What causes binge eating

Eating Disorders - Binge Eating Disorder

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In the Binge eating disorder it is a relatively new term that can best be translated as "binge eating disorder". However, the Anglo-American term is also common in Germany.

The American Psychiatric Association recognized the binge eating disorder late as an independent eating disorder. A corresponding classification was first made in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification system, which was published in May 2013. In advance, only anorexia nervosa and bulimia nervosa were described as eating disorders in the DSM, all other disorders of food intake were classified as "unspecified" eating disorders.

Frequency and causes

According to American estimates, binge eating disorder affects around two to three and a half percent of the population. This makes it the most common eating disorder. In the case of overweight people, the proportion is 5 percent, in groups for weight loss it is 30 percent.

Unlike anorexia and bulimia, there is no typical age group. In addition, the proportion of men with this eating disorder is significantly higher. Around a third of those affected are men.

Exact causes are not yet known. Experience from the Basel University Clinic has shown three factors as possible causes: being overweight in childhood, low-carbohydrate, high-fat diet and problems in dealing with conflicts.

In addition, studies have shown that around half of those affected have been depressed at some point. It is currently unknown whether depression causes binge eating or whether it is part of the disease.

Surveys of patients showed that negative feelings such as anger, frustration, etc. are triggers of binge eating, i. H. the binge eating often occurs in times of psychological stress. Eating, which is generally associated with positive feelings, aims to compensate for negative feelings. Various studies have shown that many people with emotional difficulties are unable to distinguish hunger from other uncomfortable feelings.

As with other eating disorders, those affected often report long-term dissatisfaction with their own figure and a large number of diet attempts.

In the case of binge eating disorder, too, fashion trends, the obsession with slimness and the excess of food have a major influence on the development of the disease.


Binge eating disorder has similarities with bulimia, but there are also some differences. Criteria for diagnosing Binge Eating Disorder are summarized below.

Diagnostic criteria for binge eating disorder (DSM-IV criteria)

Regular binge eating with the following characteristics
- excessive food consumption in a definable period of time
- Loss of control during the binge eating
The binge eating are associated with at least three of the following characteristics
- it is eaten much faster than normal
- It is eaten until one feels uncomfortably full
- large amounts are eaten without any noticeable hunger
- it is eaten alone because one is embarrassed how much one eats
- After overeating, disgust, depression and feelings of guilt appear
Mental health
noticeable despair over binge eating
Frequency of binge eating
an average of at least two days a week for six months
No compensation behavior
no laxative measures, fasting, or excessive exercise
no occurrence in the course of anorexia nervosa or bulimia nervosa

A detailed medical history is required for diagnosis. Since during the binge eating mainly foods are consumed that are rich in carbohydrates and fat and that contain only a few vitamins and minerals, those affected often show symptoms of deficiency.


As with bulimia nervosa, recurring cravings are the main characteristic of binge eating. In most cases, people lose control during the seizures. In contrast to bulimia, however, there are no appropriate compensatory measures such as vomiting, abuse of laxatives, etc. Because of the high calorie intake during such an eating attack, many sufferers develop obesity over time. However, they differ in their eating behavior from a "typical" overweight person. While obese people constantly overeat, overweight people with binge eating disorder have occasional binge eating.

The seizures are associated with self-disgust, depression, shame, and guilt. Often times, in an effort to control, an attempt is made to suppress further binge eating. If this attempt fails, those affected often withdraw and live out their binge eating in secret. They are usually good at hiding their addiction from family and friends.


The chances of success for the treatment of binge eating disorder are quite good. Behavioral therapy is similar to that of bulimia. There are two objectives:

  1. Normalization of eating behavior
  2. Treatment of the underlying emotional conflicts

The normalization of eating behavior should z. This can be done, for example, by shopping together, cooking and eating in a group, as well as through instructions on conscious eating.

In the therapy sessions, those affected get to know the triggers of their binge eating and practice new strategies in order to be able to deal with the critical situations that were triggers up to now. In order to identify the moods, feelings, and habits that lead to the attacks, those affected can keep a diary.

Since patients often have a disturbed physical experience, exercise therapy and sport are also part of the therapy.

Diet is not part of the treatment concept. Attempts to lose weight should be avoided. Body weight can be regulated by normalizing eating habits.