The Most Common Binge Eating Disorder Symptoms to Know

Binge eating disorder (BED) is a seemingly straightforward label for a really complex condition. The binge eating part sounds clear enough: eating too much, too fast, until you’re too full. And the disorder part implies the eating pattern has health consequences.

But the simplicity of the name doesn’t capture the wide array of binge eating disorder symptoms, causes, triggers, and profound emotional effects this condition can have. It doesn’t reveal how devastating it can be.

On the other hand, it also doesn’t hint at the hope there is for treating what has become the most common eating disorder in America, according to the National Institute of Diabetes, Digestive, and Kidney Diseases.

The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) describes binge eating disorder as eating more than an average amount of food in a limited timeframe—usually around two hours—while feeling out of control.

That’s a very basic description of this disorder, but most people will have a variety of behaviors and feelings around binge eating. According to the National Eating Disorder Association (NEDA), the key factors for diagnosis include:

• Recurrent episodes of binge eating
• Extreme distress over binge eating episodes
• Not compensating for binge eating with behaviors like purging or exercise
• Episodes that include three or more of the following:
• Eating very rapidly
• Eating until you feel uncomfortably full
• Eating large quantities of food despite not feeling physically hungry
• Eating alone due to embarrassment about how much you are consuming
• Feeling disgusted, depressed, or guilty about overeating

For some, binge eating starts as a way to cope and self-soothe in a bad situation, for example, when a person is dealing with trauma or abuse. For others, it’s a response to food insecurity. That’s when there is plenty to eat after payday and not enough later on, which can trigger you to eat while you can.¹

However the pattern begins, it can quickly become overwhelming. Binge eating is hard on your mind and body. An episode is usually followed by a toxic blend of physical discomfort and feelings of shame or self-loathing—none of which are your fault. If the condition isn’t treated, it can disrupt your life, harm your health, and even bring about an early death.

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Exactly what people do during a binge eating episode varies from person to person—it’s a lot different from simply overeating at dinner. Not everyone experiences all of these symptoms, and you may have others that aren’t mentioned here. If you occasionally eat your breakfast in a rush to get out the door, that would not signify binge eating disorder. It’s when you display multiple eating behaviors and generally feel out of control in these moments that could signal a problem.

Even so, a few behaviors stand out as binge eating disorder symptoms, according to the NEDA. They can include:

• Eating large amounts in brief periods
• Eating in a rush
• Hiding food or certain eating behaviors
• Hiding the evidence of eating, like wrappers and packages
• Withdrawing from others
• Avoiding events where people will be eating
• Eating on intense impulse, rather than on a schedule
• Restricting what you eat in public and bingeing when you’re alone
• Creating lifestyle schedules or rituals around binge eating, such as avoiding activities with friends to make time for binge eating or rituals like not allowing foods to touch
• Criticizing your body cruelly and relentlessly
• Trying numerous fad diets (more on this below)

People with binge eating disorder do not use compensatory behaviors, meaning they don’t purge, use laxatives, fast, or overexercise to try and rid themselves of the calories they’ve eaten (unlike people with anorexia or bulimia, who do engage in these behaviors). While this might seem counterintuitive, people with binge eating disorder often do go through periods of food restriction and fad dieting, however. It’s just that after a binge eating episode, they do not try to directly “make up for” the calories they’ve consumed with those other behaviors.

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During a binge episode, you might not notice anything other than the drive to keep eating. But afterward, a host of physical symptoms may begin. According to a 2019 study published in the journal Nutrients,² these can include:

• Stomach discomfort, pain, or cramping
• Nausea or feeling ill
• Difficulty concentrating
• Bloating
• Low energy
• Heartburn or other signs of acid reflux
• Diarrhea
• Constipation or feeling blocked
• Weight gain

If the eating pattern continues, you might notice that your body’s hunger and fullness signals change too. If you are less sensitive to those signals, it can affect your ability to stop eating during a binge episode.

It’s important to know that even though weight gain is a symptom, not everyone with binge eating disorder is overweight, and most people diagnosed with obesity don’t have binge eating disorder—BED can develop at any weight. Since people with BED often take great pains to hide their eating behaviors, you may not even know if a friend or loved one is struggling with this.³

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During a binge eating episode, the main thing you feel is out of control. You might feel embarrassed or afraid to eat around other people. You might feel scared to eat certain kinds of food that are viewed as unhealthy, like carbs or sugar, even though they are perfectly okay to enjoy, according to the NEDA.

When you have binge eating disorder, you’re also likely to be awash in feelings such as anxiety, shame, guilt, disgust, and even anger. In fact, a 2020 study published in the journal Psychiatria Danubina found that behaving anxiously as a response to anger was found to be a predictor for disordered eating—including binge eating—in people with depression.⁴

All of these feelings are part of the human experience. Everyone has them. But if you have an eating disorder, they can drive a destructive cycle. Negative emotions like anxiety and anger can trigger binge eating. Binge eating episodes then fuel more negative feelings. They may even leave you with the feeling that you hate yourself.

If you have a mood disorder such as depression or anxiety, BED may be even harder on you emotionally. A 2016 study published in Obesity Research and Clinical Practice shows that roughly 20% of those with mood disorders have trouble with binge eating. And people with binge eating disorder experience more severe anxiety than others.⁵

You’re dealing with what Rachel Goode, Ph.D., LCSW, assistant professor at the University of North Carolina’s School of Social Work, calls “a great deal of emotionality.” Coping with BED’s emotional symptoms means learning the skills to “navigate these feelings and manage crisis events,” she tells SELF.

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The first step toward a binge eating diagnosis is reaching out for help. Unfortunately, only about 28% of people with a binge eating disorder are currently receiving treatment, and only about 43% will seek treatment at some point in their lives, per the NEDA.

The secretive nature of eating disorders may be one reason people don’t get help, but there are other factors at play. For one, “since eating disorders have stereotypically been associated with the identities of white women, many Black women go undiagnosed and may not even receive the same referrals to eating disorder clinicians,” notes Dr. Goode, who has researched this problem extensively. In fact, the lack of diagnosis for eating disorders is more severe among Black women in the U.S., she says. But eating disorders affect all kinds of people, not just one race or gender. 

Another factor is that doctors may focus only on weight loss or gain without ever discussing the possibility of an underlying eating disorder, which can actually worsen the problem.

For people who do reach out for help, the process of being diagnosed usually involves an interview with a health care professional. To guide the interview, a doctor or therapist might use an eating disorder questionnaire such as the Binge Eating Scale or Eating Disorder Examination. This tool has questions about symptoms, how often and how intense the episodes are, and when they happen. The American Psychiatric Association says people with a binge eating disorder binge at least once a week for a period of three months or longer.

There’s no specific lab test to confirm that you have an eating disorder, but your doctor will probably measure your body mass index, your waist circumference, and your blood pressure. You might also be screened for other health conditions that can sometimes develop due to binge eating disorder, like type 2 diabetes and gastroesophageal reflux disease (GERD).

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The health complications associated with binge eating disorder can include rapid weight fluctuations and mental health issues, but again, this eating disorder can be diagnosed at any weight. Only about a third of people with BED have clinical obesity, per the NEDA.

According to Johns Hopkins Medicine, these are some other binge eating disorder complications that can arise:

• Metabolic syndrome, a cluster of changes in the body that can increase your risk for type 2 diabetes, stroke, and heart disease
• Heart disease, including high blood pressure and high cholesterol
• Sleep apnea
• Type 2 diabetes
• GERD
• Fatty liver disease
• Hormone imbalances
• Irregular periods
• Osteoarthritis
• Colon, breast, and other cancers
• Depression
• Substance use disorder

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Researchers don’t know exactly what causes an eating disorder. But they do know there’s a genetic link. They’ve also identified other factors that raise your risk of developing one.

“For so long we have believed disordered eating is the result of a preoccupation with the thin ideal,” Dr. Goode says. It turns out there’s much more to it than that. “There is emerging evidence that disordered eating may also be the result of poverty, racism, perceived discrimination, and trauma.”

Here’s what we know so far about what causes binge eating disorder.

• Family history: Family conflicts, family eating problems, and certain parenting styles can lead to binge eating. In particular, a 2020 study published in the journal European Eating Disorders Review noted that parenting with a style called “affectionless control”—obedience above all—is associated with higher rates of binge eating.⁶
• Trauma: Sexual assault, a car accident, or even the sudden loss of a loved one can trigger BED. In the aftermath of the trauma you experience, binge eating somehow becomes a way of comforting, numbing, distracting, or even punishing yourself. “Trauma is actually quite a common root to the development of disordered eating,” Dr. Goode points out.
• Food insecurity: According to a 2020 study published in the journal Current Psychiatry Reports, researchers have found a link between food insecurity and binge eating disorder. For low-income families and individuals, food may only be available in waves, so in times when food is available, you may overcompensate by eating more or hoarding food.¹
• Racism: A 2018 study published in the Journal of Clinical Medicine found that day-to-day race discrimination increases the risk of developing BED, especially among Black women.⁷ Over time, exposure to racial discrimination changes your body’s stress response, making it more likely you’ll resort to stress eating.
• Physical, emotional, or sexual abuse: According to a 2017 study published in the International Journal of Eating Disorders, if you experienced any of these forms of mistreatment when you were growing up, your chances of developing binge eating disorder (or any eating disorder, for that matter) as an adult are higher.⁸
• Harmful self-talk: How you talk to yourself matters, so it’s no surprise that extreme perfectionism and self-criticism go hand in hand with binge eating, according to a 2020 study published in the International Journal of Eating Disorders.⁹
• Overvaluing weight or specific body shapes: In some families, individuals, and cultures, a heavy emphasis is placed on maintaining a certain weight or body shape. One 2015 study published in the Journal of Adolescent Health found that this infatuation with body type was linked to weekly binge eating in girls as young as 12 years old.¹⁰

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Ready for the good news? Even though it can feel hard to stop binge eating, binge eating disorder can be treated successfully and many people go into recovery. Research shows that these approaches can help people heal and create healthier eating patterns. Here is a brief overview of the types of treatments and therapy you may encounter.

• Cognitive behavioral therapy (CBT) can help you learn to recognize distorted thought patterns and replace them with healthier ideas.
• Interpersonal therapy (IPT) works in group, family, or individual sessions to help you learn to spot problems in relationships, make changes, and resolve grief and conflict.
• Eye-movement desensitization and reprocessing (EMDR) is a treatment that uses eye movements to disempower disturbing memories and beliefs.
• Dialectical behavior therapy (DBT) helps you balance your emotions, tolerate stress, and stay in the moment.
• Acceptance-based commitment therapy helps you identify your values, accept yourself, and align your eating behaviors with your chosen values.
• Appetite-awareness training is a treatment approach that helps you tune in to your body’s hunger signals, eat before you’re too hungry, and build up the ability to avoid eating when you’re not actually hungry.¹¹
• Other treatments can include certain medications, such as antidepressants, and acceptance-based behavioral weight-loss programs.¹² These are typically done under medical supervision after the binge eating disorder is treated, as any major diet changes can be triggering, the Mayo Clinic says.

So we know there are treatments that do work for binge eating disorder, but right now there are huge gaps in who can access them. Such help is especially unavailable for people without health insurance or in marginalized communities.

“The real challenge,” Dr. Goode points out, “is providing treatment spaces they can access.” Many programs are still centered in costly in-patient treatment centers. Dr. Goode and other researchers in the field recognize that eating disorder treatment depends partly on health care and economic reform.

“We are going to have to see that individual-level treatments may not be enough to truly help the most underserved in our society,” she says. “Having a lens toward social justice will position us to think in a different way and work to achieve health equity.”

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Binge eating disorder recovery (or any eating disorder recovery, for that matter) can be a lifelong journey. Even though treatments may not be easily accessible for everyone right now, there are still ways to find help. If you have a trusted friend, family member, or health care provider you can turn to, reaching out to them is often a good first step in seeking support. These resources may also help:

• National Eating Disorder Association Helpline is available at  (800) 931-2237.
• Alsana offers online eating disorder support groups.
• Recovery Record is an eating disorder treatment app.
• MEDA has online support groups.
• Inclusive Therapists is a resource for finding a therapist who shares your identities.
• Center of Excellence for Eating Disorders offers treatments and opportunities to join research studies.

Recovering from binge eating disorder isn’t easy. It takes time, commitment, self-compassion, and support. “There is no rush,” Dr. Goode says. “Moving at a slow pace in the work is still movement. You have to just keep going.”

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Sources:

1. Current Psychiatry Reports, Food Insecurity and Eating Disorders: A Review of Emerging Evidence
2. Nutrients, Eating Disorders and Gastrointestinal Diseases
3. International Journal of Eating Disorders, I Didn’t Want Them to See: Secretive Eating among Adults with Binge-Eating Disorder
4. Psychiatria Danubina, Evaluation of Eating Attitudes, Anger and Impulsivity in Atypical and Non-Atypical Depression and Assessment of Comorbidity of Binge Eating
5. Obesity Research and Clinical Practice, Binge Eating in Adults with Mood Disorders: Results from the International Mood Disorders Collaborative Project
6. European Eating Disorders Review, Affectionless Control: A Parenting Style Associated with Obesity and Binge Eating Disorder in Adulthood
7. Journal of Clinical Medicine, Perceived Discrimination and Binge Eating Disorder; Gender Difference in African Americans
8. International Journal of Eating Disorders, Child Maltreatment and Eating Disorders Among Men and Women in Adulthood
9. International Journal of Eating Disorders, Longitudinal Relations of Self-Criticism with Disordered Eating Behaviors and Nonsuicidal Self-Injury
10. Journal of Adolescent Health, Prospective Association Between Overvaluation of Weight and Binge Eating Among Overweight Adolescent Girls
11. Eating Behavior, The Feasibility of a Binge Eating Intervention in Black Women with Obesity
12. Cognitive and Behavioral Practice, Developing an Acceptance-Based Behavioral Weight Loss Treatment for Individuals With Binge Eating Pathology

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