The diagnostic criteria of BED is outlined by DSM-5, there are 3 parts to it:

1. Experience binge eating weekly in the last 3 months, and that is characterised by:
   a. Eating in a discrete amount of time (usually <2 hours), an amount of food which is definitely larger than what most people would eat
   b. The sense of lack of control overeating during the episodes (where you cannot stop eating during the sitting)
2. Experience 3 or more of the following in the last 3 months:
   i. Eating more rapidly than normal
   ii. Eating until uncomfortably full
   iii. Eating large amount of food when physically not hungry
   iv. Eating alone because of feeling embarrassed by how much you're eating
   v. Feeling disgusted depressed or very guilty after overeating
3. Do not engage in any compensatory behaviours such as purging, vomiting, or overexercise to make up for the calories (which will fall under Bulimia)

Wondering if you should get reach out for support and get a diagnosis? 

EDE-Q is a effective screening tool for eating disorder (Diagnostic assessment is recommended with a score of 3 or above) to access

Populations at higher risk for binge eating:

• Women & men in late adolescent and early adulthood (Approx. women:men ratio is 60:40)
• People experienced food insecurity
• LGBTQIA+ populations
• Neurodivergent populations
• People with a history/current depression, anxiety and mental illness
• People with diabetes (type 1 and 2)
• People who are on a restrictive diet due to gut issues (e.g. Low FODMAP diet, elimination diet, etc.)
• People who've been/currently on a restricted meal plan/diet
• People who experienced violence, deprivation and trauma (both acute & complex/small "t")
• Athletic populations

Who can make a diagnosis:

• A mental health specialist with eating disorder training
• A GP or medical practitioner with eating disorder training

What does the assessment involve:

• A preliminary screening test will be carried out (e.g. EDE-Q)
• Further evaluations by talking about your feelings and eating habits & history
• Physical exam might be carried out
• A blood and urine test is usually recommended to check for related health complications

What after getting a diagnosis:

• Your practitioner will help you pick a team of healthcare professionals that suit your need
• If you are an Australian citizen, you are eligible for Medicare Eating Disorder Plan (EDP) - which rebate for up to 40 mental health appointment and 20 dietetic appointments

There are only a few medications that can help assists with Binge Eating Disorder treatment, none has proved to treat binge eating or manage it for long term due to its nature being more than biological. These include:

Selective serotonin reuptake inhibitors (assist with dopamine regulation), helping adhering to nutritional and psychotherapies:

• Vyvanse
• Sertraline
• Fluoxetine
• Fluvoxamine
• Escitalopram
• Citalopram
• Topiramate

GLP-1 (assist with appetite regulation), helping to adhere to nutritional and psychotherapies:

• Ozempics
• Wegovy

Preliminary research suggested that GLP-1 might disrupted the long-term success of treatment due to inconsistent and lower than optimal food intake and disrupting natural hunger-fullness cues attunements.

 Physical Implications

• Digestive discomfort (bloating, nausea, reflux) - can be confuded with IBS or food intolerance

• Fatigue and low energy

• Fluctuating blood sugar levels, Increased risk of type 2 diabetes.

• Weight cycling-induced metabolic stress

• Fertility health, PMS, PCOS, endometriosis

• Sleep disturbances

Psychological Implications

• Guilt, shame, and self-criticism

• Low self-esteem or body dissatisfaction

• Anxiety or depression

• Feeling out of control around food

• Emotional numbness or distress after eating

Social Implications

• Eating in secret or avoiding social meals

• Feeling isolated or embarrassed around others

• Strained relationships due to mood changes or hiding eating habits

• Avoiding events due to body image concerns

Behavioural Implications

• Food restriction to “make up” for binges

• Compulsive eating or emotional eating patterns

• Obsessive thoughts about food, weight, or eating

• Repeated dieting or “starting over” cycles

• Skipping meals or chaotic eating routines

Binge eating doesn’t happen because you’re “weak” or “lack willpower.” It’s far more complex — and deeply human.

Binge eating is often rooted in a combination of genetic predisposition, environmental influences, and triggering life events. That means it’s not your fault — and you’re not alone.

For many people, binge eating is the body’s way of coping or protecting you:

• It might be shielding you from overwhelming emotions or stressful situations.

• It may act as a temporary escape from trauma or painful memories.

• Or it might be your body’s survival response to restriction, long term dieting, or food rules — reacting as though food is scarce or danger is near.

Binge eating isn’t the problem — it’s the body’s attempt at a solution. That's why many "appetite control" and "willpower/discipline" strategies fail to work - because the root problem is unsolved.

Understanding this is powerful. Because when we stop blaming ourselves and start listening to what the binge is trying to tell us, true healing can begin.

There’s no such thing as “sick enough” to ask for support. If binge eating is affecting your mind space, focus, work, relationships, finance, time, or energy — that’s reason enough.

Start by asking yourself: What has binge eating cost me? Your struggle is valid, and you don’t have to wait for things to get worse to deserve care.

The gold standard for recovery includes a medical doctor, psychologist, and dietitian, alongside other professionals who can help manage any complications or co-occurring conditions.
➡️ It’s important to work with professionals who are trained in eating disorders — they understand the unique challenges, make better assessment and can provide safe, evidence-based support and referrals.

But support isn’t one-size-fits-all. You can decide how much help you want and where to begin. Even one small step is a powerful act of care for yourself.