More than one million Australians are living with an eating disorder, according to The Butterfly Foundation, the national charity for those impacted by eating disorders and body image issues.
These include anorexia, bulimia, disordered eating and binge eating disorder.
Of those with eating disorders, 47% have binge eating disorder (BED) compared to 3% with anorexia , 12% with bulimia nervosa and 38% with other eating disorders, according to the foundation. In fact, BED is the fastest growing eating disorder in the world and is commonly associated with mood and anxiety disorders that are also rapidly rising in our challenging world.
A World Health Organisation Mental Survey Study, which included adult respondents across 14 countries, found a lifetime prevalence rate of BED of between 1.4 and 2.6 percent.
What does binge eating disorder look like?
Binge eating is characterised by eating larger amounts of food in a restricted period of time, that is less than two hours, and a lack of control over that, according to the APA Centre for Psychology and Health’s diagnostic criteria.
“Episodes are associated with three or more behaviours – eating more rapidly, eating large amounts of food, and eating alone because of embarrassment, feeling guilty, or being disgusted or depressed,”
says Raindrum dietitian Anna Millichamp, who has extensive experience treating eating disorders.
“This behaviour would occur at least one day a week for three months for it to be classified as an eating disorder.”
Someone who has BED won’t consistently use compensatory behaviours, such as over-exercising or purging, such as in anorexia nervosa or bulimia nervosa, says the APA.
You are also unable to tell if someone has BED based on their appearance.
Indeed, people with BED often experience a significant amount of shame and guilt around their eating disorder and may be secretive about their eating behaviours, choosing to eat alone often.
It’s also important to realise, that BED is a mental illness, it’s not simply a lifestyle choice.
Why does binge eating disorder occur?
It is understood that there are many potential triggers for a binge eating episode including negative emotions and feelings about weight, shape or size.
All eating disorders are complex in their aetiology and highly individual.
For BED, it is thought that genetics, dieting, environmental, social and cultural factors are implicated.
“Our diet culture and the way food and body image are portrayed in the media is a major factor,”
says Millichamp.
“There is a lot to be said about the way we idolise thinness in the West and the pressure to be a certain weight, shape or size.”
Indeed, dieting is one risk factor for ED development in general.
The risks of binge eating
Obesity and its complications, diabetes and hypertension are some of the risks posed for BED sufferers.
They may also face an elevated occurrence of osteoarthritis, chronic kidney problems and high cholesterol, according to The Butterfly Foundation.
Treating binge eating disorder
Psychological interventions are recommended as first-line treatment for BED.
These include Cognitive Behaviour Therapy and Interpersonal, according to the National Eating Disorders Collaboration.
“Identifying triggers is particularly helpful, so that treatment can be individualised,”
says Millichamp.
“Challenging faulty thinking about what is appropriate to eat is key.
“An important part of recovery is for people with BED to stop dieting and restricting food intake.”
Learning to accept body shape and size and working towards developing skills around intuitive eating where you feed your body what it needs in response to internal cues without restriction or guilt or shame is also crucial.
Addressing factors such as anxiety, depression, emotional dysregulation and self-acceptance is important.
“Ultimately, someone with BED will likely benefit from working with a psychologist who is familiar with eating disorders, as well as a GP and a dietitian.”
Medication may also be prescribed to those suffering from BED and this may range from antidepressants, to antiobesity drugs and medication for attention deficit hyperactive disorder.
The last has been shown to reduce binge eating episodes and impulsivity.
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