Binge Eating Disorder (BED)
Counselling in Perth
In 2013, Binge Eating Disorder (BED) was officially recognised by the American Psychiatric Association (APA)1 as a mental illness and was subsequently listed in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). Diagnostic criteria are as follows:
- Recurrent and persistent episodes of binge eating
- Binge eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of being embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty after overeating
- Marked distress regarding binge eating
- Absence of regular compensatory behaviours (such as purging).
Statistics estimate that in 2012 approximately 4% of the Australian population had an eating disorder, of which 64% were female. Of this 4% total, 47% had a Binge Eating Disorder2.
Why Do People Binge Eat?
There are different reasons why people end up binge eating. These include:
- Being overweight
- Low self-esteem / self-confidence
- Negative views on body image, shape and weight
- Emotional distress and dysregulation
- Interpersonal / relationship problems
Any, or all of these factors may contribute to the start of, and continued binge eating behaviour.
Medical Co-Morbidities as a Result of Obesity
Not all people who are obese binge eat and not all people who binge eat are obese. However, for those people who are obese, there are a number of co-morbid medical issues that are often present. Some of these include:
- Cardiovasular (stroke, coronary heart disease)
- Sleep apnoea
- High cholesterol
- Hypertension (high blood pressure)
There are a number of psychological issues that are highly correlated to BED. Some of these include:
- Substance use (including alcohol)
- Social isolation
How can a psychologist or counsellor help me with my binge eating?
A psychologist can provide counselling to deal directly with the emotional and behavioural aspects of the BED, as well as other co-morbid issues such as depression and anxiety often associated with BED. The most common forms of psychological therapy for BED is Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT).
Cognitive Behavioural Therapy
CBT specifically for Binge Eating Disorder (CBT-BED) has been shown to be an effective treatment in adults when emotional dysregulation is the precursor to the BED. This type of therapy addresses thoughts (cognitions), feelings, and behaviours directly, with treatment focussing on:
- Normalising eating – set up a regular eating routine
- Reducing or eliminating binge eating behaviour
- Reducing or eliminating any avoidance of specific foods or strict dieting
- Reducing eating due to mood or event triggers
- Exploring core beliefs about body image and the self
- Exploring fears relating to weight (loss) and body shape
- Exploring self-esteem
- Increasing a sense of self-control
- Increasing self-awareness of normal, healthy appetite cues
Dialectical Behaviour Therapy (DBT)
DBT for binge eating teaches skills for emotional regulation and distress tolerance – alternatives to binge eating.
Do I Binge Eat?
Click here to complete a short questionnaire to see if you may have a Binge Eating Disorder.
Despite many people starting to binge eat in their late teens or early 20s, most do not present for therapy until well into adulthood, and do so, often accompanied with a deep sense of shame relating to their behaviour. It can be hard to make the decision to seek help as this binge eating behaviour is often done in secret.
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- American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Butterfly Foundation. (2012). Paying the price: the economic and social impact of eating disorders in Australia. Melbourne: Butterfly Foundation.