When you hear the term eating disorder, you probably think: super-strict diet or restricting food. But actually, the most common and undertreated eating disorder in the United States is binge eating disorder (BED), a condition that involves over-consumption of food.
About 1.25% of adult women and 0.42% of adult men have binge eating disorder, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
“Binge eating is when a person eats an excessive amount of food and feels unable to control their eating behaviors,” explains Courtney Morgan, LPCC, a licensed therapist. “People with binge eating issues often feel ashamed, which makes seeking treatment incredibly challenging.”
Below is more about this difficult-to-manage disorder, its symptoms, and doctors treat it. Plus, new research into semaglutide as a promising new treatment for binge eating disorder.
If binge eating is a concern, semaglutide can help.
The elements of binge eating disorder
BED differs from bulimia nervosa, an eating disorder that comes with a compensatory behavior like purging, exercising, or laxative abuse post-binge, according to the National Library of Medicine. People with BED don’t usually demostrate those behaviors. It’s also more common in those who have obesity, but it can impact people of all sizes.
“To be diagnosed with binge eating disorder, a person has to report recurrent episodes of binge eating,” says Samantha DeCaro, Psy.D, a licensed clinical psychologist. “These episodes must occur at least once a week for three months, which is considered mild. But can be as extreme as 14 times a week or more.”
People who binge eat may be so disconnected from themselves during episodes that they are unaware of what’s happening, says Amy Goldsmith, RD, a dietitian who specializes in eating disorders. They might also eat without feeling physically hungry.
Common symptoms of BED
The disorder presents with different signs, symptoms, and behaviors, Goldsmith says, but some of the most common are:
- Eating large amounts of food quickly
- Losing control while eating, especially being unable to stop
- Eating large amounts of food when one isn’t necessarily hungry
- Eating in secret
- Eating until one is uncomfortably full
- Feeling guilt and shame post-binge
- Having consistent thoughts of food, and planning around when one will be able to eat alone
- Hoarding favorite foods
- Restricting food throughout the day to prepare for a binge, or restricting after a binge
What triggers binge eating episodes
Every person with BED has personal triggers that fuel an episode of binging, but there are a few common threads. Those with BED tend to binge to regulate their emotions, after attempting a severely restrictive diet, or to cope with depression and anxiety, says Morgan.
In those cases, binge eating usually functions as an escape from tough feelings. “Shame, guilt, sadness, and anxiety are commonly reported as emotional triggers to binge eating episodes,” says Dr. DeCaro. “Those who experience weight-based stigma, discrimination, or bullying may also be at elevated risk of binge eating.”
Feelings of scarcity—whether those are physical or psychological—can also contribute to BED, she adds. Similarly, experiencing food insecurity or a lack of regular access to balanced meals can put a person at heightened risk.
The health dangers for people with BED
Untreated BED can bring on many health issues, some more serious than others. Those include:
- Gastrointestinal distress like acid reflux, constipation, and diarrhea
- Obesity
- Depression and anxiety
- Low self esteem and negative body image
- Difficulty focusing
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Gallbladder disease
- Sleep apnea
How doctors treat binge eating disorder
Because BED is both a mental and physical condition, treatment often comes from multiple angles. It often administered with the help of “a therapist, a dietitian, a primary care physician, and a psychiatrist, if needed,” says Dr. DeCaro. Together, they work to assess progress and target the various medical, nutritional, and emotional factors that fuel the binge eating cycle, she adds.
Therapy, in particular, might include the processing of emotions, addressing unresolved trauma, deepening connections with others, and taking a morally neutral approach to food and weight. This last one is very important, says Dr. DeCaro says. This is because many people in recovery from BED turn to dieting and weight loss to combat the condition and improve body image.
“There is mounting evidence that restricting food and repeatedly losing and regaining weight worsens binge eating disorder cycles,” she says. “It also causes tremendous harm, both medically and psychologically.
“An effective treatment approach should provide the support and skills needed to navigate even the most frequent and intense urges,” she continues. “[It should also include] tools to mindfully observe emotional patterns.”
Medications with potential to help
The only medication approved by the U.S. Food and Drug Administration to treat BED is lisdexamfetamine, a stimulant developed to treat the inattention, impulsiveness, and hyperactivity associated with attention-deficit/hyperactivity disorder (ADHD). It’s prescribed off-label to help control the impulses associated with BED.
However, Dr. DeCaro says it’s worth noting that an important part of BED treatment is that patients learn to “consistently nourish themselves, tune into and trust their body’s signals, and gradually reintroduce foods they may have once been afraid of.”
RELATED: 18 Signs of Binge Eating You Should Never Ignore
Lisdexamfetamine and its comparative drugs may make that difficult, because possible side effects include decreased appetite, stomach pain, nausea, and vomiting, she adds. It’s also a controlled substance with high potential for abuse, misuse, and dependence.
“BED rarely travels alone, and substance use disorders can be common in people with it,” Dr. DeCaro explains. “If someone stops taking the medication due to any adverse effect, withdrawal symptoms may include increased appetite, which can potentially exacerbate binge eating urges and episodes.”
Recent preliminary studies found that new weight loss drugs, including semaglutide and some other similar meds (including liraglutide), show potential for the treatment of BED:
- A small study on the impact of using semaglutide to treat severe to moderate BED found that participants’ scores on the binge eating scale (which researchers utilize to measure how BED symptoms are affected) were greatly reduced, compared to those who were treated by existing meds like lisdexamfetamine.
- Another study showed a reduction in binge eating frequency, BED comorbidities, and mental health side effects in those treated with liraglutide and similar GLP-1 receptor agonists.
Both studies concluded that more research is necessary to define the drugs’ impact and how exactly these meds are reducing symptoms, and what the optimal dosage and treatment should be. Dr. DeCaro agrees that more research is needed and expresses concern that the meds could interfere with other eating disorder treatments for BED.
Ways to find support for BED
For those who are looking for help with binge-eating disorder, Morgan recommends reaching out to a primary care doctor or utilizing resources from the National Eating Disorders Association, Families Empowered And Supporting Treatment for Eating Disorders, or the National Association of Anorexia Nervosa and Associated Disorders.
“If you or someone you know is struggling with binge-eating disorder,” she says, “you are not alone.”
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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