What Is Binge Eating Disorder?
Comprehensive information for you or a loved one — including treatment options and discounts on popular medications.
Binge eating disorder (BED) is when you have repeat episodes of binge eating. A binge means eating a large amount of food in a short time — more than most people would eat in the same setting. It’s different from simply overeating. During a binge, people with BED often feel distressed or like they can’t control the amount (or type) of food they eat.
Though BED wasn’t officially recognized as a separate eating disorder until 2013, it’s actually the most common eating disorder in the U.S. It affects between 2% to 5% of adults and 1% to 3% of adolescents and children.
BED can affect people at any age, but it usually starts in teens or young adults. It’s somewhat more common in women, but it can affect anyone. While many people may think that eating disorders only affect young, white women, they’re just as common in people of color.
BED also affects all body sizes — only about half of people with BED are considered to have obesity according to their BMI (body mass index).
There’s no single cause of BED. Factors like your genes, behaviors, and life experiences may play a role in whether you’re at risk for developing BED. Each person is different, but here are some common risk factors for BED.
Physical and genetic risk factors:
Having a close relative (like a parent) with an eating disorder
Having a family member with a mental health condition
Having an anxiety disorder
Having a history of controlling your weight through diets or other methods
Having certain genes that may be linked to BED
Having Type 1 diabetes, which can lead to skipping insulin injections to stay thin (diabulimia)
Psychological risk factors:
Being a perfectionist, especially toward yourself
Being unhappy with your body image
Having a hard time changing your behaviors
Social risk factors:
Feeling lonely and isolated
Being exposed to weight stigma (discrimination or stereotyping based on weight)
Being teased or bullied in the past, especially about weight
Having a traumatic life event or stress
People with BED have repeated episodes of binge eating. During these episodes:
A person eats a large amount of food in a short period of time. The amount of food is more than what most other people would eat in the same setting.
The binge feels beyond a person’s control. They feel they can’t stop or control what they’re eating.
For BED to be diagnosed, a person must have distressing episodes of binge eating at least once a week, for at least 3 months. To “qualify” as binge eating, the episodes must also have at least three of the following features:
Eating much faster than normal
Eating until uncomfortably full
Eating a lot of food even when not hungry
Eating alone because of shame
Feeling depressed, guilty, or disgusted with the binge eating behavior
Other signs of possible BED include:
Hiding food containers or wrappers
Gaining or losing a lot of weight
Being preoccupied with your weight, food, and body
Skipping meals or eating at unusual times
Eating to deal with stress
Having frequent and intense food cravings
If you’re concerned about binge eating disorder, talk to your healthcare provider. They will ask you about your eating habits, feelings, and behaviors related to food as well as any other problems you might have. Sometimes they might do a physical exam or order other tests to make sure.
Your provider can use all of this information to decide whether or not you have BED. They may also use the DSM-5 (a clinical manual) to confirm your diagnosis. The DSM-5 is a book that lists all of the symptoms of mental health conditions, including eating disorders.
And keep in mind: It might take a few visits to your provider before you know for sure if you have BED. It’s important to be patient. Though it might feel hard to talk about food, try to be as honest as you can. And if you need to, don’t be shy about taking a stand against weight bias. All of these things can help you get the right diagnosis as soon as possible.
Binge eating disorder is treated with therapy and medications. Treatment often involves a team of providers, like a primary care provider, psychiatrist, and nutritionist. The main goal is to work together to reduce binge eating episodes.
Therapy is a first-choice treatment for BED. Options include:
Cognitive behavioral therapy (CBT): CBT can help identify and change your thoughts, feelings, and behaviors.
Interpersonal psychotherapy: This can help improve relationships and resolve interpersonal issues.
Dialectical behavior therapy: This can help people accept themselves, change their behavior, and regulate difficult or overwhelming emotions.
If in-person therapy for BED isn’t available in your area, there’s evidence that online therapy may also be an effective alternative.
Medications can also be used along with psychotherapy. Most medications work by decreasing binge eating behavior or treating obesity associated with BED. Scientists continue to study new medications.
Here are some of the most commonly used medications:
Lisdexamfetamine (Vyvanse) is the only medication the FDA has approved to treat BED. It works by stimulating your brain to release dopamine and norepinephrine, chemicals that lower the urge to binge.
Topiramate (Topamax) is a medication commonly used to treat seizures and migraines. It can help lower binge eating and extra weight in people with BED. This medication is used “off-label” for BED.
SSRIs, like citalopram (Celexa) and sertraline (Zoloft), are examples of medications often used to treat depression that can work for BED. These medications are also used “off-label” for BED.
Living with — and treating — an eating disorder can be challenging. Be kind to yourself and take it one day at a time. Here are some self-care tips that can help:
Find a healthcare team that you trust. Your team might include your primary care provider, a therapist, a nutritionist, or other healthcare provider(s). What matters most is finding a team that supports and listens to you.
Stick with your treatment plan.
If you have a setback, don’t give up on the whole plan.
Don’t diet unless you’re in a supervised weight-management program.
Avoid your triggers as much as possible.
Find a friend or family member you can talk to about what’s going on.
Try keeping a journal of your feelings and behaviors.
Consider joining a support group.
Binge eating disorder, anorexia, and bulimia are different types of eating disorders. All three can cause binge eating. Here’s the main difference: People with BED don’t usually have other changes in their behavior, like restricting food or purging. BED also tends to start at a later age than other eating disorders.
Binge eating disorder, anorexia, and bulimia are different types of eating disorders. All three can cause binge eating. Here’s the main difference: People with BED don’t usually have other changes in their behavior, like restricting food or purging. BED also tends to start at a later age than other eating disorders.
No. Both BED and emotional eating can be driven by emotional or psychological factors rather than hunger. But BED is associated with loss of control over eating, more frequent episodes, and significant distress. Occasional emotional eating is pretty common, and it usually doesn’t cause any health problems.
A binge usually starts as a thought or craving about eating a certain food. The urge to eat gets stronger and stronger until the person eats. As they start to eat, they may feel pleasure or happiness followed by numbness.
Some people report feeling “zoned-out” during a binge. It’s also common to feel a loss of control. After a binge, some people report feeling shame, guilt, or disgust. Some people may feel physical discomfort from eating so much — like stomach pain or heartburn.
Yes. BED is associated with many different medical conditions. Some of these are related to also having overweight or obesity, but other health complications of BED can happen in people with lower weights. Examples include:
Chronic pain (like back pain or headaches)
Gastrointestinal (gut) problems (like heartburn, bloating, and diarrhea)
Other mental health problems (see below)
Yes. Almost 75% of people with BED may have another mental health condition at some point in their lives. Mental health conditions common in people with BED include:
Depression and other mood disorders (including increased thoughts of self-harm or suicide)
Anxiety disorders (like generalized anxiety disorder and obsessive-compulsive disorder)
Alcohol dependence and other substance use disorders
Attention-deficit/hyperactivity disorder (ADHD), and other impulse-control disorders
Beat Eating Disorders. (n.d.). Binge eating disorder.
Bohon, C. (2019). Binge eating disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America.
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