Binge eating disorder and the trauma of weight stigma

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Someone who is struggling with binge eating disorder experiences recurring episodes in which they eat large amounts of food in a short period of time. These binge eating episodes often result in shame, disgust, guilt, and depression. While binge eating disorder can occur in people of any body shape or size, it frequently occurs in people who live in a higher body weight. (1)

Unfortunately, our society is fatphobic and stigmatizes people with larger body types. This fatphobia, or weight stigma, can have horrific consequences on an individual with an eating disorder including shame and isolation, both of which perpetuate the cycle of binge eating.

Last updated on 
November 19, 2021
In this article

What is binge eating disorder?

Binge eating disorder is the most common eating disorder in the United States, affecting about 1.25% of adult women, 0.42% of adult men, and 1.6% of teens. (1) Someone with this condition regularly exhibits episodes of binge eating, which means they consume a large amount of food in a relatively short period of a couple hours. They also experience a lack of control over their food consumption during this episode. (2)

The binge eating episodes are associated with at least three of the following: (2)

  • Eating much faster than typical
  • Eating until feeling uncomfortably full
  • Eating significant amounts of food even when not feeling hungry
  • Eating alone due to embarrassment of how much they are eating
  • Feeling depressed, disgusted, or guilty after the episode

People struggling with a binge eating disorder will generally engage in binge eating episodes at least one a week for three months or more. (2) Although some people with binge eating disorder maintain a lower body weight, many people experience significant weight gain due to their eating disorder. Binge eating disorder can be extremely distressing as it is, and that distress can be compounded further by weight stigma.

What is weight stigma & what are the harmful effects?

Weight stigma, also known as weight-based discrimination or weight bias, is discrimination based on someone’s weight. This type of discrimination is so prevalent and ingrained in our society that many people of average or low weight do not even realize it’s happening or that they are participating in it. But people with a higher body weight most certainly feel the horrifying consequences of weight stigma, day in and day out.

Weight stigma is extremely dangerous and can have countless harmful effects, including: (3,4)

  • Increasing body dissatisfaction
  • Increasing the risk of developing an eating disorder
  • Depression
  • Poor body image
  • Low self-esteem
  • Psychological stress
  • More frequent binge eating episodes

Weight stigma doesn’t come from one or two sources—it’s all around us, from television to social media; with family members and physicians being reportedly the most common sources of weight discrimination.

Despite the fact that physicians are supposed to be trusted healthcare providers and resources, they frequently mistreat people with larger bodies by viewing them as undisciplined or noncompliant, spending less time with them on visits, and giving them less health information. (3) 

Family members frequently discriminate against heavier people by engaging in weight-based teasing and diet discussions, which may result in extreme weight control behaviors, weight gain, and binge eating. (3) Language can lean heavily into shaming the individual for their choices, rather than understanding that everyone’s bodies, and nutritional needs are different.

The cycle of trauma, shame, and isolation in binge eating disorder

Weight stigma means people living at higher weight bodies are often judged and treated poorly due to their weight and size. Discrimination against people who have a higher body weight is so ingrained in our society that many people may be unaware of its implications, including the trauma these individuals experience due to social pressure and stigma.

Instead, people with larger bodies are often blamed for their weight and shamed as a means to motivate them to lose weight—despite the mountain of evidence proving that shame doesn’t lead to healthy eating behaviors and weight loss. 

In fact, people who are overweight frequently encounter negative stereotypes, such as the assumptions that they are lazy, and lack willpower or discipline when it comes to eating and exercising.:4 These harmful stereotypes are not true and often contribute to discrimination, weight stigma, and prejudice, which are so incredibly damaging to both mental and physical health. (4)

You cannot tell simply by looking at a person what they are going through internally. Many underlying mental health conditions co-occur with eating disorders, as well as past or present traumas, making them difficult to overcome simply by “willpower.” 

How weight discrimination increases binge eating behaviors

Research has revealed that the intense psychological stress caused by weight stigma contributes to weight gain and binge eating. In fact, stress caused by weight discrimination can increase appetite and dull the satiety system, which increases food consumption and fat retention, thereby creating a cycle that can be very challenging to break. (4)

Shame plays a huge role in the perpetuation of binge eating disorder as well. From trying to squeeze into small airplane seats to hearing “fat jokes” on TV, to having a doctor minimize their symptoms due to their weight, many people with binge eating disorder feel an intense sense of shame associated with their bodies. That shame can cause severe psychological distress and turmoil, which often leads to social isolation and further binge eating episodes.

Several studies have documented this connection in both adults and children who experienced weight stigma. These studies revealed that overweight children who experienced weight-based teasing were more likely to engage in binge eating episodes compared with overweight peers who weren’t teased. This is true even five years after the weight-based teasing occurred. Other research has indicated that weight stigma in children has been linked to lower levels of exercise and negative attitudes about sports. (4)

Similar findings have been found in adults with larger bodies. Numerous studies revealed that adults who have experienced weight discrimination engage in more frequent binge eating episodes. They are also at an increased risk for unhealthy eating patterns. Weight stigma causes significant psychological stress and shame, causing many people to try to cope with this stigma by engaging in unhealthy eating behaviors, such as refusing to diet, binge eating, and avoiding exercise. (4)

How to combat weight stigma 

Weight stigma is all around us—from work to school to doctors’ offices. Many of these places do not have policies in place to help combat weight discrimination and stigma. Instead, they frequently utilize outdated methods of health and body weight, such as Body Mass Index (BMI).

Some helpful things to do to reduce weight bias include: (5)

  • Providing training for healthcare providers on how to give compassionate care to patients with larger bodies, including those with binge eating disorder
  • Using anti-bullying policies in schools to protect students from weight-based discrimination and bullying
  • Addressing weight discrimination in workplace harassment training
  • Prioritizing public education about the complex causes of having a higher body weight, disproving common misconceptions

Although individuals may not have the power to implement various policies all on their own, they do have the power to make suggestions to their workplace or school. It’s especially important that people of “average” weight or without an eating disorder advocate for those affected by weight stigma.

Here are some things individual people can do to try to change the narrative around body shape, and size: (5)

  • Be mindful of language and use sensitive, person-centric terms 
  • Speak up when witnessing weight-based bullying or discrimination
  • Stand up to friends and family members who perpetuate negative stereotypes
  • Take the time to educate friends and family about the harms of weight stigma

If you are struggling with an eating disorder, or are feeling the pressures of weight stigma affecting your daily eating habits, we are here to help. Within Health treats every body, with our clinically-superior virtual care treatment programs

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Definition & Facts for Binge Eating Disorder.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  3. National Eating Disorders Association. (n.d.). Weight Stigma. 
  4. Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491
  5. Obesity Action Coalition. (2017). Combating Weight Bias: Why We Need to Take Action.

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