Is Binge Eating Disorder the Same as Overeating? 8 Myths, Debunked.

The Truth About Binge Eating Disorder: 8 Myths and 8 Facts

The Truth About Binge Eating Disorder: 8 Myths and 8 Facts
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Although binge eating disorder (BED) is the most common eating disorder among Americans, it’s also one of the most misunderstood.

Some people have preconceived notions about BED, like that it only occurs in young white women. These are harmful misconceptions that can make it harder for people to recognize potential symptoms in themselves or realize that they may need help.

BED is a serious health condition that can happen to anyone of any age, race, gender, or size. It requires prompt diagnosis and professional treatment to reduce the risk of developing other chronic health problems as a result, says Jason Nagata, MD, a pediatrician specializing in eating disorders and an associate professor of pediatrics at the University of California, San Francisco.

“Binge eating can result in psychological effects like depression and anxiety and physical problems including weight gain, heart disease, and diabetes,” Dr. Nagata says. “These health consequences can impact one’s long-term health for decades.”

That’s why it’s so important to know the truth about this condition. Here are eight common myths about BED, and the facts about each one.

1. Myth: Binge Eating Disorder Is Rare

Fact: Many people may think BED is rare because there’s a general lack of public awareness about it compared with other eating disorders, Nagata says. That may be due in part to the fact that it’s a relatively new diagnosis — the American Psychiatric Association first recognized it as a clinical diagnosis in 2013 in its most recent update of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

But as mentioned earlier, BED is actually the most common eating disorder in the United States. An estimated 1.2 percent of adults have BED, while 0.6 percent have anorexia nervosa and 0.3 percent have bulimia nervosa.

This is likely an undercount, though, because BED has historically been underrecognized and underreported. (Research backs this up.) Good estimates are hard to come by because many people don’t talk about it, says Nagata.

“People with binge eating may feel too ashamed to share their struggles, which can make the disorder seem less common than it is,” Nagata says.

2. Myth: Binge Eating and Overeating Are the Same Thing

Fact: Pretty much everyone overeats at some point, whether because of a delicious food spread on Thanksgiving, the irresistible allure of a favorite dessert, or a grandmother who insists on serving everyone seconds even if they already feel full, says Cynthia Bulik, PhD, a professor of psychiatry and nutrition and founding director of the Center of Excellence for Eating Disorders at the University of North Carolina in Chapel Hill.

“What distinguishes a binge from overeating is the sense of loss of control,” Dr. Bulik says. “Once you start eating, you feel like you can’t stop.”

In addition to the loss of control, a binge is also characterized by the amount of food you eat in one sitting. It’s not just that you’re eating more than you usually do; it’s that you’re eating more than most people would in a similar situation, such as eating more than one full meal, or several entrees, or multiple desserts, or a variety of foods that, added together, make up a large amount. A binge isn’t eating three pieces of pizza when you’d normally eat two, for example.

Unlike with overeating, binge eating involves an impulse to eat that can nag at people with BED even when there’s no food around or they’re at work and won’t have a meal break for hours, says Bulik, who’s also a professor and director of the Center for Eating Disorders Innovation at the Karolinska Institute in Stockholm, Sweden.

“For example, I have had patients tell me that they might get an urge to binge in the afternoon at work and sort of go through the motions the rest of the day, all while their brain is planning out where they are going to stop on the way home to get food, what they are going to buy, and whether they are going to binge in the car or at home,” Bulik says.

It’s also important to note that an infrequent binge isn’t considered a symptom of an eating disorder. For a diagnosis of BED, binge eating episodes must happen at least one day a week for three months, according to the DSM-5.


3. Myth: All You Need to Stop Binge Eating Disorder Is Willpower

Fact: “Willpower dominated the thinking for decades about obesity and eating disorders, but we now know that this is blaming the victim,” Bulik says. She uses asthma as an analogy: Blaming binge eating on a lack of willpower is like saying someone with asthma needs more willpower to breathe, she says.

BED is caused by a complex mix of biological, psychological, and environmental factors, and not a lack of willpower, Nagata says. It’s not possible to will it away, either. People often need professional treatment to recover from BED, he says.

The most common treatments for BED include psychotherapy (aka “talk therapy”), prescription medications like lisdexamfetamine (Vyvanse), and counseling with a registered dietitian to help develop eating patterns that aid recovery.


4. Myth: Binge Eating Disorder Only Impacts People With Obesity

Fact: While compulsive overeating is one of many factors that can lead to weight gain, many people with BED aren’t overweight or don’t have obesity, Nagata says. Research suggests that up to about 88 percent of people with BED have obesity in their lifetimes, meaning that not everyone does. “Binge eating doesn’t care what size you are,” Nagata says.

5. Myth: Dieting and Weight Loss Can Cure Binge Eating Disorder

Fact: Binges can be triggered by dieting and calorie restriction for some people, Nagata says. “Dieting can lead to feelings of deprivation and a greater focus on food, often triggering more binge eating,” he says. “This cycle of dieting and binge eating can also increase feelings of guilt and shame, adding to the emotional struggle of binge eating disorder.”

As mentioned earlier, the standard treatments for BED are psychotherapy, medication, or dietary counseling.

6. Myth: Only Adults Can Have Binge Eating Disorder

Fact: Though the median age for developing BED is 21 — meaning that half of people develop the eating disorder before that age and half develop it later — research shows it can happen in kids and teens, too.

In a study of more than 10,000 United States youths ages 9 to 14, Nagata and his colleagues found that 6.6 percent of them reported at least some behaviors typical of BED. They also found that 1.7 percent had received a BED or other specified feeding and eating disorder–binge-eating disorder (OSFED-BED) diagnosis within 2 years after the study. Another study of American children ages 10 to 11 years old found that 1.1 percent met the criteria for BED, and 6 percent had binge eating behaviors.

That said, kids and teens may not always be able to recognize the symptoms of BED in themselves, or articulate what they’re experiencing in a way that gets them formally diagnosed, Bulik says. It can be helpful for parents to ask their kids whether they feel like they lose control of how much they eat in one sitting, Bulik says.

There are also often some common clues around the house. “Parents might find foods going missing, or lots of wrappers in the rubbish, or foods hidden in places where they are normally not stored, like the night stand or the desk,” Bulik says.

7. Myth: Binge Eating Doesn’t Have Lasting Consequences

Fact: “Binge eating disorder is not benign,” says Bulik. Left untreated, some of the long-term health effects of BED can include weight gain and obesity, heart disease, type 2 diabetes, hypertension, and mood disorders like depression and anxiety.

People with BED can also develop sleep problems, digestive issues, and joint and muscle pain over time. Beyond this, it can also interfere with your ability to do your usual daily activities and function in social settings.

While obesity on its own can also contribute to some of the aforementioned health issues, frequent weight fluctuations due to alternating periods of fasting or restricting food and binge eating can also play a role, even among people without obesity, says Bulik.

8. Myth: Binge Eating Disorder Only Occurs in Women

The idea that eating disorders such as BED only happen to women and girls is a common stereotype. In reality, men and boys account for about 1 in 3 people with an eating disorder. Approximately 0.8 percent of U.S. men have BED.

Because of persisting stereotypes that only women develop eating disorders, men are much less likely to recognize symptoms of an eating disorder like BED in themselves and seek treatment for it.


Resources We Trust

EDITORIAL SOURCES
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Stephanie Albers, PhD

Medical Reviewer

Stephanie Albers, PhD, is an eating disorder clinical assessment program manager for Project Heal and a size-inclusive therapist for Libra Virtual Care. She maintains clinical lice...

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Lisa Rapaport

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Lisa Rapaport is a journalist with more than 20 years of experience on the health beat as a writer and editor. She holds a master’s degree from the UC Berkeley Graduate School of J...