Signs and symptoms of binge eating disorder

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The prevalence of binge eating disorder (BED) is on the rise in the US, with an estimated 1.25% of adult women and 0.42% of adult men having the condition. (1) Therefore, it’s important to understand the signs and symptoms of BED so you can recognize them in yourself, or support a loved one you suspect is struggling

Binge eating disorder can be hard to detect, as the guilt and shame that often come with binge episodes can result in secrecy around eating habits. Binge eating is a cyclical condition, rotating from binge eating episodes to food restriction that leads back to bingeing.

As bingeing episodes increase, people may start to experience physical effects that can have a negative impact on their quality of life. While potentially severe, if treated quickly, these physical effects can be reversed.


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Signs of binge eating disorder

Physical signs of binge eating disorder

Weight fluctuation

People with BED often have noticeable fluctuations in weight the longer the binge and restriction cycle continues. More often than not people will gain weight as a result of regularly bingeing on large quantities of food. Although, not all people with BED are overweight.

Cardiovascular issues

A growing number of studies have indicated that the weight fluctuation and weight gains seen with BED can increase the likelihood of developing signs associated with metabolic syndrome and heart problems. (2,3) They include:

  • Lack of physical fitness
  • High cholesterol
  • High blood pressure
  • Heart disease
  • Type II diabetes

Gastrointestinal disturbances

Repeated binging episodes can result in long-term effects on the gastrointestinal system. In extreme cases, it can result in acute gastric dilation and gastric perforation, where the stomach becomes so full, it ruptures. (4)

Skin and hair effects

It’s common for people with BED to eat large amounts of food during bingeing episodes. These eating habits are unlikely to meet the body’s full nutritional needs, which can result in the hair becoming brittle and/or falling out. 

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Emotional and behavioral signs of binge eating disorder

Eating habits

A person with BED will often display some distinctive eating habits. They may eat very quickly, become distressed at mealtimes, skip meals, eat lightly during the day but eat more at night, eat a large amount of food over a period of just a few hours, and/or choose to eat alone.

Food rituals

A person with BED may develop noticeable food rituals, such as only eating a particular food group, excessive chewing, skipping meals, eating small portions at mealtimes, hoarding food in strange places, hiding empty food wrappers, and being secretive about what they eat.

You may also notice that someone is frequently engaging in food restriction, fasting, or dieting with little weight loss. (5)

Anxiety and depression

BED commonly co-occurs with several psychiatric disorders. Mood disorders are seen in 54.2% of those with BED,  especially anxiety, which co-occurs in 37.1%. (6) This may manifest as irritability, isolating, sensitivity when people discuss food, and problems functioning at work, school, or in social settings.

Other mental health issues that commonly occur with BED include: (7)

  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder
  • Self-harm
  • Alcohol or substance use
  • Borderline personality disorder

Symptoms of binge eating disorder

Physical symptoms of binge eating disorder

Low energy levels and fatigue

Bingeing often involves an intake of a large amount of calories, flooding the body with sugar, carbohydrates, and fat. This influx of food requires a large amount of energy to digest, which can lead to fatigue and low energy levels.

Gastrointestinal discomfort

Bingeing episodes can cause people to feel uncomfortably full or nauseous. Furthermore, ingesting large amounts of food in a short space of time can lead to heartburn, acid reflux, bloating, and abdominal pain. (8)

Binge eating may also lead to irritable bowel syndrome with BED patients, showing an increase in the instances of diarrhea, constipation, feelings of an anal blockage, and chronic stomach discomfort. (8)

Emotional and behavioral symptoms of binge eating disorder

Feeling a loss of control when eating

Binge eating is completely different from overindulging. One of the major characterizations of BED is a feeling of a total loss of control over eating during bingeing episodes. This is often evidenced by:

  • Eating despite having no appetite
  • Eating large amounts of food over a short period of time
  • Eating until uncomfortably full

Self-medicating with food

Those with BED may struggle to cope with negative and uncomfortable emotions in a helpful or constructive way. Instead, they may deal with emotional stress and negative thoughts by binge eating. A person may feel a sense of relief and respite from their emotions during a binging episode, but it’s often short-lived. 

Feelings of shame and guilt

Following a binge episode, many people may experience feelings of shame or guilt. (9) This can result in secret eating  or hiding all the evidence of a binging episode.

Feeling of shame may extend to when they are with other people, for example, feeling too embarrassed to eat high fat or high sugar foods in front of other people.

Low self-esteem

BED is a vicious cycle. People binge to distract from negative emotions. The resulting feelings of shame can lead to feelings of worthlessness. (10) The bad feelings associated with a poor self-image can trigger another binging episode. And so the cycle continues.

In addition, people with BED may have a distorted or overly negative body image, which exacerbates feelings of low self-esteem. As a result, a person may hide their body with baggy clothing. A poor body image could also be an indication that someone is also struggling with body dysmorphic disorder.

No purging

Unlike someone with bulimia nervosa (BN), someone with BED won’t regularly compensate for extra calories by exercising excessively, using laxatives, or inducing vomiting. Instead, BED sufferers may restrict their diet regularly to try and offset the binge episodes. However, this may lead to more binge eating. (11)

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When to get help for binge eating disorder

If you notice recurrent episodes of binge eating (at least once a week for 3 months), along with several of the above signs and symptoms, it’s time to seek help for binge eating disorder, either for yourself or your loved one.  (6)

It can be hard to identify providers who are trained and knowledgeable about disordered eating. Medical providers are not always familiar with the nuances of eating disorders and the multidisciplinary team approach that is often most helpful to treat eating disorders effectively.

In fact, they may not be aware of all the risks involved and potential harm providers unknowingly and unintentionally inflict by being uninformed. Many health care providers do not fully understand how a preoccupation with BMI, internalized weight stigma or fat phobia, and diet culture can have a negative impact on people who are struggling with eating and body image challenges--and may even perpetuate eating disorders.

A comprehensive treatment approach may entail a team of medical professionals, dietitians, counselors, therapists, and other practitioners to help patients in their healing journey. 

Within Health offers virtual treatment programs for eating disorders that are attuned to your needs. If you or someone you love needs support, call our clinical care team to learn about your care options.

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. Udo T, Grilo CM. Prevalence and Correlates of DSM-5-defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biological Psychiatry. (2018) 84(5):345–35
  2. Mitchell, J.E., Medical Comorbidity and Medical Complications Associated with Binge ating disorder. (2016) Int. J. Eat. Disord., 49: 319-323
  3. Mathisen, TF, Rosenvinge, JH, Friborg, O, et al. Body Composition and Physical Fitness in Women with Bulimia Nervosa or Binge ating Disorder. Int J Eat Disord. (2018); 51: 331– 342.
  4. Sato Y, Fukudo S. Gastrointestinal Symptoms and Disorders in Patients with Eating Disorders. Clin J Gastroenterol. (2015) Oct;8(5):255-63
  5. Physical Signs and Symptoms of an Eating Disorder. National Eating Disorders Association. (2019, August 22). 
  6. Santonicola, A., Gagliardi, M., Guarino, M., Siniscalchi, M., Ciacci, C., & Iovino, P. (2019). Eating Disorders and Gastrointestinal Diseases. Nutrients, (2019) 11(12), 3038. 
  7. Cremonini F, Camilleri M, Clark MM, Beebe TJ, Locke GR, Zinsmeister AR, Herrick LM, Talley NJ. Associations Among Binge Eating Behavior Patterns and Gastrointestinal Symptoms: a Population-based Study. Int J Obes. (2009); 33(3):342-53.
  8. Mandl, E. (2019, December 3). Binge Eating Disorder: Symptoms, Causes, and Treatment. Healthline. 
  9. Wheeler, R. B. (2021). Binge Eating Disorder Symptoms. WebMD. 
  10. Mayo Foundation for Medical Education and Research. (2018, May 5). Binge ating Disorder. Mayo Clinic.

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