Binge eating disorder is a medical syndrome in which, according to currently accepted definitions, people:

-feel their eating is out of control;
-eat what most people would think is an unusually large amount of food;
-eat much more quickly than usual during binge episodes;
-eat until so full they are uncomfortable;
-eat large amounts of food, even when they are not really hungry;
-eat alone because they are embarrassed about the amount of food they eat;
-feel disgusted, depressed, or guilty after overeating.

Binge eating also takes place in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating. Purging, fasting, and overexercising are dangerous ways to try to control your weight.

While binge eating is similar in nature, it is different than being a compulsive overeater.

Occurrence and risk factors

Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese (see note), but normal-weight people also can have the disorder.

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.

Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups. People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.

Note: The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.

Causes

No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known.

Many people who are binge eaters say that being angry, sad, bored, or worried can cause them to binge eat. Impulsive behavior (acting quickly without thinking) and certain other emotional problems can be more common in people with binge eating disorder.

It is also unclear if dieting and binge eating are related. Some studies show that about half of all people with binge eating disorder had binge episodes before they started to diet.

Researchers also are looking into how brain chemicals and metabolism (the way the body uses food energy) affect binge eating disorder. This research is still in the early stages.

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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