Am I Bingeing or Am I Overeating?

Are you unsure if those instances of excessive eating are a harmless indulgence or a possible sign of binge eating? Join me as I explore the staggering statistics that reveal how this disorder affects millions of lives and its profound seriousness.

I shed light on the emotional and psychological factors driving binge eating, as well as the toll it takes on one's physical and mental health, affecting their overall quality of life. I share with you the various treatment options available, from therapy to essential nutritional support. So whether you're personally affected or simply curious to learn more, tune in to gain insight into the complex nature of binge eating disorder.

TOPICS COVERED 👇 

Binge Eating vs. Overeating [00:02:06]

Binge Eating Disorder Diagnosis [00:04:29]

Physical and psychological symptoms [00:12:40]

Therapy options [00:19:58]

Nutrition interventions [00:21:11]

RESOURCES MENTIONED

Beating Binge Eating Disorder in Less Than 4 Months (Client Confessional with Breanna) Episode

How Christen Stopped Bingeing After 25 Years (Client Confessional) Episode

Read the article associated with this episode here

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Transcript

Welcome back to the Nurture Free podcast. I'm your host, Michelle Yates, a registered dietitian who specializes in eating disorders. If you're new to this show, this is where I like to create space for conversations around things that people typically don't talk about, like eating disorders or body image or binge eating. And today's episode, we're diving deep into that topic. We're talking about binge eating. Binge eating is one of the most common concerns among the women that I work with, because binge eating can be a really sensitive topic and there's a lot of shame around it. I like to be really intentional about talking about it on the show and in my social media, because I want those who are struggling with binge eating to not feel so lost and like they have no idea what to do about this thing they're struggling with. Today's episode is specifically about how to know when you are binge eating instead of just like overeating. So I'm going to walk through some of the signs and symptoms that you can be looking for. We'll also talk about risk factors and some treatment strategies.

Be sure to subscribe to the show because in the next episode is going to be about the difference between emotional eating and binge eating. So you're definitely going to want to listen to that. If you struggle with either or, if you just struggle to know the difference between the two. Let's get into it. Binge eating disorder is estimated to be actually more common than anorexia and bulimia combined, which is interesting because when we think about eating disorders, we typically think about anorexia, maybe bulimia, but we do not think about binge eating disorder. But from what we're seeing in the data, it's actually more common than both combined. And I think a big reason why this is so surprising is that people aren't really talking about it. They have a hard enough time talking about when they're struggling with anorexia and bulimia. But binge eating disorder has this extra layer of shame around it. And so I actually think that the reports we have are really underreported. And there's probably many more cases of it than we know of. But other than that, if people are seeking treatment, they might be doing that much more privately and not sharing it with other people, which is why data like this can be really surprising because we just aren't having conversations around binge eating.

So what is binge eating? Let's talk about binge eating just as a symptom, not binge eating disorder, which we will get into. But let's talk about the symptom of binge eating. So binge eating is characterized as eating an amount of food, typically within about a two hour window that is definitely larger than anybody else would eat in that same circumstance. So when we're talking about like a Thanksgiving binge, I wouldn't really call that binge eating because everybody else is doing that. And remember that it has to be an amount that is definitely larger than anybody else would eat in that same circumstance. So Thanksgiving doesn't count. There also has to be a feeling of loss of control around the eating episode. Some people will describe this as like storm eating or were they black out and they don't remember it. Some are fully cognizant of what's going on, but it's just that there's this disconnect between it's almost like they can't think fast enough to tell their body to stop. And before they know it, all of the food that was in front of them is gone and they've over eaten to the point of maybe feeling sick or feeling definitely uncomfortable.

So if we really look at this definition, it isn't the most cut and dry explanation of what a binge looks like. It's kind of subjective because what one person defines as definitely larger than somebody else would eat in that same circumstance might be different than what somebody else's definition is. So it's not the most perfect explanation of what a binge is, but it's kind of the best we got right now from a clinical standpoint. Now, when there's recurrent episodes of binge eating, then we may be looking at a binge eating disorder diagnosis and official eating disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition, in other words, the DSM five, the official criteria for binge eating disorder is as follows As number one, the binge eating has to be happening at least one day a week for three months. Now, binge eating is as defined in the way that I just described it. That loss of control around the eating episode and the eating episode is a large amount of food more than anybody else would eat in that same circumstance in a short period of time, typically about two hours or less.

So that has to be happening at least one day a week for three months. Binge eating disorder is also not the same as bulimia nervosa, which involves some sense of compensatory behaviors that could be purging or vomiting, that could be laxative use exercise, Fasting Binge eating disorder does not involve trying to get rid of those calories. So that's a really big distinction here, is that there's no compensatory behaviors. Those with binge eating disorder also experience a great sense of distress. Over the bench and at least three of the following points are true eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when they're not physically hungry, eating alone because they're embarrassed by how much one is eating or feeling disgusted with oneself or depressed or very guilty after eating. So at least three of those statements that I just said need to be true. And that's what creates a binge eating disorder diagnosis. There's also differing levels of severity depending on how often the binges are happening. Now, how is that different than just overeating? Well, this is tricky because there's no official definition for overeating.

But I think we can agree that overeating is just having a few more bites than was actually needed. Right. Which can lead us to feel maybe a little extra full, maybe even uncomfortable. But binge eating, on the other hand, is more like we've eaten so much food so quickly that we're physically sick or it's painful how full you are. Official binge eating also involves feeling a loss of control during the binge. And typically with overeating, we're not going to feel that way. We are fully conscious of the fact that we're eating more like it can happen a lot during a social situation too. So I don't want you to think like, Oh well, because I lost track of time and I was talking with friends, that means I binge. Not necessarily. I would say that's just overeating too. So there's going to be a lot of nuances to like I said, the definitions aren't perfect. They're not cut and dry. So kind of use your discretion here around the circumstance. But generally speaking, with a binge, we feel a loss of control and we eat so much that it feels like we're physically sick or it's painful.

With overeating, there's not usually a sense of loss of control, and we're getting to a point where it's more just like uncomfy and it's just too much. But it wasn't like a massive amount. So I want to revisit really quick this discussion around bulimia nervosa and highlight again the key differences there between binge eating disorder and bulimia nervosa, which is that bulimia involves those compensatory behaviors and binge eating disorder does not. So if anybody tells you that they have binge eating disorder, but they're somehow making up for those calories eaten by fasting or exercising or purging or abusing laxatives, then that is not true. Binge eating disorder. That's more of like a bulimia nervosa type of situation. I also say this with hesitation because I think the labels aren't really that important here. Obviously, this is a discussion around what binge eating looks like and binge eating disorder diagnoses and all of that. I think in some sense those can be helpful. But in others I just want to say that if you're struggling with food, it doesn't matter if you have a diagnosis or not or if you fit this specific criteria or not.

And I feel compelled to say that because when I was struggling with my relationship with food, I, I remember reading through the different diagnoses and I was like, that sounds like me, that sounds like me, that sounds like me. But that doesn't and that's not quite where I'm at. So therefore I don't have that problem. Therefore I don't have a problem. And so it was really easy for me to just justify away that I didn't need help or that I was fine, just purely based on the fact that I didn't fit these criteria perfectly for having an official eating disorder. Now, at different points of my life, I did. And I but, you know, of course, those are times when I'm not actually looking at the diagnoses. So I just, like I say, all this to highlight that you don't need an official diagnosis to get help or to need help or to be someone who would benefit from help. So please get the help if you're struggling with food at all, if it stresses you out at all, you deserve help and you don't need to wait until you're, quote unquote sick enough.

Okay, moving on. That was a bit of a tangent. It wasn't in my notes, but I felt compelled to say it. So how common is binge eating disorder? I already talked about how it's more common than anorexia and bulimia combined. But let's talk about numbers here. So binge eating disorder has an estimated prevalence of about 1.5% of women and 0.3% of men worldwide. But America seems to have a higher rate than the global estimates, with about 3.5% of women and 2% of men struggling with binge eating disorder. I just did the math, and that's about 11,550,000 women in America are struggling with binge eating disorder. So, yeah, it is a problem that many women are struggling with. And as I mentioned earlier in the episode, we think that that's underreported anyway because most women don't want to volunteer the information that they're struggling with binge eating. And that goes for men as well. A lot of times I say women, but that's just because that's who I work with. It's also applies to men.

A lot of men don't want to volunteer that information either. It's important to note here as well that the research done on Americans to come up with those estimates of 3.5% for women and 2% for men was based on a study done only on 9000 people, which is a tiny pocket of people compared to our US population of about 332 million. So keep that in mind that this isn't the best data and we can't necessarily generalize it, but as far as we know, it's the only data we have on this. So we kind of are using it to generalize. So it's not perfect, but we do know that it's a problem, that's for sure. Now, what about specific populations? Is there anybody in particular who's most at risk for binge eating disorder? I don't have a perfect answer to that. But what I do know is that there were two meta analyses from 2023 reviewing 39 studies total. And we were seeing that in those meta analyses that about 1.3% of children and adolescents meet criteria for binge eating disorder and 3% for subclinical binge eating disorder.

And what subclinical means is that they just don't quite meet the criteria for binge eating disorder. But they're close. Young adults are potentially the most at risk because we are seeing some reports of binge eating disorder beginning in late teenage years or early 20s. But it has been reported in both young children and older adults as well. I mean, honestly, nobody is immune to this. If you want to see the studies that I'm referring to, I will link all of those in the article associated with this podcast episode. So just look for that in my show notes. Okay. So I want to talk about some really common signs and symptoms of binge eating disorder. We've talked about diagnostic criteria and some clinical signs, but I want to talk more about like the nitty gritty, specific things that might be a sign you're struggling with binge eating disorder. So let's get into it. Remember, this is not a substitute for meeting with a health care professional and discussing your specific case, but hopefully it will help you to understand a little bit more about your story and give you the encouragement to reach out for help if that's what you need.

Some behavioral signs of binge eating can be large amounts of food disappearing, sometimes without even memory of eating it. If we're hiding food or finding empty containers and wrappers, stockpiling food, maybe you're saving up calories all day so that you can binge at night. Maybe you're actually looking forward to that. Eating in secret, withdrawing from social activities or driving by a drive through to eat large amounts of food alone in the car. I've even talked with somebody who said that they would go by a drive thru after eating with their family, like their parents, when they didn't live at home. So they were going to their parents house eating dinner with them, and then they would go by the drive thru after and have a whole other meal and binge on that while they were alone. Some psychological symptoms of binge eating can be depression, distorted body image, feelings of shame or guilt or embarrassment, anxiety about food or anxiety about others. Seeing your body feeling like you're not good enough, maybe even suicidal thoughts or feeling disgusted towards yourself.

And then some physical symptoms of binge eating and side effects of binge eating can be fluctuations in your weight. Excessive weight gain, eating until becoming physically sick, high blood pressure, high cholesterol, coronary artery disease, cardiovascular disease of any kind, painful joints, gastrointestinal problems like diarrhea, bloating, nausea, constipation, acid reflux, maybe even pre-diabetes or type two diabetes or possibly some difficulty sleeping. As binge eating disorder becomes more and more common, we do need to step back and evaluate some potential risk factors that are contributing to binge eating disorder rising in terms of prevalence. Here are some things that the research is showing may increase your chances of binge eating. So if we have a family pattern of disordered eating, any disordered eating, it doesn't have to be binge eating. It can be a mom who was hyper obsessed with dieting and always going on a diet, or maybe she was struggling with binge eating or just openly used food as an emotional coping mechanism. Which brings me to my next point. If you have a family pattern of dysfunctional emotional coping in any way, not necessarily just food, if you have a family history or personal history, I mean of trauma or abuse, if you have a personal history of food insecurity, maybe you grew up with not a lot of money.

And so food was not necessarily guaranteed. It wasn't something that you knew you were going to get that day or you knew you'd be able to have a meal in a few hours. Maybe you have ADHD, PTSD, substance abuse disorder, body dysmorphic disorder or body dysmorphia or difficulty self regulating. All of these things can be risk factors that increase your chance of binge eating. So I mentioned earlier how it's important not to wait until you're sick enough to get help with binge eating. And I want to talk about when it is appropriate to get help. And what I will say is that, honestly, the earlier you can get help, the better, because binge eating left untreated may lead to some serious physical conditions like chronic pain, excessive unhealthy weight gain, diabetes, heart disease. And psychologically, the impact it can have is huge. It can wreak havoc on someone's mental health. About 1 in 5 individuals struggling with binge eating disorder attempt suicide. So this is not something that you want to wait until it's bad enough to fix.

Binge eating may even be impacting your marriage. A study done this was really interesting. A study done on over 2000 married women with binge eating disorder showed that binge eating was comparable or even worse for a marriage than other psychiatric conditions. So this can be wreaking havoc not only in our mental health, your physical health, but also just the health of your marriage. So needless to say, this can have a really huge impact on you, and I don't want you to put it off and put it off and put it off. And then by the time you actually get help, you've actually had some pretty irreversible damage done. Get the help. If you identify with binge eating in any way, shape or form, even if you don't meet official criteria or have like the official definition of a binge, it's still worth reaching out. If you question at all that you might not have a healthy relationship with food. So I've talked a lot about binge eating disorder and the criteria for a diagnosis. How is it actually diagnosed though? Is there like a lab test for that or how does that how does that work? So receiving a binge eating disorder diagnosis, it's up to you if you find that that's necessary or not.

Because like I said, you don't need a diagnosis in order to be in a place where getting help would be beneficial for you. But maybe there's some motivation there, like insurance coverage or just peace of mind, I don't know. So if you'd like to receive an official binge eating disorder diagnosis, then you'll want to have either an appointment with your primary care physician or with a psychiatric doctor to get that diagnosis. They are the ones that can do that. So maybe you have a diagnosis, maybe you don't. But regardless if you feel that you're struggling with binge eating, then you probably also want to know how the heck do I fix this thing? So let's talk about some tips for recovering from binge eating or recovering from binge eating disorder. So binge eating is a biopsychosocial condition, which just means it involves someone's biology, psychology and sociology, which means it's complicated. It's not as easy as just not doing it anymore or just like keeping food out of the house. Right. It's complex. There's a lot of layers here.

So to try and fix binge eating with these quick fix Band-Aid solutions is ultimately a disservice to somebody because when we're not digging deep into all aspects of this, it's just delaying this, getting any better. And ultimately, that delay might make things even worse for someone. So in order to truly heal and recover from binge eating disorder, we need to take an all inclusive approach. Now, the gold standard treatment for treating any eating disorder, including binge eating disorder, is working with a therapist. A dietician, a psychiatrist if needed, and a medical doctor if needed. Now, the psychiatrist, if needed, is is just if you need any type of psychiatric medications for depression, anxiety, bipolar disorder, whatever. And then having a medical doctor on the team is just so that you can make sure that physically your labs are fine. There's no like immediate medical needs that need to be addressed. But other than that, those are more as needed. The therapist and the dietitian are really essential for attacking all aspects of what's happening inside of someone's relationship with food that's causing them to have binge eating disorder.

So I mentioned therapy. Cognitive behavioral therapy or CBT is actually assigned as great a treatment for binge eating disorder. There is some evidence that even self guided CBT has some really promising results, as well as interpersonal psychotherapy, which is IPT for short or dialectical behavioral therapy, which is DBT. So therapy can for sure be incredibly helpful. But there's even some promising research, like I said, showing that self guided CBT can be helpful in some cases. I know I mentioned getting medication from a psychiatrist if needed. That's really in the cases of like if we need antidepressants or other psychiatric medications to help reduce the psychological barriers that someone might have for full recovery from binge eating disorder. And it's worth bringing up because I just want to normalize that. Like, hey, sometimes there's just a chemical imbalance. You might need some medication or some help for medication, and that's okay. And then when it comes to nutrition interventions for binge eating disorder and the role of the dietitian, one of the goals of binge eating disorder recovery is to normalize eating patterns and increase psychological well-being.

So typically, when somebody is experiencing guilt or shame around their food choices and the way they eat and the way their body looks, that can actually be a trigger that drives them to food even more. So it doesn't make sense for us to take this really like, deity like weight loss approach to diet and nutrition when we're struggling with binge eating disorder because that might just make the shame and the guilt worse and make the binge eating worse. So for that reason, I have found, and with the research is telling us to, is that having a positive relationship with food and really working on like the holistic aspects of our relationship with food is often so critical in binge eating disorder recovery, especially removing like the good and bad labels and getting off of like the diets that make us feel so bad about ourselves and just drive us to food even more in the long run. And also with a dietitian you can work to normalize eating patterns and reduce cravings for binge foods. So often there's some education that's needed around blood sugar stabilization and consistent balanced eating. Some work is also done around gentle nutrition and how we can still have some nutrition goals, but it doesn't mean that we're going to be obsessive about it and we're definitely not going to be following a diet.

So when you're working with a dietitian, it's not going to be a rigid plan that tells you exactly what to eat and when to eat it. It's more of a flexible, intuitive, eating approach that takes into consideration what you like and don't like. And then also just like the timing of your day and what works for you and your lifestyle. So that's something that I think is so wonderful about working with a dietitian is that it's really individualized and it's going to be whatever it needs to be for you. Now, what if you're the one who doesn't have a diagnosis but you are worried that you might have a binge eating problem? What can you do about that? I would say that binge eating is still a problem. Even if you don't meet the official criteria, it's still a problem. If you are eating in a way that makes you feel bad about yourself and it's making you feel guilty or it's making you feel ashamed, or you're just obsessed with food and it's ruining your mental health, that is a problem that is causing you some emotional distress. So you deserve help. You don't need to wait until you meet that criteria. So in that case, what I would do is actually follow up with a dietitian.

Even if it's not an official binge eating disorder diagnosis, you can still meet with a dietitian and get help. Dietitians are equipped to work with people struggling with food in any capacity. And remember that dietitians can work with you to normalize your eating patterns and reduce cravings for binge foods and really help you to create a more balanced relationship with food and to help you not have so much emotional distress around food. So I would say the dietitian route would be a great route for you. And also a therapist, a therapist can be really great to help you manage some of the psychological components of binge eating. So regardless of whether or not you have that official diagnosis, please know that you're not alone in your struggles with binge eating. And that there are people out there who can help you with this. So that is it for today's episode, but don't forget to subscribe so that you don't miss the next episode where I talk about the difference between emotional eating and binge eating. And as always, I really appreciate you being here. You're taking the time to listen to this show. It means a lot to me. And if you're struggling with binge eating, please reach out for help, whether that's with me or with someone else, you deserve to have a peaceful and positive relationship with food and your body. And it is possible. So thank you for being here today. Have a great day.