With the 2013 release of the Diagnostic and Statistical Manual, 5th edition, Binge Eating Disorder (BED) was recognized as a distinct eating disorder apart from the category of Eating Disorders Not Otherwise Specified (EDNOS) with which it had been previously grouped. For those who struggle with Binge Eating Disorder, this felt like a triumph—finally this malady was receiving recognition not simply as a physical issue, a lack of willpower or something easily fixed by dieting and a treadmill.
While this clarification is surely an advance, it doesn’t automatically make diagnosis any easier. The identification of Binge Eating Disorder is illusive given the hard-to-nail-down criteria. What constitutes binge eating for one sufferer may not qualify in the case of another. It is, then, a highly individualized disorder and one that is hard to pinpoint.
The difficulty also lies in that fact that there is not one established, textbook profile of the binge eater. Those who compulsively overeat do so in very different manners and for different reasons and with different results. What constitutes a binge for one may not be so for another person. Is eating two or three sandwiches in succession a marker of Binge Eating Disorder? For a middle-aged woman, it may very well be. For a high school male on the football team, this is a pre-practice snack. While quantity of food eaten does factor into the diagnosis of binge eating disorder, it is not a hard and fast indicator; the age, gender and activity level of the eater must also be taken into account.
And in a culture in which overindulgence is the norm, it is hard to differentiate between a sweet tooth, a fondness for food and an actual mental disorder. Is that extra helping to accommodate a gracious hostess or is it a binge? How many pieces of pie does one have to eat? So many people eat compulsively that it is hard to often find the clear line that distinguishes frequent poor choices and bad habits from a disorder having its basis in mental illness.
According to the Binge Eating Disorder Association, “Binge eating disorder (BED) is the most common eating disorder in the United States. An estimated 3.5 percent of women, 2 percent of men, and 30 to 40 percent of those seeking weight loss treatments can be clinically diagnosed with binge eating disorder.”
When it comes to binge eating, individuals tend to know it when they see it. They experience a sense of being out of control and an inability to stop eating — they eat great quantities not out of hunger but out of emotional need and craving. Food calls to them and they turn to it for validation, excitement, an escape, companionship, in fear, in distress, in a general sense of needing something and not knowing what. When there is this relation of emotional need that is seeking its satisfaction in food, the individual is moving into eating disorder territory. The situation is more than a stream of unhealthy choices or a proclivity for sweets, it is a mental/emotional disorder.
While many who suffer from binge eating disorder are overweight or obese, many are not. Due to high metabolism or a combination of compulsive eating and compulsive exercise, the individual may not show the physical signs of disordered eating, but the mental anguish is no less intense. Eating disorders are more than distress over what the eating or not eating does to the physical self. They are mental illnesses that are often wrapped up in anxiety, depression and past trauma. The real disease is a mental one, the eating patterns and the physical appearance of the illness are merely symptoms.
Treatment generally has, as its aim and focus, the reestablishment of a peaceful and healthy relationship between the individual, his or her body and food. Long-term recovery will always involve the kind of therapy that helps the Binge Eating Disorder sufferer dig deeper into his or her past, seeking out instances of trauma, abuse, bullying and dysfunctional family patterns and relationships. In order to recover and learn new patterns, the old patterns must be examined and healing must be sought. Though the disease is crafty and difficult to understand, recovery and hope of a healthy relationship with food is possible.
The DSM describes Binge Eating Disorder as such:
Binge eating disorder is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. Someone with binge eating disorder may eat too quickly, even when he or she is not hungry. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior. This disorder is associated with marked distress and occurs, on average, at least once a week over three months.