Is Binge Eating Disorder a Mental Illness

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Supermarket shelves of typical binge foods: biscuits, sweets and chocolates

Binge eating disorder is thought to affect 1.5% of women and 0.3% of men worldwide and is classified as a mental health disorder. Psychologists help people recover by understanding the links between a person’s background, thoughts, feelings and emotions.

Perhaps you are wondering whether you, or someone you love, has binge eating disorder? This blog talks about what binge eating is and why it’s considered a mental health problem. 

What is binge-eating?

Before we can answer the question about why binge eating disorder is classed as a mental health problem, we need to understand what binge eating is. Binge eating is different to overeating or emotional eating. 

A binge involves eating a large amount of food in a short period of time, usually very quickly. When people binge, they usually have the sense of having totally lost control of their eating and would find it very hard to stop eating. 

After a binge people usually feel extremely guilty and may do things to ‘make up’ for the binge. For example, someone with binge eating disorder might commit to ‘doing better’ tomorrow by dieting.

Someone with bulimia may do the same but with more extreme methods. For example, vomiting, laxative use or fasting. 

Binges can be categorised as subjective or objective. Objective binges are binges where the amount of food eaten is more than what most people would eat given the situation. 

Subjective binges are binges when someone has the sense of having lost control of eating, and eats extremely quickly, but the amount of food eaten would not be considered unusually large.  

Definitions can be helpful, but let’s look at some case examples to really understand the differences. 

Sara is 45 and splits her time between part-time work and looking after young children. Sara has always worried about her weight and has dieted on and off since she was 17. In the day she is ‘good’ with her eating, sticking to low-calorie meals and limits junk food. In the evening after her children are in bed, Sara feels like she totally loses control over her eating. On an average night Sara eats the leftovers from dinner, a family bag of crisps, a box of cake slices and half a loaf of bread and butter. Afterwards she feels awful and hates herself for losing control again. She plans on cutting out carbs the next day to try and limit the ‘damage’ from the binge. Sara can’t understand why she always loses control of her eating and worries that she is lazy and greedy. Sara is struggling with binge eating disorder. 

Ben is 50 and has struggled with depression on and off for his whole life. He was recently made redundant, and his family are now worrying about how they will pay the mortgage and bills. Ben feels guilty for not working and worries that he is not good enough as a dad or husband. He has noticed that his eating patterns have changed. He is sleeping late in the morning so missing breakfast and is eating more and more ‘comfort’ foods (cakes, biscuits, takeaways) through-out the afternoon and evening. He feels soothed when eating, and distracted from his low mood but also feels bad as there is a history of diabetes in his family, and he doesn’t want to become unwell. Ben is struggling with depression and emotional overeating eating. 

Why is binge eating disorder considered a mental illness?

Mental illness is a term used to describe diagnosable mental health problems. Binge eating disorder is classified as a type of mental health problem. 

Medical professionals tend to use the term mental illness (or disorder). Psychologists focus more on understanding a person’s life history, personal beliefs and the loops that keep people stuck in binge eating.

Sometimes people think that because binge eating is a physical behaviour, it might not be a mental health problem. It is classed as a mental health problem because it involves significant changes to people’s thoughts, feelings and behaviours and usually causes a lot of distress in every-day life. 

Being diagnosed with binge eating disorder does not mean you are “crazy” or that there is something fundamentally wrong with you. It is a surprisingly common difficulty from which it is possible to completely recover. 

Diagnostic criteria 

Front cover of the ICD-11 book

There are two main diagnostic classification systems. The ICD-11 is created by the World Health Organisation and is the main manual used in the UK. The DSM-5 is the main system used in the US. 

These systems are used to examine symptoms and make a diagnosis. 

ICD-11 
Frequent episodes of binge eating (e.g., once a week) over a period of time (e.g., 3 months). 
Binge eating episodes happen in a distinct time period (e.g., 2 hours).
A sense of having lost control over their eating (i.e., feel like they can’t stop). 
Objectively large amounts of food eaten, or subjective (i.e., persons feels it is a large amount when others wouldn’t think it is).
Binges cause significant distress (e.g., guilt, shame) or disrupt daily functioning (e.g., work, finances, relationships). 
May eat until in pain or uncomfortably full.
Not better explained by another disorder (e.g.,  Prader-Willi Syndrome or Depression).
Not followed by compensatory behaviours (e.g., vomiting, laxatives, excessive exercise). 
Poor body image may be a problem, but is not required for diagnosis. 

DSM-5
Criterion 1 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

-Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

-The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating) 
Criterion 2Binge-eating episodes are associated with three (or more) of the following:

-Eating much more rapidly than normal
-Eating until feeling uncomfortably full
-Eating large amounts of food when not feeling physically hungry
-Eating alone because of being embarrassed by how much one is eatingFeeling disgusted with oneself, depressed, or very guilty after overeating 
Criterion 3Marked distress regarding binge eating is present.
Criterion 4The binge eating occurs, on average, at least 1 day a week for 3 months (DSM-5 frequency and duration criteria) 
Criterion 5The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

What causes binge eating disorder?

There are four main causes of binge eating. Usually someone will experience a mixture of causes. 

infographic showing the four main causes of binge eating

1. Under-eating 

We know that not eating enough food (either in the day, or over a period of days / weeks) puts people at a high risk of binge eating.

This is because the human body is designed to keep weight within a certain range (set point theory). If someone goes into an energy deficit, their blood sugar reduces, and it triggers the body to seek food. 

2. Food rules

Following food rules also puts people at risk of bingeing. 

There are lots of different types of rules that people can have about eating. Examples include avoiding types of food (e.g., ‘junk’ food, carbohydrates, fats), delaying eating until later in the day, eating less than other people. 

The problem with these rules is that they are unsustainable. Everyone will ‘break’ a rule at some point. This can trigger a ‘stuff it’ mindset (i.e., “I’ve already ruined my diet, I might as well carry on eating now and start again tomorrow”). 

3. Disinhibition 

Disinhibition is when you have less control over your behaviours. 

Alcohol and recreational drugs are common causes of reduced self-control. Many people have eaten lots of food late at night after drinking.

If someone with binge eating disorder drinks or takes drugs, they are more likely to binge. 

4. Emotional reasons

This is the broadest category! 

We know that there are numerous emotional reasons that might cause people to binge. 

From when we are babies, feeding (bottle or breast) is linked with soothing. Some people binge eat as adults as an attempt to soothe themselves if they are feeling upset, sad, or angry.

Even if someone feels soothed whilst binge eating, they normally feel extremely negative emotions afterwards. This can create a vicious cycle of binge eating. 

Other people may binge eat as a distraction from emotional pain. This is different from soothing because the purpose of binge eating is to block out pain (e.g., traumatic memories) rather than giving a temporary feeling of being soothed. 

How do I recover from binge eating disorder?

The best place to start is by speaking to your health professional, this is usually your GP in the UK. This article explains how to find a good eating disorder therapist in the UK. 

Cognitive Behavioural Therapy (CBT) for eating disorders has the best evidence base. It involves supporting you to eat regularly again, understand your emotional links, the beliefs you hold about yourself, and building skills and alternative ways of coping.

For people who struggle with body image, it will also include dedicated time on this. 

If binge eating has become a coping mechanism for trauma, your treatment might also involve specific trauma focussed therapy.

If you are looking for a comprehensive self-help guide on how to recover from binge eating disorder, take a look at this list of the 15 best eating disorder recovery books in 2024


We offer online therapy for binge eating disorder. Book a free consultation to discuss whether we might be a good fit for you.

About

Welcome. I'm Dr Jenny Davis, a Clinical Psychologist with a special interest in eating disorders. I'm passionate about helping people recover and build a healthy relationship with food. 

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