Q: A close friend of mine recently told me that she believes I may have a binge eating disorder. Some weeks I don’t binge at all and other weeks I binge daily. Do I really have a binge eating disorder?
A: You ask a very interesting, and common, question. It also happens to be a complicated one! First off, are you really binge eating? Some people may feel like they’ve binged after eating one candy bar, a handful of peanuts or a single ice cream cone. For these people, a binge involves eating any amount of something they consider to be a “bad” or “dangerous” food. Technically, this is referred to as a SUBJECTIVE binge because it relies on each individual’s own, sometimes inaccurate, definition of how much food is “too much”. On the other hand, while difficult to precisely define, a formally defined, or OBJECTIVE, binge consists of 1) eating a significantly larger amount of food than an average person might eat, 2) doing so in a relatively brief period of time (less than two hours) and 3) sensing a loss of control over eating during the episode. Distinguishing between a subjective binge and an objective binge is an important part of helping you to answer the question about whether you have a binge eating disorder (BED).
That being said, episodic, or occasional binge eating alone does not constitute BED. Current diagnostic criteria indicates that an individual is bingeing at least twice a week for six months and experiences that “out of control” feeling during the binge in order to be diagnosed as having BED.*
People with BED tend to eat quite rapidly, binge even though they’re not hungry, and often eat until they are feeling exceptionally full. At the emotional core of BED is a sense of shame, and possibly disgust, about one’s eating behavior and, consequently, binges are apt to occur secretively. Around 2-3% of the general population meets the criteria for BED and interestingly, women are somewhat more likely to have BED than men. Some research suggests that upwards of 50% of people with BED are not obese, contrary to what people may assume.
Its important to point out that even if you don’t think you meet full criteria for BED, it doesn’t mean you don’t have an eating disorder or that you shouldn’t seek help. Any problematic disordered eating behaviors, including infrequent binges, could be symptoms of an eating disorder. Regardless of the specific diagnosis, early assessment and intervention will significantly help to improve your chances for recovery.
Blog answer contributed by David Roth, Ph.D.
Dr. Roth is a psychologist and therapist at The Center for Eating Disorders. He specializes in the treatment of individuals with Binge Eating Disorder.
* It is important to note that new diagnostic criteria for BED and its inclusion as a separate disgnosis is currently being developed and will likely be updated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, scheduled to be released in May of 2013.