The technical term for what is commonly described as “overeating disease” is Binge Eating Disorder (BED). This is a serious, formally recognized mental health condition, classified as an eating disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is characterized by recurrent episodes where an individual consumes an unusually large quantity of food in a short period, accompanied by a profound feeling of loss of control. This pattern of eating is associated with marked distress and often occurs in secrecy.
Binge Eating Disorder: The Primary Diagnosis
A diagnosis of Binge Eating Disorder relies on meeting specific criteria established in the DSM-5, differentiating it from occasional overindulgence. The core of the disorder involves recurring episodes of binge eating that happen at least once a week for a period of three months or longer. Each episode must include eating an amount of food that is clearly larger than what most people would consume in a similar timeframe and context.
An episode is further defined by a sense of being unable to stop eating or control the quantity of food being consumed once the binge begins. Furthermore, a binge eating episode must be associated with three or more specific behavioral indicators. These include eating much more rapidly than usual, consuming food until feeling uncomfortably full, and eating large quantities of food even when not feeling physically hungry.
The episodes often involve eating alone out of embarrassment regarding the quantity of food consumed. Profound negative emotions follow the eating, such as feelings of guilt, disgust, or depression. Significantly, the person must experience marked distress regarding their binge eating for the diagnosis to be made, distinguishing it from non-pathological overeating.
The severity of the disorder is determined by the frequency of the episodes. Severity ranges from mild (one to three binges per week) to extreme (fourteen or more binges per week).
Distinguishing Binge Eating from Other Conditions
Binge Eating Disorder is often confused with other conditions involving excessive food intake, but a primary distinction rests on the presence or absence of subsequent behaviors. The condition is clearly separated from Bulimia Nervosa (BN) because it does not involve the regular use of inappropriate compensatory behaviors. Compensatory behaviors, such as self-induced vomiting, misuse of laxatives, or excessive exercise, are defining features of Bulimia Nervosa.
The absence of these purging or compensatory actions is a fundamental difference in the clinical presentation of BED. This distinction highlights the focus on the binge episode and the associated distress, rather than attempts to counteract consumed calories.
While many people with BED are overweight or obese, the diagnosis is a psychiatric condition based on the specific pattern of eating behavior and associated psychological factors. Simple overeating, such as at a holiday gathering, lacks the persistent, recurring pattern of loss of control and marked distress seen in BED. This psychological component elevates the behavior from a lifestyle issue to a recognized clinical disorder.
Biological and Psychological Factors
The development of Binge Eating Disorder is understood to result from a complex interplay of genetic, neurobiological, and psychological factors. Research indicates a significant genetic component, with heritability estimates for the disorder ranging between 41% and 57%. This suggests that a person’s biological makeup can create a predisposition for developing the condition.
Neurobiological studies have identified alterations in brain circuits related to reward processing and impulse control. Individuals with BED often show a heightened response in the orbitofrontal cortex and ventral striatum when exposed to palatable food cues, which are regions associated with reward and incentive. This heightened reward sensitivity can be coupled with reduced activity in areas like the prefrontal cortex, which is responsible for inhibiting impulses and regulating behavior.
Psychological factors also play a significant role, including a high prevalence of co-occurring conditions such as depression and anxiety. A history of restrictive dieting is a common precursor, as chronic restriction can increase preoccupation with food and heighten the physiological and psychological drive to consume. Past experiences of trauma, including childhood abuse or being shamed about weight, are frequently reported risk factors that contribute to the disorder’s onset.
Paths to Recovery and Management
Effective treatment for Binge Eating Disorder typically involves a multidisciplinary approach combining psychotherapy, nutritional counseling, and sometimes medication. Cognitive Behavioral Therapy (CBT) is considered a primary and highly effective psychological treatment for BED. CBT focuses on identifying and changing the distorted thoughts and unhelpful behaviors that maintain the cycle of dieting and binge eating.
A specific approach, Dialectical Behavior Therapy (DBT), has also shown promise, particularly for individuals who struggle with emotion regulation. DBT teaches skills in mindfulness, distress tolerance, and emotional regulation, offering adaptive strategies to replace the maladaptive coping mechanism of binge eating. These psychotherapies are often more efficacious than medication alone in achieving long-term abstinence from binge episodes.
Pharmacological options are available, with one medication specifically approved by the Food and Drug Administration (FDA) for treating moderate to severe BED in adults: lisdexamfetamine dimesylate. This central nervous system stimulant is thought to help control the impulsive behavior associated with binge eating by modulating the brain’s dopaminergic system. Other medications, such as certain antidepressants, may be used to address co-occurring mood disorders like depression and anxiety, which can help to reduce the frequency of binge episodes.