In 2023, it was estimated that around 1.1 million Australians struggled with an eating disorder. Of that figure, about 21% wrestled with binge eating disorder (BED)1. What might surprise you is that BED is more prevalent than Anorexia Nervosa and Bulimia Nervosa combined1. Recent research suggests that although members of both sexes struggle with BED, the condition is far more common among women than men.
BED is a serious mental illness, causing a great deal of distress, pain, anguish, and shame. Unfortunately, due to weight stigma and various misconceptions concerning the condition, guilt may prevent people from seeking much-needed help.
As we explore this topic today, I aim to present BED through a compassionate, trauma- informed lens. I hope that people with the condition who are reading this will feel heard and encouraged. More than that, I hope that they will consider reaching out for the help they both need and deserve.
What is Binge Eating Disorder?
Binge eating disorder is, in fact, a diagnosable mental illness. It is characterised by eating a large amount of food in a short period of time, often with a sense of being out of control or unable to stop.
Such actions are often accompanied by distress, guilt, and shame. People with BED might find themselves eating alone or secretively, and unlike those with Bulimia Nervosa, will not engage in compensatory behaviours (like purging or exercise) after a binge.
How does binge eating differ from emotional eating and overeating?
Food is soothing and comforting. For many people, food is the preferred way of coping with life’s challenges and hardships. If this is your experience, you aren’t broken; in fact, you’ve probably been doing the best you can to take care of yourself, even with food. Given food’s natural ability to provide such comfort, there is a common thread linking BED, emotional eating and overeating. Nevertheless, BED is a distinct condition with its own aetiology and features.
Given that BED, emotional eating and overeating are often confused or conflated, it’s worth taking a moment to highlight some of the most notable differences:
Emotional eating
Emotional eating is eating food to soothe or distract oneself from unwelcome emotions such as stress, boredom, loneliness, anger, or a low mood. Portions consumed may vary, but emotional eating does not come with a sense of being out of control. It’s important to note that some emotional eating is normal.
Eating food is an inherently emotional experience; we use it to connect, bond, celebrate and grieve. Emotional eating isn’t something to be ashamed of or rejected. Of course, a person may benefit from exploring their reasons for emotional eating, particularly if food is their only way of coping with distress. But when food is accepted and used as a part of a “tool kit” for coping with emotions, it will likely feel more balanced.
Overeating
Overeating is eating beyond the point at which you feel comfortably full. Some people might feel like they have overeaten simply because they have eaten more than they usually allow themselves. However, this does not necessarily mean they have eaten an inordinately large amount of food.
Like emotional eating, overeating isn’t associated with being out of control. It may occur when alone (eating some delicious takeaway after a stressful week) or with others (at a Christmas celebration, for instance). This is a normal human experience and may happen for several reasons: enjoyment of a meal, eating while distracted, missing one’s fullness cues, eating as a result of “breaking” a food rule, or eating when famished.
It is not necessary to judge or criticise the act of eating more than is comfortable. Again, it is normal to do this at times. However, if overeating is something you constantly struggle with, it might be worth examining the underlying reasons for this pattern.
What can contribute to binge eating disorder?
This brings us finally to BED and the reasons for its emergence. Why does it arise? A whole host of factors tend to be at play, including genetics, trauma, culture, social, and environmental contexts. For many people, bingeing can occur in response to emotions such as stress, loneliness, anxiety and boredom.
Negative body image and internalised weight bias are also shown to be significant contributing factors to the binge eating cycle. Body image distress may arise before or after a binge, often leaving people with a sense of shame. Internalised weight bias can make it very difficult for people to accept their body and the food they eat. Introducing stress, confusion, and shame into one’s relationship with food can act as a key trigger for bingeing.
For people who have experienced trauma, particularly in childhood (but also at any age), food may have been their only way of coping. They may not have had the skills or support to manage otherwise. Binge eating may therefore be a response to lingering trauma.
There are several psychological and physiological risk factors for the development of a binge disorder. People who follow food rules, avoiding foods or food groups in response to body image distress are often burdened with a strong sense of restriction and deprivation. This may lead to a lack of enjoyment with food and or inadequate food intake. The combination of deprivation and restriction are strong triggers for binge eating patterns.
Finally, it’s important to note that people with BED frequently experience a great deal of shame, guilt and distress about their eating patterns. This in itself can act as a perpetuating factor in the condition by preventing people from seeking the help they need to break the binge eating cycle.
Myths associated with Binge Eating Disorder
Unfortunately, there are some harmful myths out there about BED and the people who wrestle with it. I want to address two of these in the hope that they aren’t barriers to any of you seeking help.
Myth 1: People who binge just lack will power or self-control
Binge eating is not about a lack of willpower or self-control. As we saw earlier, BED is a diagnosable mental illness and is often a response to significant trauma. There are also numerous psychological and physiological factors – many of which lie outside the person’s immediate control – that sustain the cycle of bingeing. Simply having “willpower” will not stop bingeing, bring healing, or cultivate a healthy relationship with food and the body.
Myth 2: People who binge just need to restrict their food intake to recover
Diets or restrictive eating patterns are not the solution for BED. They lack a clear evidence base and will likely cause more harm. Moreover, restrictive eating patterns are a very strong trigger for bingeing. Not eating enough food to meet your body’s needs places your body in a survival response mode, where it increases its hunger signals, leading to preoccupation with food. Existing in a state of extreme hunger will naturally lead people to eat more rapidly – and therefore, binge.
Furthermore, avoiding foods that you enjoy is also likely to trigger increased preoccupation and cravings. The absence of full and unconditional permission to eat certain items will eventually – and ironically raise the likelihood of bingeing on them, hence restriction is not the pathway to recovery.
How can a dietitian help you in your recovery from binge eating disorder?
An experienced dietician can be a true pillar of support when dealing with a BED. Here are the main benefits a professional can provide:
Sharing your story
Telling your story and making sense of your eating patterns is an important place to start. Doing so with a trained health professional is a crucial part of that process. As a dietitian, I help you make sense of your struggles with food and offer compassionate responses to reduce shame. From a kind and curious standpoint, we can draw your eating disorder cycle and consider what physiological, psychological and nutritional factors might be triggering and sustaining your bingeing.
Building a regular and adequate food intake
Our bodies are hardwired to survive, and this requires adequate, regular food intake. Developing insight, motivation and strategies to start providing your body with enough food is a key stage of our work together. When your body is adequately fed, you can start to heal and begin a journey of trust with food.
Identifying and understanding the role of food rules and judgments
Many people have long viewed food through a black-and-white or moralistic lens. For some, food rules have been anchors, bringing them back to safety when they feel out of control with food. And yet, these very same rules and judgements can foster and perpetuate bingeing patterns. Hearing this might sound anxiety-provoking, and if so, you are not alone. That is why we can gently explore food rules in conjunction with nutrition facts, considering their impact, and gradually redefine your relationship with them. Moving away from food rules doesn’t mean you are giving up on health or eating those dreaded “avoided” foods all the time. It will be about learning to rebuild trust with your body and honour its needs.
Broadening your imagination
Take a moment to imagine an alternative future. Imagine you are faced with a “forbidden food”, but instead of bingeing, you now have options. You can consume it there, then decide to consume it another day or leave it altogether. There is no right response; rather, you can honour yourself and your body in the moment, without the kind of guilt or shame on which bingeing feeds. That is where I hope to take those who come to me wrestling with BED.
Develop mindful eating skills
Removing judgment from food helps to bring safety back into your relationship with both it and your body. One way we can practice this is through developing mindful eating skills. This is a practice where you can learn to appreciate nourishing your body in a non-judgmental way and learning to be present to the tastes, textures, smells, sounds, and appearance of food in a neutral way. In session, we can practice this skill together so you feel supported as you learn to redefine your relationship with food.
Intuitive eating skills
At certain points in your recovery journey, we will also look at building other intuitive eating skills such as honouring your hunger, honouring your fullness, gentle nutrition, discovering the “satisfaction factor,” and learning body respect. And this is just a sampling of the kinds of techniques you can add to your toolbox.
Weight-neutral care
People with BED need a safe space free from weight stigma. Although people with the condition will come in a wide range of body shapes and sizes, research suggests that a high proportion of people with BED will be in a larger body2. As a dietitian, I support people in developing body acceptance and respect. This partly entails learning to care for and adequately nourish your “here-and-now body.” Indeed, we can explore all the ways to improve your health and wellbeing without focusing on weight loss or the number on the scales.
Recovery is never a linear journey
It’s often messy and staggered, accompanied by wavering motivation and fluctuating resolve. Sometimes it’s a case of three steps forward and two steps back. That is perfectly normal. In a gentle and compassionate setting, you can learn to hold onto hope and find your way forward, knowing that even with setbacks and hurdles, you can enjoy genuine recovery.
If you’re considering support but not sure where to start, why not book a free discovery call with me? This is a pressure-free space where you can have your questions answered and reflect on the next steps in your recovery journey.
References
- Deloitte Access Economics. (2024). Paying the Price, Second Edition: The economic and social impact of eating disorders in Australia—report commissioned for Butterfly Foundation.
- McCuen-Wurst C, Ruggieri M, Allison KC. Disordered eating and obesity: associations between binge-eating disorder, night-eating syndrome, and weight-related comorbidities. Ann N Y Acad Sci. 2018 Jan;1411(1):96-105.
