HealthNess: What Do Binge Eating Episodes Have In Common?

Not all binge eating looks the same. And I say that despite the DSM-5 criteria for Binge Eating Disorder. Binge eating disorder is the most common eating disorder in the U.S. It's characterized by recurrent and persistent episodes of binge eating. The episodes feel out of control. They're also associated with distress regarding the bingeing, and with 3 or more of the following: • Eating much more rapidly than normal • Eating until uncomfortably full • Eating large amounts of food when not physically hungry • Eating alone due to embarrassment over the quantity of food eaten • Feeling disgusted with oneself, depressed, or guilty afterward. In bulimia, the above behaviors are typically followed regularly by compensatory purging. But purging behaviors are either absent or only sporadically used in binge eating disorder. Okay, diagnostic criteria aside, I've observed different types of bingeing, both in my clients and in the participants in my doctoral research study. Some episodes fit the criteria with dead-on accuracy. Others vary - perhaps in quantity of food eaten, or in the "speed" with which it's eaten. Or sometimes in the time it takes for the binge to occur. That last variation allows me to include a phenomenon that I call a "binge day." Participants in my doctoral study kept food logs and were instructed to circle anything they considered a binge. A number of them, on several occasions, put a circle around the entire day's food log. That was a Binge Day. What's Up With Binge Days? The quantity of food over the entire Binge Day was typically quite large, but at no particular time of day did they binge by standard criteria. Yet these days happen too often and for too many participants/clients for me to ignore. What do those binge days have in common with DSM-5 binge eating episodes? The eating feels out of control. And here's what I've observed in my study and in my practice: Bingeing - "traditional" or otherwise - is often triggered by the consumption of sugar. Participants in my low-sugar group improved more than either the low-fat group or the controls in terms of the number of binge episodes, the food quantity eaten, the number of cravings, and the intensity of the cravings.

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