The phrase ‘binge eating’ is so commonly used and I think it’s important to distinguish that there is a difference between binge eating and binge eating disorder.
When we say we struggle with binge eating, it can be very subjective. What one person perceives as a ‘binge’ can be very different from how another person perceives one. For example, one might feel like they’ve binged because they added an extra serving to what they normally eat or they might have consumed a bar of chocolate, since they’re generally very strict when it comes to their diet and it may feel like a binge to them. Similarly, a binge for another person might involve very large quantities of food, such as several bars of chocolate, crisp packets, ice cream, and much more. In that sense, it is very subjective.
As an Eating Disorder Therapist, however, I thought it would be helpful to examine what binge eating disorder actually is and the criteria that we use to classify it. The purpose of this post is to provide a little bit of insight into what binge eating disorder is and then highlight the gray area of disordered eating in general, and that it doesn’t necessarily require a diagnosis, and what that might look like.
Classifying Eating Disorders
We use a criteria known as DSM five for classifying eating disorders. The diagnostic criteria provide us with guidelines around how we would classify binge eating disorder. Let me begin with the first criteria. It is characterized by recurrent episodes of binge eating. A binge eating episode is distinguished by both of the following. You need to have both of these.
- Within two hours, you’re eating an amount of food that is definitely larger than most people would eat in a similar period of time, under similar circumstances, so an unusually large amount of food within roughly two hours.
- In addition, there is a sense of loss of control over eating during that two hour episode. Feeling really like although one part of you might desperately want to start feeling like you have no control over it, and that you can’t stop it.
The second criteria is that your binge eating episodes are accompanied by three or more of the following.
- A person eats much more rapidly than normal
- Eating until they feel uncomfortably full
- Eating large amounts of food when you’re not feeling physically hungry
- Eating alone, because you’re embarrassed by the quantity that you’re eating
- Feeling disgusted with yourself feeling depressed or feeling guilty after overeating.
Criterion three then is marked stress regarding binge eating is present.
Criterion four, then is that the binge eating occurs on average, at least one day a week for a period of three months.
And finally, criterion five. The binge eating is NOT associated with the regular use of inappropriate compensatory behaviour. Compensatory behaviour refers to what you do to make up for your binge. You might purge by making yourself sick, fasting for a long time, or engage in excessive exercise to do this.
If you feel that you meet those criteria, what should you do?
This is such a hard question to answer and to be able to discuss. Whenever you feel like you’re struggling with something and need support, you should always consult your GP and seek help. Honestly, I am hesitant to even say that because I have unfortunately heard of horror stories where people have gone to their GP and said that they think they struggle with binge eating and have been offered advice, such as going to Slimming World or Weight Watchers, or you just need to eat less calories.
There is a lack of awareness around binge eating disorder among GPs, who are often simply misinformed. Additionally, the support and help that are available can be extremely limited. The resources of qualified and experienced eating disorder therapists are limited, and the funding is insufficient.
Horror stories aside, if you go to your GP seeking help, you may be offered a referral for cognitive behavioral therapy. CBT can be helpful in treating BED as it targets unhelping thinking, habits and behaviours associated with eating. It might however be limitied in terms of the number of sessions you receive and the counsellor may not have expereince working with Eating Disorders. As opposed no alternative proposal, I would say a referral is worth pursuing.
Referrals to eating disorder services are usually made only when someone’s body mass index is very low. People with anorexia are given priority. The result is that a huge percentage of people who struggle with binge eating disorder and bulimia don’t get the support or referrals that they need.
Hence we can make assumptions about eating disorders based on that. Often when we hear the words eating disorders, we immediately think of someone who is extremely thin. The truth is, binge eating disorder is actually the most common of all eating disorders.
There is a myth that if you have binge eating disorder, you’re more likely to be overweight. That’s not necessarily true, since it’s also possible to have an eating disorder and exist in many different sizes. Therefore, you can have binge eating disorder even if your body size is smaller. Additionally, you can have an eating disorder as well as a larger body size. Therefore, there are no hard and fast rules about what binge eating disorder looks like.
My personal view is that there is a huge spectrum of disordered eating. For individuals who recognize that they are having a very difficult relationship with food, they really struggle as they do not necessarily fit into one category of eating disorders. They might show several characteristics of all the eating disorders, but may not fall into any one specific category.
Should I seek help even if I don’t meet the criteria?
It would be very personal to you. Consider how your food issues impact you on a day-to-day basis. How they affect your day-to-day functioning. How much distress they cause you. When the answer to that is that it is causing significant distress, I would really urge you to seek help.
When it comes to choosing where you go, if you have a good supportive GP, then certainly making your GP your first port of call is a good idea. If that fails, or if it’s something you would prefer not to pursue, perhaps explore therapy with a qualified professional.
I would recommend you check out the credentials of the people you’re searching for, and make sure they have experience, as well as training, in working with eating disorders. A good place to start if your looking to work with someone face to face is https://eating-disorders.org.uk/
I have only a few limited 1:1 online slots available currently. If you’d like to find out more about how I can help you heal your relationship with food, book a disocvery call via https://www.eatology.co.uk/get-help-with-binge-eating/
If therapy is not an option at the moment, access to quality self-help resources may be beneficial. Here are a few https://www.beateatingdisorders.org.uk/get-information-and-support/get-help-for-myself/downloads-resources/helpful-books/