have anorexic behaviors. There is no overlap between
binge-eating disorder and anorexia. Most people who
have binge-eating disorder are obese, but not all obese
people have binge eating behaviors.
Demographics
Estimates of the number of Americans who have
binge-eating disorder range from less than 1% to 4%,
with 2% being the most commonly cited figure.
Although women with binge-eating disorder outnum-
ber men 3:2, binge eating is the most common male
eating disorder. The disorder affects blacks and whites
equally; little research as been done on other racial or
ethnic groups. Unlike the eating disorders anorexia
nervosa or bulimia nervosa that start in the teenage
or young adult years, binge eating disorder is more
likely to occur in middle-aged adults between the ages
of 46 and 55. Although binge eaters may be of normal
weight, binge eating is a common disorder among
people who are obese. Some estimates suggest that
up to half the obese people in formal weight loss pro-
grams have problems with binge-eating.
People at higher risk of developing binge-eating
disorder share certain characteristics. These include:
frequent dieting. People who go on rigorous diets or
who frequently gain and lose large amounts of
weight (weight cycling) are more likely to become
binge eaters.
impulsiveness. Binge eaters, like bulimics, have prob-
lems with impulse control.
low self-worth and negative self-talk. This occurs
almost universally among people with all types of
eating disorders.
difficulty managing anger and appropriately express-
ing feelings.
preoccupation with body image and weight.
sexual abuse. Some, but by no means all, people with
binge eating disorder report being sexually abused as
children. This is an area of ongoing research.
depression. It is not clear whether depression causes
binge eating or if binge eating causes depression, but
the two are often found together.
Causes and symptoms
Binge eating is a relatively new area of research.
Like all eating disorders, binge eating appears to have
multiple causes. Some people seem to be genetically
predisposed to become binge eaters. Researchers think
this may be related to abnormalities in neurotransmit-
ters in the brain that help to regulate appetite. Research
continues actively in this area.
For many binge eaters, stress is the factor that
triggers a binge. Stress can be caused by very restric-
tive dieting, but it is often caused by social and cultural
factors, such as family conflict, job-related stress, dys-
functional relationships, and the repeated message
from the media that a thin body is a sign of success,
while being obese results in failure to find a mate or
succeed in life.
Symptoms of binge eating may be difficult to
detect. Binge eating is different from continuously
snacking, and it is often done in private.Obesityand
obesity-related diseases such ashypertension(high
blood pressure) Type II diabetes, and joint pain are
signs that binge-eating disorder could be present, but
not all obese people are binge-eaters. Behaviors such
as secretive eating, constant dieting without losing
weight, obsessive concern about weight, depression,
anxiety, and substance abuse are all clues, but none
of these signs are definitive. The individual may com-
plain about symptoms related to obesity, such as
fatigue and shortness of breath, or mention unsuccess-
ful dieting, but again, these signs are not definitive.Diagnosis
Binge eating can be hard for healthcare providers
to diagnose. Binge eaters often go out of their way to
hide how much they eat. They may, for example, buy
snack food at the grocery store and eat it in the car
before they go home, or they may buy food in secret
and hoard it, so that people close to them will not
know they are bingeing. Normally healthcare profes-
sionals begin diagnosis with a family and personal
history. However, people with binge-eating disorder
often lie about their eating habits.
A physician will begin with a physical examina-
tion and usually order standard laboratory tests such
as a complete blood count (CBC), urinalysis, and
blood tests to check the level of cholesterol,triglycer-
ides,andelectrolytes. Additional tests, such as a thy-
roid function test, may be ordered to rule out other
disorders. If the individual is obese, tests may be done
check for obesity-related diseases such as diabetes,
cardiovascular disease, and sleep apnea.
Several different evaluations can be used to exam-
ine a person’s mental state. A doctor ormental health
professional will assess the individual’s thoughts and
feelings about themselves, their body, their relation-
ships with others, and their risk for self-harm.Treatment
The medical community does not completely
agree on the best treatment for binge eating. MedicalBinge eating