Binge eating disorder is a newly recognized condition that probably affects millions of Americans. People with binge eating disorder frequently eat large amounts of food while feeling a loss of control over their eating. This disorder is different from binge-purge syndrome (bulimia nervosa) because people with binge eating disorder usually do not purge afterward by vomiting or using laxatives.

Episodes of binge eating also occur in the eating disorder bulimia nervosa. Persons with bulimia, however, regularly purge, fast, or engage in strenuous exercise after an episode of binge eating. Purging means vomiting or using diuretics (water pills) or laxatives in greater-than-recommended doses to avoid gaining weight.

Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, is defined as exercising for more than an hour solely to avoid gaining weight after binge eating. Purging, fasting, and strenuous exercise are dangerous ways to attempt weight control.

Although it has only recently been recognized as a distinct condition, binge eating disorder is probably the most common eating disorder. Most people with binge eating disorder are obese (more than 20 percent above a healthy body weight), but normal-weight people also can be affected.

Binge eating disorder probably affects 2 percent of all adults, or about 1 million to 2 million Americans. Among mildly obese people in self-help or commercial weight loss programs, 10 to 15 percent have binge eating disorder. The disorder is even more common in those with severe obesity.

Binge eating disorder is slightly more common in women, with three women affected for every two men. The disorder affects blacks as often as whites; its frequency in other ethnic groups is not yet known. Obese people with binge eating disorder often became overweight at a younger age than those without the disorder. They also may have more frequent episodes of losing and regaining weight (yo-yo dieting).

What are the causes of binge eating disorder?

The causes of binge eating disorder are still unknown. Up to half of all people with binge eating disorder have a history of depression. Whether depression is a cause or effect of binge eating disorder is unclear. It may be unrelated.

Many people report that anger, sadness, boredom, anxiety or other negative emotions can trigger a binge episode.

Impulsive behavior and certain other psychological problems may be more common in people with binge eating disorder.

Researchers also are looking into how brain chemicals and metabolism (the way the body burns calories) affect binge eating disorder. These areas of research are still in the early stages.

Dieting's effect on binge eating disorder is also unclear. While findings vary, early research suggests that about half of all people with binge eating disorder had binge episodes before they started to diet. Still, strict dieting may worsen binge eating in some people.

Signs and symptoms of binge eating disorder

Most of us overeat from time to time, and many people feel they frequently eat more than they should. Eating large amounts of food, however, does not mean that a person has binge eating disorder.

Doctors are still debating the best ways to determine if someone has binge eating disorder. But most people with serious binge eating problems have:

Frequent episodes of eating what others would consider an abnormally large amount of food.

Frequent feelings of being unable to control what or how much is being eaten.

Several of these behaviors or feelings:

What are the complications of binge eating disorder?

The major complications of binge eating disorder are the diseases that accompany obesity. These include diabetes, high blood pressure, high cholesterol levels, gallbladder disease, heart disease, and certain types of cancer.

Obese people with binge eating disorder often feel bad about themselves, are preoccupied with their appearance, and may avoid social gatherings. Most feel ashamed and try to hide their problem. Often they are so successful that close family members and friends don't know they binge eat.

People with binge eating disorder are extremely distressed by their binge eating. Most have tried to control it on their own but have not succeeded for very long. Some people miss work, school, or social activities to binge eat.

Treatment for binge eating disorder

Several methods are being used to treat binge eating disorder.

Cognitive-behavioral therapy teaches patients techniques to monitor and change their eating habits as well as to change the way they respond to difficult situations.

Interpersonal psychotherapy helps people examine their relationships with friends and family and to make changes in problem areas.

Treatment with medications such as antidepressants may be helpful for some individuals.

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