is a serious, life threatening and curable eating disorder by which a person have recurrent episodes of rapid consumption of large quantities of food frequently. It is accompanied by an inability to stop without using purging methods, such as self-induced vomiting. 

Causes of binge eating is not well defined, however, a combination of genetics, biological factors, long-term dieting and psychological issues can lead to binge eating disorder.
 

There are many factors may increase the risk of developing binge eating, such as:

• Family history

Inherited genes increase the risk of developing an eating disorder, where individuals who have first-degree relatives with binge-eating disorder are more prone for binge eating disorder.

• Psychological issues

Negative self-thoughts, such as stress and poor body image, food and boredom are considered as binge eating disorder triggers.

• Dieting

Usually, a history of dieting or restricting calories are related to an increased risk of getting binge eating disorder since they could case an urge for binge eating.

• Age

People at any age are susceptible to develop binge eating disorder. However, late teens or early 20s form the age range most affected by binge eating disorder.

Generally, in all eating disorder types some changes occur with lesions and the left orbitofrontal cortex which is a component of the neural system that aids in controlling decision making. This leads to an increased volume of the insula; a separate lobe of the fifth lobe in the human brain. Increased volume of gray matter gyrus rectus; part of the frontal lobe of the cerebral hemisphere, is in specific relation to increased weight gain and an exaggerated response to sucrose pleasantness ratings in general. Binge eating may also be linked with decreased white matter in the medial temporal lobe, in addition to the parietal lobe.

During childhood, misconceptions like overvaluation of body weight and a specific focus that the child is overweight may arise; this may explain the negative view on excess weight and may solidify as a belief between caregivers and children that continues through adolescence and adulthood.

Binging can extremely relieve negative mood, which can adversely return to the person in an exaggerated bad mood, reinforcing binging. Lower self-esteem and overvaluation of shape and weight contribute to negative view on excessive weight among patients with binge eating disorder.

Signs and symptoms that appear on a person who suffers from binge eating disorder include:

• Behavioral symptoms of binge eating and compulsive overeating

• Loss of control or the inability to stop eating.
• Consuming large quantities of food quickly.
• Continue to eat even after feeling full.
•  Hide food in order to eat it secretly without anyone noticing.
• Eat normally in front of people while devouring food when being alone.
• Eat during the day without stopping and not setting specific meal times.   

• Emotional symptoms

• Eating to relieve stress or tension.
• Feeling embarrassed about the large quantities of food eaten.
• Feeling numb while bingeing.
• A person does not feel full regardless of the amount of food eaten.
• Feeling depressed, guilty, or disgusted after binging.
• Obsession about controlling weight and eating habits.

Diagnostic criteria for binge eating disorder from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), published by the American Psychiatric Association includes:

• Abnormally large amount of food is consumed in recurrent episodes.
• Not having control during bingeing, such as the amount of food and the inability to stop eating.
• Binge eating in relation with at least three of these factors eating rapidly, eating until an uncomfortably full feeling, eating large amounts when not feeling hungry, eating alone out of embarrassment, or feeling disgusted, depressed or guilty after eating.
• Anxiety towards one’s binge eating.
• Binge eating at least once a week for at least three months.
• Binge eating that's not associated with purging, such as self-induced vomiting, or other compensating behaviors to lose weight, such as excessive exercise or laxative use.

Usually, binge eating is treatable. The two main goals for treatment are to reduce body weight and eating binges.

• Psychotherapy

Psychotherapy or talk therapy is based on encouraging the patients to change their unhealthy eating habits.

• Cognitive behavioral therapy (CBT)

CBT helps patients to deal with their problems that lead to binging and how to cope with these issues away from excessive consumption of food.

• Interpersonal psychotherapy

This type of therapy aims at improving the patient’s social skills. This could assist in decreasing binge eating that is caused by poor relationships and unhealthy communication skills.

• Dialectical behavior therapy

This therapy focuses on reducing the patient’s desire to binge eat, by finding a balance between acceptance and change throughout teaching them behavioral skills, which may help them out in tolerating stress, regulating their emotions and improving their relationships with others.

• Medications

• Antidepressants

The way how antidepressants or as known as selective serotonin reuptake inhibitors (SSRIs) help patients with binge eating is unclear. However, they work on increasing the level of neurotransmitters which by their role affect mood and emotions.

• The anticonvulsant topiramate (Topamax)

This medication is prescribed to control symptoms, such as seizures, in addition to reducing binge eating episodes.

• Lisdexamfetamine dimesylate (Vyvanse)

Originally, this drug is used to treat attention-deficit hyperactivity disorder and was approved by Food and Drug Administration (FDA) to treat moderate to severe binge-eating disorder in adults.

• Losing weight

Weight reducing diet is recommended to patient with binge eating disorder after resolving, because diet restrictions can trigger more binge eating episodes, which ruins the weight loss plan.

Weight-loss programs should be done under medical supervision to make sure that the patient’s nutritional requirements are met.

Patients with binge eating may suffer from physical and psychiatric complications as listed below:

Physical complications:

• Obesity.
• Obesity related problems, such as heart disease, type 2 diabetes, gastro- esophageal reflux disease, joint problems, and some sleep-related breathing disorders.
• High blood pressure.  
• Elevated cholesterol levels.
• Heart disease due to high levels of triglyceride.
• Kidney disease.
• Gall bladder disease.
• Arthritis, as a result of vitamin deficiencies and hormonal imbalances, in addition to increased pressure on the joints.
• Increased rates of irritable bowel syndrome.
• Several types of cancer.
• Edema (swelling).
• Infertility.
• Low quality of life.
• Social problems at work and with personal life situations including isolation.

Psychiatric complications:

• Depression.
• Anxiety.
• Bipolar disorder.
• Substance abuse disorders.

There is no direct way to prevent people from getting binge eating disorder. However, early identification and treatment could prevent the worsening of the case.

Possible procedures to prevent binge eating disorder in children include:

• Enhance and strengthen a healthy body image, regardless what their size or shape is.
• Staying in touch with the pediatrician, because they are able to detect early signs of an eating disorder and in stopping its development.

Patients with bulimia or anorexia nervosa that seek treatment tend to be younger than patients with binge eating disorder. Long-term outcome studies show that binge eating disorder could have higher recovery rate compared to other eating disorders. However, binge eating shares similar severity, persistence, and duration, in addition to suicide tendency same as other disorders.

 As reported in a study in an American journal, Biological Psychiatry, it was found that 3.5% of women and 2.0% of men had binge eating disorder during their life. These percentages make binge eating disorder more than three times more common than anorexia and bulimia combined.