The Mystery of Binge Eating Disorder

The information available about eating disorders is widespread and available across many platforms. National organizations link people to diagnoses and basic understanding of these illnesses. Social media shows a plethora of individuals speaking about their own experiences. Journal articles give more clinical information and research discussions. And the DSM-V, the psychiatric bible, offers the criteria used to make the diagnoses.

Despite the multitude of ways to learn about eating disorders, Binge Eating Disorder (BED) remains a mystery to so many people, even those suffering for many years.

It’s not uncommon for me to see people who have suffered with BED for many years only learn about their own diagnosis at a first appointment.

There are several reasons for this anomaly and also some consequences.

The most common eating disorder symptoms people know about are restricting food, binging and purging. When most people think about eating disorders, these symptoms are typically the ones widely known.

Widespread fat phobia and fat shaming in our culture promote the idea that being fat is a result of personal weakness and shame. Thus, most people with BED believe they are flawed and ought to bury their heads and feel awful about themselves. They often don’t consider they may have an illness.

The medical field knows about Anorexia and Bulimia but are so focused on the faulty association between weight and health that they almost never screen for BED and instead only reinforce the fat shaming in our society.

The end result is that people with BED hide from doctors, feel trapped by shame and often don’t learn about their illness until much later in life, often well into adulthood.

The most unfortunate result is that people with BED, in my experience the most easily treated of a difficult set of illnesses, don’t receive treatment until the eating disorder has had a profound effect on their adult lives. Once starting CBT, as discussed in the last post, these patients start to see benefit within a few months, if not sooner.

A comprehensive screening of primary care patients can make a big difference in diagnosing these patients earlier. People with anorexia and bulimia have signs doctors can see more easily: low weight, missing their period, low bone density for anorexia or electrolyte abnormalities, excessive tooth decay or swollen eyes and face for Bulimia.

To screen for BED, primary care providers need to ask a few simple questions about dietary patterns and specifically if someone ever eats an amount of food significantly larger than a typical meal at any time. One question may open the door for diagnosis, education and treatment. Earlier diagnosis of BED can truly change the course of someone’s life.