National Eating Disorders Association

Beyond Hunger: Struggling with Binge Eating Disorder

Dana Fierstein, RD, CDN

Have you ever felt so full, yet you couldn’t stop eating? Do you often eat in secret because you are ashamed to eat in front of people? Do you feel unworthy or unlovable, and use food to comfort yourself in spite of your adamant commitment to weight loss?

If you or someone you know experiences this ongoing torment, you (they) may be struggling with binge eating disorder .

Binge eating disorder (BED) is the most common eating disorder in the United States, affecting nearly 5 million women and 3 million men. In 2013, the American Psychiatric Association (APA) formally recognized binge eating disorder as a diagnosis in its DSM-5 publication. 

Historically, there is a lot of shame surrounding BED, and many people suffer in silence. Many are unaware that they are suffering from an eating disorder, and others might choose not to speak up because they are embarrassed that their behaviors may be viewed negatively. With continued visibility and an officially recognized diagnosis, our hope is that people will become increasingly aware and more willing to seek help. 

Many of those suffering from BED are a larger size than the culture condones and have been perhaps labeled “overweight” their whole lives. Growing up in a society that reveres the thin ideal for women and washboard abs for men is a challenge for most people. Many people suffering from eating disorders, and even those who are not, have a hard time finding their self-worth in a world that seems to say, “You are not okay the way you are.” Individuals who are genetically predisposed to be larger usually feel a shame that, in this culture, seems to come automatically with a larger body frame. From a young age, we see the diet, binge and restrict cycle begin. We see the back and forth of dieting, restricting and deprivation lead to shameful binges, which often circle back to restriction. Sufferers might feel that they shouldn’t eat at all, certainly not in public, because someone their size is not entitled to food.

Those suffering from BED have likely dealt with feelings of unworthiness from a very young age. Often, they are unable to say “no,” whether it’s in regard to food, driving a friend to the airport or staying late at work; the need to please those around them leads to an inability to set limits and boundaries, which comes at a cost to themselves. 

We need to get the word out that binge eating disorder is a real eating disorder that does not materialize from one’s lack of will power. BED is a psychological disorder and getting appropriate treatment is key to recovering. Early intervention is important for increasing the probability of a successful recovery. 

If you recognize the following warning signs in yourself or a loved one, it may be time to reach out and receive the help you/they deserve. 

  • Feeling guilty, disgusted or depressed after eating or overeating
  • Desperation to control weight and eating habits
  • Feeling stress or tension that is only relieved by eating
  • Hiding or stockpiling food to eat later in secret
  • Inability to stop eating or to control what you’re eating
  • Feeling numb while bingeing—like you’re not really there or you’re on autopilot
  • Rapidly eating large amounts of food
  • Eating even when you're full
  • Eating normally around others, but gorging when you’re alone
  • Embarrassment over how much you’re eating
  • Eating continuously throughout the day, with no planned mealtimes
  • Never feeling satisfied, no matter how much you eat

Finding a therapist and/or nutritionist who specializes in eating disorders is a great first step. From there, your practitioner can help set up a team with all the key players.  Successful treatment is individualized to the needs of the person. Several treatment approaches are being used effectively for binge eating disorder. Different therapies include: 

  • Cognitive Behavioral Therapy: works on exploring the connection between thoughts, feelings and behavior. CBT helps one to cope with unhealthy/negative thoughts that may usually lead to bingeing, in a more productive way.
  • Interpersonal Psychotherapy: focuses on improving relationships. This can help reduce binge-eating episodes resulting from unhealthy relationships and communications. 
  • Dialectical Behavior Therapy: Learn behavioral skills and tools to help tolerate stress, regulate emotions and improve relationships—all of which may lead to bingeing episodes.
  • Medication: certain medications have been approved to treat BED and may be used as an adjunct to nutritional and psychotherapeutic treatments.

So, if you or a loved one can relate to what you just read—if you’ve felt disgusted with yourself after a meal, you feel you can’t stop eating when you want to or you feel worthless in relation to your size, it’s time to seek help. The first step in any journey to recovery and change is becoming more aware. As hard as it may be, you can get started by reaching out and asking for help from a friend or a licensed professional, or by attending a support group. Although this is not an easy venture, it is worth it, and you deserve recovery. 

About the Author: 

Dana Fierstein, RD, CDN is a Registered Dietitian Nutritionist/Eating Coach at the Eating Disorder Treatment Collaborative. She specializes in nutrition counseling. F.E.E.D. IOP, CONNECT & CONCIERGE Programs