IMAGE: Tomas Pap
Text: Alejandra Misiolek Marín
What is the difference between a binge and a binge eating disorder? How do we know what pathological behavior is and what we consider normal?
The most known eating disorders are anorexia and bulimia. However, they are not the only ones. Lately statistics seem to show that the most prevalent eating disorder is Binge Eating Disorder. This label was added to the manual on psychiatric disorders in 2013, when the fifth version of this manual (DSM-V) came out.
What is a binge?
For food intake to be considered binge eating, two conditions must be met:
- on the one hand, it has to be an intake of an amount of food that is clearly higher than what most people would eat in a similar period under similar circumstances,
- and on the other, it appears together with a feeling of lack of control over what is ingested during the episode
Having a binge is a somewhat destructive behavior, but one that many people have experienced at some point and especially at times when we do not know how to process emotions or when the nutritional balance has been lost because of a series of restricted diets. Bingeing on food doesn’t mean that we have a binge eating disorder.
So when does a binge turn into a binge eating disorder?
When we talk about the disorder, the difference is not only qualitative, but especially quantitative.
For binge eating to be pathological, it has to produce intense discomfort and binge episodes are associated with three (or more) of the following events:
- Eating much more quickly than normal.
- Eating until you feel unpleasantly full.
- Eating large amounts of food when you are not physically hungry.
- Eating alone, due to the shame you feel for the amount you eat.
- Then feeling uncomfortable with yourself, depressed, or very ashamed.
And finally, for binges to be conceptualized as a disorder, they have to occur, on average, at least once a week for three months.
The severity of binge eating disorder is evaluated according to the number of binges that the person has per week.
Mild: 1–3 binges a week.
Moderate: 4–7 binges a week.
Severe: 8–13 binges a week.
Extreme: 14 or more binges a week
What is the main difference between binge eating disorder and bulimia?
Those binges also occur in bulimia nervosa. However, in bulimia, binge eating is associated with the recurrent presence of a compensatory behavior such as vomiting, the use of laxatives or intense physical exercise.
Are binges just about food?
Binge eating disorder refers only to food intake, however, the word bingeing is increasingly used in reference to other types of behaviors that we do excessively and without a healthy control mechanism, such as, for example, watching series. These behaviors are used as a mechanism of emotional anesthesia when what we are feeling is very intense or difficult to handle or when we do not have healthy tools for emotional processing.
Cossrow, N., Pawaskar, M., Witt, E. A., Ming, E. E., Victor, T. W., Herman, B. K., … & Erder, M. H. (2016). Estimating the prevalence of binge eating disorder in a community sample from the United States: comparing DSM-IV-TR and DSM-5 criteria. The Journal of clinical psychiatry, 77(8), 968-974.
Kessler, R. C., Berglund, P. A., Chiu, W. T., Deitz, A. C., Hudson, J. I., Shahly, V., … & Bruffaerts, R. (2013). The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biological psychiatry, 73(9), 904-914.