Diagnostic Criteria for Binge Eating Disorder
As per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Binge Eating Disorder (BED) is diagnosed when:
- Recurrent episodes of binge eating are present, as characterized by both:
- Eating, within any 2-hour period, an amount of food that is definitively larger than what most individuals would eat in a similar experience.
- A feeling that one cannot stop eating or control what or how much one is eating.
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for 3 months.
Risk Factors for the Development of Binge Eating Disorder
Biological Factors
Family history: Parental psychopathology, where parents have their own mental health issues, can increase the risk of BED in children.
Body shape: Living in a larger body during childhood is considered a significant risk factor due to the societal experiences that may arise.
Brain chemistry and neurotransmitters: The brain’s reward centres, particularly in the dopamine pathways, are heavily involved in the development of binge eating disorder. The brain reward system and impulse control, making individuals more susceptible to binge eating.
Brain structure: The prefrontal cortex, responsible for decision-making and self-control, may have reduced activity or impaired functioning in individuals with BED.
Psychological Factors
Perfectionism: This prominent personality trait can create high self-expectations and intense self-criticism. This can lead to using food as a coping mechanism, such as binge eating.
Childhood resistance: Behavioural issues and difficulties adhering to social norms throughout childhood can predispose individuals to binge eating disorder.
Body image: Distorted perception of one's body, body dysmorphia at the extreme, is associated with binge eating disorder.
Substance use: People who struggle with substance abuse may be more prone to impulsive behaviours, which can extend to binge eating. Substance use is also associated with an increased risk for BED as they both serve as maladaptive coping mechanisms.
Other mental health concerns: General mental health issues like anxiety and depression can significantly contribute to the development of binge eating disorder.
Sociocultural Factors
Cultural pressure: Societal norms around body shape, size and appearance are very narrow, and there is significant pressure to meet these standards. Exposure to these beliefs can exacerbate the risk of BED.
Family dynamics: Food beliefs, weight talk and negative eating behaviours within the family are significant contributors to the potential development of binge eating behaviours. Conflict within the household also plays a role.
Trauma: Trauma can significantly increase the risk of developing binge eating disorder as a common coping mechanism can be leaning into binge eating behaviours.
Discrimination: Adolescents facing racial or ethnic discrimination have a higher risk of developing binge eating disorder compared to their peers who do not experience such discrimination.
Signs and Symptoms of Binge Eating Disorder
Individuals with binge eating disorder (BED) often experience a wide range of physical, behavioural, and psychological symptoms that can profoundly affect their daily lives and overall well-being.
Demographic Considerations: Age and Gender
In children and adolescents, BED may present as an increased weight gain velocity, or "jumping growth curves". This population may also exhibit secretive eating behaviours such as eating in their bedroom and hiding wrappers. Adults with BED might experience more severe physical health complications due to prolonged episodes of binge eating.
The presentation of BED also varies across genders. While women are more likely to report feelings of loss of control and distress about their eating behaviours, men with BED might be less likely to seek treatment due to societal stigma. Men more commonly engage in binge eating in the context of muscle-building or other performance-related activities, where they are "bulking" or having "cheat days".
Canadian Statistics for Binge Eating Disorder
2% of Canadians aged 15 and older reported experiencing symptoms consistent with BED during their lifetime in the 2014 CCHS study.
Binge Eating Disorder is more prevalent than Anorexia and Bulimia combined.
Binge Eating Disorder is more prevalent among women, with ~3% of women and 1% of men affected.
Researchers suspect that binge eating behaviours are extremely under-reported, suggesting that prevalence is much higher than recorded.
Type 2 Diabetes and Binge Eating Disorder
Individuals living with Type 2 Diabetes Mellitus (T2DM) are at an increased risk of developing disordered eating behaviours, including Binge Eating Disorder (BED). Conversely, those living with binge eating disorder are at high risk of developing T2DM. One study suggests that BED usually predates T2DM in individuals living with both conditions.
Compared to individuals without binge eating tendencies, those who do experience binge eating were diagnosed with T2DM at a much younger age. Research suggests this increases the risk for negative cardiovascular outcomes, which supports the importance of early screening, detection and intervention for binge eating disorder in the T2DM population. The mSCOFF and DEPS-R are screeners specifically for use with the diabetes population, but may only be relevant for those using insulin. The SCOFF and ODES-Y may also be suitable screeners.
Our team helps individuals all across Canada overcome binge eating.
Binge Eating Disorder is the most prevalent eating disorder, and researchers estimate the prevalence of the disorder is much higher than what is actually recorded.
Our team of Registered Dietitians and Registered Therapists support clients across Canada to overcome Binge Eating Disorder. Book a free consultation call below to learn more.
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