There are different types of eating disorders and all have unique symptoms. Most people have heard of anorexia nervosa, a serious psychiatric disease in which a person restricts their eating to such a point that it’s potentially fatal.
And you may also be familiar with bulimia nervosa, which is characterized by binge eating followed by purging through vomiting, laxatives, or other methods.
What you may not know, however, is that the most common eating disorder in the United States is binge eating disorder (BED), studies show. And BED’s red flags might be the most difficult to spot because they are less obvious and usually take place in the shadows or behind closed doors. That might be why BED is the most underdiagnosed and undertreated eating disorder of them all.
No two cases of BED look exactly alike. That’s why one of the first steps in seeking treatment for the disorder is to understand what triggers a specific person to binge eat, says Courtney Morgan, LPCC, a licensed therapist. “Triggers vary from person to person,” she adds.
Below, experts explain the common mental and physical symptoms of binge eating disorder, so that you can be armed with information about this serious disorder, as well as possibilities for treatment.
Physical symptoms of binge eating disorder
The physical signs of BED are the behaviors that people display when they’re suffering from an episode of binge eating, including the following:
- Eating large amounts of food in a short period of time (within two hours, per the National Institute of Mental Health)
- Eating their food quickly
- Eating in secret, or isolating themselves while they eat
- Being unable to stop eating
- Eating to the point of being uncomfortably full
- Eating large amounts of food even when they’re not feeling hungry
- Undergoing frequent dieting
- Making plans ahead to eat by themselves
- Hoarding their favorite foods
- Restricting what they eat either before or after a binge
Mental symptoms of BED
These signs are the emotions that a person with BED often feels, including the following:
- Feeling out of control over eating
- Feelings shame or guilt over their eating behaviors
- Feeling embarrassment about their eating behaviors
- Having consistent thoughts about food
- Suffering from depression
- Experiencing anxiety
- Having signs of low self-esteem
- Having a low “social battery”—meaning, feeling mentally and physically drained by being around other people within a short period of time
How doctors diagnose BED
Some of these symptoms are common in other mental health conditions and eating disorders. For instance, a person suffering from clinical depression may also have low self-esteem and a low social battery. Someone with anorexia may also be secretive about their eating habits.
That’s why experts have specific criteria when diagnosing a person with BED. First, their episodes of binge eating must be recurrent, explains Samantha DeCaro, Psy.D, a licensed clinical psychologist.
And their episodes of binge eating have to happen at least once a week for three months. That would be a mild case, Dr. DeCaro says, but she points out that in extreme cases, the person can have episodes as often as 14 times a week, or even more.
It’s hard to define the amount of food that constitutes a binge. It’s nuanced and can vary, and diagnosis is best left up to an experienced eating disorder specialist, Dr. DeCaro explains. With that said, she adds that a BED diagnosis is likely warranted when a person experiences a loss of control during a binge eating episode and reports at least three of the following symptoms:
- Eating much more rapidly than normal
- Eating until they feel uncomfortably full or sick
- Eating large amounts of food when they are not physically hungry
- Eating alone for fear of embarrassment over the size of their meals
- Feeling disgusted with themselves, depressed, or guilty after the binge episode
The potential of new treatments
Given that the symptoms are both physical and mental, BED is best treated by a team of health professionals, to tackle what causes the triggers that bring on an episode of binge eating, as well as to work to shift the patterns. Medications can also help.
An ADHD medication, the stimulant lisdexamfetamine, is the only med that has FDA approval to treat BED. One downside is that it’s a controlled substance with a high potential for abuse.
Other medications are also used off-label to treat BED. The most recent one that holds promise is semaglutide, a medication that studies have shown can decrease appetite. More research is needed, but one small study has already found that semaglutide helped reduce participants’ scores on a scale that researchers use to measure BED symptoms.
If you worry about binge eating and think semaglutide might be right for you, talk to your doctor or chat with a ReflexMD Wellness Advisor now.
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