What is Binge Eating & Binge Eating Disorder (BED)? Understanding, Diagnosis & Causes

What's A Binge | What's BED | Prevalence | Diagnostic Criteria | Getting A Diagnosis | Causes | Risk Factors | Chracteristics | Complications

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Content note: This article discusses binge eating in detail to help readers understand and identify these experiences. If you find this content distressing, please take care of yourself and reach out for support.

If you've ever felt out of control around food, eaten past the point of comfortable fullness, or felt overwhelming shame after eating, you're not alone.

Binge eating is far more common than most people realise, and binge eating disorder (BED) is the most prevalent eating disorder—affecting more people than anorexia nervosa and bulimia nervosa combined. Yet it remains misunderstood, stigmatised, and often undiagnosed.

This comprehensive guide aims to break down binge eating and BED while reducing the shame, bias, and misconceptions that surround these experiences.

What's Considered a Binge?

Binge eating is featured a sense of lack of control. 

This is the defining characteristic that distinguishes a binge from simply eating a large meal. During the episode, you feel unable to stop eating or control what or how much you're eating. This might feel like being on autopilot, eating rapidly, or continuing to eat despite feeling physically uncomfortable or wanting to stop.

The lack of control is often described as feeling driven or compelled to eat, as if something else is controlling your actions. Many people describe it as a trance-like state or feeling disconnected from their body during the episode.

2 subtypes:

Objective binge eating: This refers to lack of control eating AND eating an objectively large amount of food. This means eating definitely larger amount (by volume of food instead of by calories) than what most people would eat in a similar period of time. For example, eating 3 slices of pizza when you plan to eat 1 isn't neccessarily a binge. However, eating an entire pizza, PLUS a tub of ice cream, PLUS other food in one setting would be objectively large amount of food

Subjective binge eating: Simply eating out of control, it tends to lead to overeating but may not meet the criteria of "objectively large amount of food"

What doesn't qualify as a binge?

 Binge eating is very different from other overeating experiences:

• Eating past comfortable fullness at a celebration (like Thanksgiving dinner) when you're enjoying the social experience and food, even if you eat more than usual
• Having seconds or thirds of a meal you're enjoying, even if it's more than you typically eat
• Eating foods you've labeled as "bad" or "forbidden," even if you feel guilty afterward—if you're in control and eating a normal amount
• Emotional eating where you eat for comfort but remain in control and eat reasonable amounts

The key differentiators are the objective amount of food (truly large, not just "more than I wanted") and the loss of control during the eating episode.

What is Binge Eating Disorder (BED)?

Binge eating disorder (BED) is a serious mental health condition, and was officially recognised as a dintinct eating disorder in the DSM-5 in 2013, though clinicians had been observing and treating it for decades before its formal recognition. (1)

For decades, BED is considered as a "less serious" eating disorder, a lack of willpower, or a character flaw. It's a complex condition incluenced by biological, psychological and social factors - just like other eating disorders and disordered eating

BED is the most common eating disorder, and binge eating is the most prevalent disordered presentation, yet it often goes unrecognised and untreated. 

Many people with binge eating and BED suffer in silence, believing they're simply "lack of self-control" or that they should be able to "just stop bingeing". This self-blame is not only inaccurate but also prevents people from seeking the treatment they need and deserve.

Understanding BED as a legitimate medical condition, rather than a personal failure, is the first step toward reducing stigma and ensuring people receive promptly, approapriate and compassionate care.

Prevalence: How Common Is BED?

• Binge Eating Disorder and binge eating is far more common than many people realise, making it a significant public health concern.
• 2.5%-4.5% of female and 1%-3% of male will struggle with BED in their life (2)
• Binge eating disorder has the latest average age of onset of all eating disorder, estimated to be ~25 years of age (3)
• Binge eating or loss-of-eating may be as high as 25% in people post-bariatric surgery. (4)
• Prevalence of BED is nearly 2x in individual with BMI 30+ (5), however, it can found in people of all sizes and shapes.
• Of people with eating disorders in Australia, 47% have BED, compared to 3% of Anorexia Nervosa, 12% with Bulimia Nervosa (binge-purge) and 38% with other eating disorders (may also present binge eating presentation). (6)
• BED can affect anyone regardless of gender, of which, ~57% are women and 43% are men. (7) Clinicians found it's underdiagnosed in men.

Diagnosis: The DSM-5 Criteria for BED

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides specific criteria for diagnosing binge eating disorder. And there are 5 criterions to make a diagnosis

Criterion 1: Recurrent episodes of binge eating

A binge eating is characterised as a objective binge eating:

• Sense of lack of control
• Eating a large amount of food in a short period of time (usually within 2 hours)

Criterion 2: Binge eating episodes include at least 3 of the following characteristics:

• Eating much more rapidly than normal
• Eating until feeling uncomfortably full
• Eating large amounts of food when not feeling physically hungry
• Eating alone because of feeling embarrassed by how much you're eating
• Feeling disgusted with yourself, depressed, or very guilty afterward

Criterion 3: Marked distress about binge eating

Binge eating causes significant psychological distress. You feel upset, anxious, ashamed, or troubled by the binge eating episodes. This criterion acknowledges that BED is not just about eating behaviours—it profoundly affects your emotional well-being.

Criterion 4: Frequency and duration

The binge eating occurs at least once a week for three months. This distinguishes BED from occasional binge eating episodes that many people might experience occasionally.

Criterion 5: Not associated with compensatory behaviours

The binge eating is not regularly followed by compensatory behaviours such as purging (self-induced vomiting, use of laxative & diuretics), fasting or excessive exercise. This is what distinguishes BED from bulimia nervosa. 

Additionally, the binge eating doesn't occur during episode of anorexia or bulimia.

Severity Levels

The DSM-5 also include severity based on the frequency of binge eating episode per week:

• Mild: 1-3 binge eating episodes per week
• Moderate: 4-7 binge eating episodes per week
• Severe: 8-13 binge eating episodes per week
• Extreme: 14 or more binge eating episodes per week

It's important to note that even you don't meet the full diagnostic criteron or a "mild" BED is serious and deserves treatment. The severity only help clinicians understand the intensitive of symptoms, but not a reflection of how much someone is suffering or derserving of care.

Subclinical Binge Eating

Not everyone who binge eats meet the full diagnostic criteria for BED. Some people experience binge eating less frequent of for shorter period of time.This is sometimes called subclinical binge eating or other specified feeding or eating disorder (OSFED). These experiences are still valid, distressing, and worthy of treatment—you don't need a formal BED diagnosis to deserve support.

Binge Eating vs. Overeating

The biggest differences between binge eating and overeating is the feeling of out of control and the degree of distress

If you occasionally overeat at celebrations but feel in control and don't experience intense shame, that's normal overeating—not binge eating. If you regularly experience loss of control, eat large amounts rapidly, and feel overwhelming shame afterward, this may indicate binge eating that warrants professional support.

Binge Eating vs. Bulimia Nervosa

Both binge eating and bulimia involve:

• Recurrent binge eating episodes
• Significant distress around eating
• Often experience body image concerns

The key difference is that people with bulimia present regular compensatory behaviours followed by binge eating or eating:

• Self-induced vomiting
• misuse of laxatives or diuretics
• fasting 
• excessive exercise (or high volume exercise)

Can you have both? 

The truth is eating disorder and disordered eating isn't that clean cut, and often transdiagnose. 

For example, someone might initially have restrictive anorexia nervosa, then the body backfires and become anorexia nervosa binge-purge subtype, and maybe later in life it has transdiagnosed to bulimia with regular purging, then purging might stop while binge eating continue, meeting BED criteria.

This fluidity between different diagnosese highlights that eating disorders and disordered eating exist on a spectrum and the specific diagnosis matters less than ensuring appropriate treatment for the presentations you are experiencing and the underlying psychological pattern - this is refered as transdiagnostic model of eating disorders.

How to Get A BED Diagnosis?

If you suspect you might have BED, you can seek out support from a qualified health professional for a diagnosis:

• Psychiatrists are medical doctors who specialize in mental health and are qualified to diagnose all mental health conditions, including eating disorders. They can also prescribe medication if appropriate.
• Psychologists with training and experience of eating disorders can diagnose BED.
• Licensed therapist who have specialised training and experience in eating disorder may able to diagnose BED depending on local regulations
• General Practitioner and medical officers with training in eating disorder can screen and diagnose BED. While they may not specialise in eating disorder or BED, they still play a crucial role in screening and referrals.

The Diagnostic Process

A diagnosis typically involve:

• Validated screening tools: Questionnaires designed to assess eating disorder, such as Eating Disorder Examination Questionnaire (EDE-Q) or Binge Eating Scale (BES)
• Clinical Interview: A thorough conversation about your behaviours, thoughts about food and body, emotional state and how these experiences impact your life
• Medical Assessment: A physical examination and possible lab test to rule out other medical condition that might affect eating and to assess the medical implication of BED
• Mental health assessment: it does not contribute to the BED diagnosis, but to evaluate co-occurring mental health conditions like depression, anxiety, or substance use disorders, which commonly occur alongside BED.

Barriers to Diagnosis

Unfortunately, many people with BED face barriers to receiving a diagnosis:

• Weight bias: Healthcare providers may not screen for BED in patients in smaller bodies, and may not register possible BED in people in larger bodies.
• Lack of awareness: Many healthcare providers are not adequately trained in eating disorders (many only recognise low weight anorexia) and may not recognize BED symptoms
• Shame and secrecy: The shame surrounding binge eating often prevents people from disclosing their symptoms to healthcare providers
• Minimisation: BED is sometimes dismissed as "just overeating" or a weight problem rather than recognised as a serious mental health condition

If you're struggling to get taken seriously by a healthcare provider, know that this reflects failings in the healthcare system, not the validity of your experience. You may need to advocate for yourself or seek out a provider who specialises in eating disorders.

Causes: Why does BED develop?

Binge Eating doesn't have a single cause. Rather it develops from a complex interaction of biological, psychological, and social factor. Understanding these factors help reduce self-blame and inform treatment approaches

Biological factors

• Genetics: Research shows ~50% of binge eating risk is genetic. (8)
• Neurodivergence: Neurodivergent population has an increased risk of binge eating due to sensory seeking tendencies or unintentional restriction. (9)
• Brain chemistry: Differences in neurotransmitters like serotonin and dopamine - which regulate mood, reward and impulse control - may contribute to binge eating behaviours (10)

Behavioural factors 

• Dieting and restriction: One of the most significant risk factors for developing BED is dieting. Restrictive eating—whether through formal diets or self-imposed food rules—often triggers binge eating.(11) The restriction-binge cycle is powerful: when you deny yourself certain foods or don't eat enough, your brain interprets this as deprivation and triggers strong urges to eat, often leading to loss of control.

Psychological factors

• Emotion regulation difficulties: Many people with BED use binge eating as a way to cope with difficult emotions like stress, anxiety, sadness, loneliness, or boredom.(12) If you haven't learned other ways to manage uncomfortable emotions, food can become your primary coping mechanism.
• Negative body image: Dissatisfaction with your body and internalization of thin-ideal standards can contribute to both dieting behaviors and binge eating.(13)
• Low self-esteem: Feeling negatively about yourself more broadly—not just about your body—is associated with BED.(14)
• Perfectionism: Having excessively high standards for yourself and being overly self-critical can contribute to eating disorder development.(15)
• Trauma: A history of trauma, including physical, sexual, or emotional abuse, increases the risk of developing BED.(16) Binge eating may serve as a way to cope with trauma symptoms or to disconnect from painful emotions and memories.

Social and cultural factors

• Diet culture: Living in a culture that glorifies thinness, demonizes certain foods, and promotes dieting creates an environment that fosters disordered eating.(17) The constant message that you should be controlling your eating and changing your body contributes to the restriction-binge cycle.
• Weight stigma and discrimination: Experiencing weight-based teasing, bullying, or discrimination—particularly during childhood and adolescence—significantly increases the risk of binge eating.(18)
• Food insecurity: Paradoxically, not having consistent access to enough food can contribute to binge eating patterns. When food becomes available after periods of scarcity, the body may respond by overeating as a survival mechanism.(19)
• Family eating environment: Growing up in an environment with rigid food rules, restriction, or where food was used for emotional regulation can contribute to BED development.(20)
• Sociocultural pressures: Messages from media, peers, and family about ideal body size and eating can create pressure that contributes to restriction and hence increase risk of binge eating. The distress from health and body ideal can also contribute to binge eating.

The bio-psycho-social model 

BED, like any other eating disorder, doesn't result from just one of those factors/domain, but from an interaction of multiple factors. For example, someone might have a genetic vulnerability, experience childhood trauma, grew up in diet culture influence, lack of protective factors, begin dieting in response to weight stigma and use binge eating to cope with anxiety - all factors work together to develop and maintain BED.

This complex causation means there's no simple answer to "why me?"—and more importantly, it means BED is not one person's fault. No one choose to develop BED, and blaming anyone for having it is both inaccurate and unhelpful.

Risk factors and protective factors

While anyone can develop BED, certain factors may increase or decrease someone's risk.

Risk factors

• History of dieting: research shows people who have dieted or currently dieting are 2.5 times more likely to binge eating
• Family history of eating disorders: Having relatives with eating disorders or other mental health conditions
• History of trauma or adverse childhood experiences
• Pre-existing mental health conditions: Such as depression, anxiety, or post-traumatic stress disorder (PTSD)
• Impulsivity or difficulty with self-regulation
• Negative body image or body dissatisfaction
• People who are neurodivergent
• LGBTQA that do not feel accepted 
• BIPOC, hispanic and latino population
• Low self-esteem
• Perfectionism or high achievement orientation
•  Exposure to weight stigma, bullying, or weight-based teasing
• Participation in sports or activities that emphasize weight or appearance: Such as wrestling, dance, modeling, or gymnastics
• Cultural pressures: Living in cultures or communities with strong emphasis on thinness or specific body ideals
• Food insecurity or inconsistent access to food
• Family focus on weight, dieting, or appearance
• Have gone through major life stressors: Such as loss of a loved one, relationship problems, job stress, or financial difficulties
• Developmental transitions: Such as puberty, leaving home for college, or other identity-forming periods
• Significant life changes: Including pregnancy, childbirth, divorce, or relocation

 Protective factors

• People with high self-esteem
• Positive body image
• Critical awareness of diet culture and media messages about bodies
• Strong emotional regulation skills and healthy coping strategies
• School/Sports achievement
• Be self-directed and assertive
• Diverse, flexible eating patterns without rigid rules
• Good social skills with success at performing social roles
• Sense of belonging to family which does not emphasise weight and physical attractiveness
• Eating regular meals with the family
• Belonging to a less westernised culture which accepts range of body shape and sizes
• Involve in sport industry where no emphasis on physical attractiveness or thinness
• Peer or social support structure and relationship where weight and appearance are not of high concern

Characteristics: What Does Binge Eating Look Like?

Beyond the diagnostic criteria, there are common patterns and presentations that people with BED often experience.

Beahvioural Characteristics

• Secretive eating: Many people with BED hide their binge eating from others, eating alone or waiting until others are asleep. The shame surrounding binge eating often leads to this secrecy, which in turn intensifies the shame—creating a painful cycle.
•  

  Food rituals: Some people develop specific rituals around binge episodes, such as eating certain foods in a certain order, or specific preparations before or after binges.

• Food hoarding: Keeping large quantities of food hidden for binge episodes, or feeling anxiety if certain foods aren't available.

• Grazing throughout the day: Some people with BED engage in continuous eating throughout the day rather than (or in addition to) discrete binge episodes.

• Binge eating with screen or distractive medium: Many people with BED report to eat in front of screen, working or reading. This fuel the disconnection between body signal and emotional state

Physical Characteristics:

• Eating rapidly: Consuming food much faster during a binge than during normal eating.
• Eating beyond comfortable fullness: Continuing to eat despite feeling physically full, sometimes to the point of pain or nausea.
• Gastrointestinal distress: Experiencing stomach pain, bloating, nausea, or other digestive issues after binges.
• Fatigue: Feeling physically exhausted after binge episodes.
• Weight fluctuations: Some people with BED experience weight cycling, though others maintain a stable weight.

Emotional Characteristic: 

• Intense shame and guilt: Overwhelming negative emotions after binge episodes are nearly universal among people with BED. This shame often prevents people from seeking help.
• Using food to cope with emotions: Binge eating in response to stress, sadness, anxiety, anger, loneliness, or boredom—or sometimes even positive emotions like excitement.
• Feeling out of control: A pervasive sense that you can't control your eating, which may extend to feeling out of control in other areas of life.

Psychological Characteristics

• Pre-occupation with food: Spending significant mental energy thinking about food, planning binges, or trying not to binge.
• Disconnect during binges: Many people describe feeling "zoned out," dissociated, or on autopilot during binge episodes.

• All-or-nothing thinking: Viewing eating in black-and-white terms—either eating "perfectly" or completely losing control.

• Food rules: Having rigid rules about "good" and "bad" foods, despite repeatedly breaking these rules.

• Body checking or avoidance: Either frequently checking your body (weighing, measuring, looking in mirrors) or avoiding seeing your body entirely.

• Negative self-talk: Harsh internal criticism about eating, body, or yourself as a person.

Complications: The impact of Untreated binge eating and BED.

Binge eating affects multiple aspects of health and well-being. And a major complications for binge eating behaviours is to develop BED. 

Understanding the potential complications emphasises the important of seeking support early to maximise your health and quality of life

Physical complications

• Gastrointestinal issues: Chronic binge eating can lead to ongoing digestive problems including acid reflux, bloating, constipation, stomach pain, disorders of gut-brain interaction (DGBI) and irritable bowel syndrome (IBS).(21)
• Metabolic changes: BED is associated with increased risk of metabolic syndrome, type 2 diabetes, high cholesterol, and high blood pressure.(22) It's important to note that these conditions can occur in people of any size, and having BED doesn't mean you'll definitely develop these conditions.
• Cardiovascular risks: Some research suggests associations between BED and increased cardiovascular disease risk.(23)
• Weight cycling: The pattern of binge eating, attempted restriction, and subsequent binge eating can lead to weight cycling (repeated weight loss and gain), which has its own health implications.(24)
• Sleep disturbances: BED is associated with sleep problems, including insomnia and sleep apnea.(25)
• Chronic pain: Some people with BED experience chronic pain conditions.(26)

Mental Health Complications

• Depression: BED co-occurs with depression at high rates. Research shows that 50-60% of people with BED also experience depression.(27)
• Anxiety disorders: Generalized anxiety disorder, social anxiety, and panic disorder commonly co-occur with BED.(27)
• Substance use disorders: People with BED have higher rates of alcohol and substance use disorders compared to the general population.(28)
• Post-traumatic stress disorder (PTSD): BED and PTSD frequently co-occur, particularly when trauma preceded the eating disorder.
• Increased suicide risk: Like other eating disorders, BED is associated with increased risk of suicidal thoughts and behaviors.(29)

Quality of Life Impact

• Social isolation: The shame and secrecy around binge eating often lead to withdrawing from social activities, particularly those involving food.
• Relationship difficulties: BED can strain relationships with family, friends, and romantic partners, especially when the disorder is kept secret.
• Work or academic impairment: The time, energy, and mental focus consumed by BED can interfere with work performance, academic achievement, and career progression.
• Financial costs: Regular binge eating can be expensive, and the associated healthcare costs add up over time.
• Reduced quality of life: Research consistently shows that people with BED report lower quality of life across physical, psychological, and social domains.(30)

The Importance of Early Treatment

The good news is that many of these complications improve with treatment. The earlier you seek help, the more you can prevent or mitigate these complications. BED is highly treatable, and recovery is possible—we'll discuss treatment options in detail below.

Key Takeaways

1. BED is a legitimate medical condition—not a character flaw, willpower issue, or personal failure.

2. You don't need to meet full diagnostic criteria to deserve help—your struggle is valid regardless of severity.

3. BED affects people of all body sizes, genders, and backgrounds—you cannot tell who has it by looking at them.

4. Dieting and restriction is the biggest modifiable risk factor to binge eating—they're major risk factors, not solutions.

5. Shame keeps you stuck; speaking about it is the first step toward freedom—secrecy maintains the disorder.

6. BED is highly treatable and full recovery is possible—with appropriate support, recovery is probable, not just possible.

7. Early intervention significantly improves outcomes—don't wait until you're "sick enough" to seek help.

8. Co-occurring mental health conditions are common and treatable—addressing them together leads to better outcomes.

9. You deserve compassionate, specialized care—dismissive providers reflect inadequate training, not the validity of your experience.

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