WIN Weight-control Information Network

U.S. DEPARTMENT

OF HEALTH AND

HUMAN SERVICES

How do I know if I have binge eating disorder?

Most of us overeat from time to time, and some of us often feel we have

eaten more than we should have. Eating a lot of food does not necessarily

mean that you have binge eating disorder. Experts generally agree that

most people with serious binge eating problems often eat an unusually

large amount of food and feel their eating is out of control. People with

binge eating disorder also may:

■ eat much more quickly than usual during binge episodes

■ eat until they are uncomfortably full

■ 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 occurs 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.

How common is binge eating disorder,

and who is at risk?

Binge eating disorder is the most common eating disorder. It affects about

2 percent of all adults in the United States (as many as 4 million

Americans).

People of any age can have binge eating disorder, but it is seen more often

in middle-aged adults (ages 46 to 55 years). Binge eating disorder is a

Binge Eating

Disorder

Binge eating

disorder is a

condition that

millions of

Americans may

have. People with

binge eating

disorder often eat

large amounts of

food and feel that

they can’t control

their eating.
2

* 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.

little more common in women than in men; three women for every two

men have it. The disorder affects blacks as often as whites. It is not known

how often it affects people in other ethnic groups.

Although most obese people do not have binge eating disorder, people

with this problem are usually overweight or obese.* Binge eating disorder

is more common in people who are severely obese. Normal-weight people

also can have the disorder.

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 weight (yo-yo diet) more often.

What causes binge eating disorder?

No one knows for sure what causes binge eating disorder. As many as half

of all people with binge eating disorder are depressed or have been

depressed in the past. Whether depression causes binge eating disorder or

whether binge eating disorder causes depression is not known.

It is also unclear if dieting and binge eating are related. Some people

binge eat after dieting. Dieting here means skipping meals, not eating

enough food each day, or avoiding certain kinds of food. These are

unhealthy ways to try to change your body shape and weight.

Studies suggest that people with binge eating may have trouble handling

some of their emotions. Many people who are binge eaters say that being

angry, sad, bored, worried, or stressed can cause them to binge eat.

Certain behaviors and emotional problems are more common in people

with binge eating disorder. These include abusing alcohol, acting quickly

without thinking (impulsive behavior), not feeling in charge of

themselves, not feeling a part of their communities, and not noticing and

talking about their feelings.

Researchers are looking into how brain chemicals and metabolism (the

way the body uses calories) affect binge eating disorder. Other research

suggests that genes may be involved in binge eating, since the disorder

often occurs in several members of the same family. This research is still

in the early stages.

Researchers are

looking into how

brain chemicals

and metabolism

(the way the body

uses calories)

affect binge

eating disorder.
3

What are the complications of binge eating disorder?

People with binge eating disorder are usually very upset by their binge

eating and may become depressed. Research has shown that people with

binge eating disorder report more health problems, stress, trouble

sleeping, and suicidal thoughts than people without an eating disorder do.

People with binge eating disorder often feel bad about themselves and

may miss work, school, or social activities to binge eat.

People with binge eating disorder may gain weight. Weight gain can lead

to obesity, and obesity puts people at risk for many health problems,

including:

■ type 2 diabetes

■ high blood pressure

■ high blood cholesterol levels

■ gallbladder disease

■ heart disease

■ certain types of cancer.

Most people who binge eat, whether they are obese or not, feel ashamed

and try to hide their problem. Often they become so good at hiding it that

even close friends and family members do not know they binge eat.

Should people with binge eating disorder try to lose

weight?

Many people with binge eating disorder are obese and have health

problems because of their weight. They should try to lose weight and keep

it off; however, research shows that long-term weight loss is more likely

when a person has long-term control over his or her binge eating.

People with binge eating disorder who are obese may benefit from a

weight-loss program that also offers treatment for eating disorders.

However, some people with binge eating disorder may do just as well in a

standard weight loss program as people who do not binge eat.

People who are not overweight should avoid trying to lose weight, because

it sometimes makes their binge eating worse.

How can people with binge eating disorder be helped?

People with binge eating disorder should get help from a health

professional such as a psychiatrist, psychologist, or clinical social worker.

There are several different ways to treat binge eating disorder.

■ Cognitive-behavioral therapy teaches people how to keep track of their

eating and change their unhealthy eating habits. It teaches them how to

People with

binge eating

disorder should

get help from

a health

professional

such as a

psychiatrist,

psychologist, or

clinical social

worker.
4

change the way they act in tough situations. It also helps them feel

better about their body shape and weight.

■ Interpersonal psychotherapy helps people look at their relationships

with friends and family and make changes in problem areas.

■ Drug therapy, such as antidepressants, may be helpful for some people.

The methods mentioned here seem to be equally helpful. Researchers are

still trying to find the treatment that is the most helpful in controlling

binge eating disorder. Other therapies being tried include dialectical

behavior therapy, which helps people regulate their emotions; drug therapy

with the anti-seizure medication topiramate; weight loss surgery

(gastrointestinal surgery); exercise used alone or in combination with

cognitive-behavioral therapy; and self-help. Self-help books, videos, and

groups have helped some people to control their binge eating.

You are not alone.

If you think you might have binge eating disorder, it is important to know

that you are not alone. Most people who have the disorder have tried but

failed to control it on their own. You may want to get professional help.

Talk to your health care provider about the type of help that may be best

for you. The good news is that most people do well in treatment and can

overcome binge eating.

For More Information

For more information, contact one of the centers listed on page 5.*

National Eating Disorder Association

Information and Referral Program

603 Stewart Street, Suite 803

Seattle, WA 98101

1-800-931-2237

(206) 382-3587

(206) 829-8501 (fax)

Web: www.nationaleatingdisorders.org

Email: info@nationaleatingdisorders.or

Academy for Eating Disorders

6728 Old McLean Village Drive

McLean, VA 22101

(703) 556-9222

(703) 556-8729 (fax)

Web: www.aedweb.org

Email: aed@degnon.org

* Inclusion of organizations and materials

is for information only and does not

imply endorsement by NIDDK or WIN.

The good news

is that most

people do well

in treatment

and can

overcome

binge eating.
Behavioral Medicine ■ ■■ ■ ■ ■ ■ ■ ■ ■

Department of Psychiatry

Stanford University

401 Quarry Road, Stanford, CA 94305

(650) 498-9111

Center for Overcoming Problem Eating/ ■■ ■■ ■■■■■

Eating Disorders Clinic

Western Psychiatric Institute and Clinic

University of Pittsburgh Medical Center

3811 O’Hara Street, Pittsburgh, PA 15213

(412) 246-6390

Eating Disorders Clinic ■ ■■ ■ ■ ■ ■

New York State Psychiatric Institute

Columbia Presbyterian Medical Center

1051 Riverside Drive, NYSPI Unit 98, New York, NY 10032

(212) 543-5739

Eating Disorder Program at the University of Chicago Hospitals ■ ■■ ■ ■ ■ ■ ■ ■ ■ ■ ■

Department of Psychiatry, MC 3077

The University of Chicago

5841 S. Maryland Avenue, Chicago, IL 60637

(773) 834-5677

Eating Disorder Research Program ■■■ ■■■ ■■

University of Minnesota

606 24th Avenue South, Suite 602, Minneapolis, MN 55454

(612) 627-1991

Rutgers Eating Disorders Clinic ■■ ■ ■■■

GSAPP Rutgers University

41 Gordon Road, Piscataway, NJ 08854

(732) 445-2292

Weight and Eating Disorders Program ■■ ■ ■■■

University of Pennsylvania

3535 Market Street, Philadelphia, PA 19104

(215) 898-7314

Yale Center for Eating and Weight Disorders ■■■■■■ ■■■

Yale University, Department of Psychology

P.O. Box 208205, New Haven, CT 06520

(203) 432-4610

Eating Disorder Program ■■ ■ ■ ■■

Golisano Children’s Hospital at Strong

601 Elmwood Avenue, Box 690, Rochester, NY 14642

(585) 275-7844

Center for Brief Therapy ■■ ■ ■■

Department of Clinical Psychology

Philadelphia College of Osteopathic Medicine

4190 City Avenue, Rolland Hall, Suite 532, Philadelphia, PA 19131

(215) 871-6487

Child and Adolescent Eating Disorders Program ■ ■■ ■ ■ ■ ■ ■ ■ ■

Menninger Clinic

P.O. Box 809045, Houston, TX 77280

(800) 351-9058

5

The following programs are for patients with binge

eating disorder or compulsive overeating.

InpatientOutpatientIndividual TherapyGroup TherapyFamily TherapyCognitive-behavioral TherapyInterpersonal TherapyDrug TherapyChildren (under 12)Adolescents (12-17)Adults (18 and up)Conduct Clinical Studies

Program Type Treatment Used Patients Treated
NIH Publication No. 04-3589

September 2004

Weight-control

Information

Network

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Email:

WIN@info.niddk.nih.gov

Internet: www.niddk.nih.gov/

health/nutrit/nutrit.htm

The Weight-control Information

Network (WIN) is a service of the

National Institute of Diabetes and

Digestive and Kidney Diseases

of the National Institutes of Health,

which is the Federal Government’s

lead agency responsible for

biomedical research on nutrition

and obesity. Authorized by Congress

(Public Law 103-43), WIN provides

the general public, health

professionals, the media, and

Congress with up-to-date, sciencebased health information on weight

control, obesity, physical activity,

and related nutritional issues.

WIN answers inquiries, develops and

distributes publications, and works

closely with professional and patient

organizations and Government

agencies to coordinate resources

about weight control and related

issues.

Publications produced by WIN are

reviewed by both NIDDK scientists

and outside experts. This fact sheet

was also reviewed by James E.

Mitchell, M.D., President,

Neuropsychiatric Research Institute,

and Professor and Chair, Department

of Neuroscience, University of North

Dakota, School of Medicine and

Health Sciences.

This publication is not copyrighted. WIN

encourages users of this fact sheet to duplicate

and distribute as many copies as desired.

This fact sheet is also available at

www.niddk.nih.gov/health/nutrit/nutrit.htm.

Additional Reading

Grilo, CM. “The assessment and treatment of binge eating

disorders.” Journal of Practical Psychiatry and Behavioral

Health, 1998: Vol. 4, pp.191-201. This article, written for

health professionals, reviews the literature on binge eating

disorder with a particular focus on its assessment and

treatment. Implications for practice and future research are

discussed.

Stunkard AJ. “Eating patterns and obesity.” Psychiatric

Quarterly, 1959: Vol. 33, pp. 284-295. This classic paper

provides one of the first descriptions of binge eating in obese

individuals.

Wilfley DE, Wilson GT, Agras WS. “The clinical

significance of binge eating disorder.” International Journal

of Eating Disorders, 2003: Vol. 34 Suppl., pp. S96-106. This

article, written for health professionals, reviews the literature

on binge eating disorder to examine whether it is serious

enough to be classified clinically as a mental health disorder.

National Institute of Diabetes and

Digestive and Kidney Diseases