Binge Eating Disorder Treatment

Content warning: Discussion of eating disorders, triggers, body image, and weight

Binge eating disorder can lead to very rapid weight gain, which in turn, causes inflammation and health problems in other parts of the body. Caroline M. Apovian, MD, a Mass General Brigham obesity medicine specialist and co-director of the Brigham and Women’s Hospital Center for Weight Management and Wellness, describes the signs and symptoms of binge eating disorder, potential triggers, the health risks, and how it's treated.

What is binge eating disorder?

Dr. Apovian explains that overeating or even bingeing once in a while is not a disorder. Binge eating disorder is more severe, and symptoms include:

• Feelings of depression
• 2 or more episodes per week of overeating a large number of calories in a short period of time (2,000-3,000 calories in 20-30 minutes)
• Feelings of guilt and shame

Bulimia nervosa vs binge eating disorder

When comparing binge eating disorder vs bulimia, they appear to be very similar conditions. Both include binge eating as a coping mechanism and have emotional and psychological impacts on people. Health consequences are similar as well.  

Both bulimia and binge eating disorder can cause:

• Heartburn
• Gastritis, when the stomach’s lining becomes inflamed or swollen
• Indigestion, a feeling of discomfort or burning in your upper belly
• Nutrient deficiencies, low levels of nutrients that help keep your body healthy and strong

The main difference is that bulimia is followed by purging often by inducing vomiting. People who struggle with binge eating disorder don't purge the food they binge.

Health risks of binge eating disorder

Binge eating disorder can lead to rapid weight gain, causing inflammation in other parts of the body like:

• The heart
• The pancreas
• The gut or digestive system

This inflammation can lead to:

• Diabetes
• Heart disease
• Clogged arteries and heart attacks
• Congestive heart failure

Triggers for binge eating disorder

Binge eating disorder has a variety of potential triggers, including:

• Anxiety
• Depression
• Social isolation
• Poor body self-image
• Dieting
• Family history of eating disorders

Some situations and environments may increase your chances of having a binge eating episode. Social gatherings that involving meals, well-meaning but pushy family members encouraging you to eat, candy or pastry dishes shared at work, or even larger food packaging and portions, can trigger an episode. It takes time to recognize your common triggers, but the best way to start is to talk to your doctor. Together, you can make a plan to help manage these triggers.

Treatment for binge eating disorder

"If you think you have binge eating disorder, it's very important to first talk to your primary care provider (PCP) about your symptoms,” says Dr. Apovian. Your PCP can then help you find the right specialty care to support you, including:

• Licensed therapists to provide cognitive behavioral therapy or other mental health treatments
• Psychiatrists to prescribe antidepressants or other medication
• Support groups
• Dietitians to support healthy eating and meal plans

“Treatment for binge eating disorder is focused on targeting the brain to stop binge eating,” according to Dr. Apovian.

Research on binge eating is offering new insights into potential treatments. Dr. Apovian and her colleagues recently published a study on carbohydrate overfeeding, showing that overeating carbohydrates and sugar releases stress hormones throughout the body.

"This study is groundbreaking because it shows that a calorie is not a calorie. Some people can take in all those extra calories and burn them off as heat. But we found that those people who tend to gain weight and have obesity, don’t burn those calories off at heat, they store them as fat,” she explains.