[Article updated on 19/09/2023]

Less known than bulimia and yet more common, binge eating disorder is also one of the eating disorders in the same way as anorexia. Its repercussions are both physical and psychological.

Definition

Conduct or eating disorders (TCA) are considered mental illnesses. The DSM-V (Diagnostic and Statistical Manual of Mental Disorders) distinguishes, among others, anorexia nervosa, bulimia, binge-eating disorder, pica (ingestion of inedible substances), merycism (regurgitation and remastications) and selective and/or avoidance feeding.

Binge eating disorder and bulimia have in common recurring episodes of binge eating. These crises are defined by the occurrence of moments, most of the time, hidden from the eyes of loved ones, where we will relatively quickly ingest large quantities of foods that we like (but sometimes also that we do not like). don’t like) with a feeling of loss of control. This is often followed by feelings of excess, heaviness, guilt and self-devaluation.

Where binge eating disorder differs from bulimia is that we are not going to try to compensate for this crisis to avoid gaining weight even if weight remains a significant concern. So no induced vomiting, no taking medications or other inappropriate compensatory means.

This is why, also unlike bulimia, if we suffer from binge eating disorder, we tend to be overweight or obese.

Diagnostic and severity criteria according to the DSM-V

A – Episodes of binge eating (absorption in less than 2 hours of a large amount of food with feeling of loss of control) take place at least once a week for 3 months.

B – These episodes are associated with at least 3 of the following elements:

• Eat a lot faster than normal;
• Eat until you feel painful feeling of abdominal distention ;
• Eating large amounts of food in the absence of feelings of physical hunger ;
• Eat alone because we are embarrassed by the quantity of food we absorb;
• Feeling disgusted with yourself, depressed or very guilty after eating too much.

C – These crises are the source of marked suffering.

D – These crises are not associated with compensatory behaviors.

These criteria are given for information only and should be put into perspective. From the moment you suffer from your eating behavior or have questions about it, it is important to consult a healthcare professional trained in eating disorders. Be careful not all health professionals are necessarily, except it is essential to understand these disorders to have the kindness and empathy necessary to welcome the confidences of someone who suffers from their eating behavior. Otherwise, the professional risks making the situation worse.

Populations at risk and epidemiological data

Binge eating disorder officially affects 3 to 5% of the population but this figure is considered underestimated because people suffering from eating disorders rarely talk about it. Unlike bulimia which is mainly female, binge eating disorder almost affects both men and women. It is often diagnosed in young adults (over 20 years old) but can also affect, in a more severe form, younger people. According to several studies, 20 to 50% of people who consult a health professional for being overweight suffer from binge eating disorder.

The causes of the appearance of binge eating disorder are not yet perfectly defined, but there is a greater risk of developing it in:

• People who have a family history of TCA: if one of your parents suffers from TCA, your risk of developing it is greater;
• People who have a history of TCA: once cured, the risk of relapse always remains possible;
• People who have suffered trauma or sexual abuse;
• People who have followed restrictive diets. This criterion is a little less specific for binge eating disorder but it seemed important to me to mention it because even if it is not necessarily at the origin of the disorder, it aggravates it.

Risks associated with binge eating disorder

The risks associated with binge eating disorder are:

• Anxiety and/or depressive disorders with sometimes suicide attempts;
• Addictive disorders;
• Difficulties in managing emotions;
• Digestive disorders: gastroesophageal reflux, bloating, abdominal pain, bad breath, etc.
• Sexual disorders, reduced fertility or infertility;
• Obesity and all its complications;
• Hepatic steatosis (fatty liver)

Treat yourself:

Binge eating disorder can be treated regardless of when treatment begins. However, the earlier this start, the easier the cure and prevention of chronic forms, complications and relapses.

The treatment is multidisciplinary (psychiatrist or psychologist, dietician, attending physician), long and there will be improvements and relapses before you can really get out of it. Ultimately the objective is to return to a regulated, balanced and pleasant diet as well as to significantly improve one’s self-esteem and body image. Support may also include family.

Psychological support: Cognitive and behavioral therapy is the most used but other approaches are possible. The work will focus on possible trauma, emotion management, self-esteem, body image and eating behavior.

Dietary support: The work of the dietician will make it possible to distinguish between what is related to an eating disorder and what is related to a regulated diet. It will also allow you to fully understand what binge eating disorder consists of, to relieve your guilt, to work on preconceived ideas, to refocus on a pleasant diet while respecting your bodily sensations (hunger, satiation and desire to eat). Management of overweight or obesity can also often be implemented in parallel or as a second intention.

Medical care : The doctor will monitor the progress of the disease, the state of health and treat any possible complications.

Sources:

• FFAB – French Anorexia Bulimia Federation – Hotline for patients, families, loved ones and professionals.
• High Authority for Health – Bulimia and binge eating disorder: Identification and general elements of treatment.
• Association Otherwise