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Binge Eating
by Allan N. Schwartz, CSW, Ph.D.

According to the Diagnostic and Statistical Manual IV, the following features characterize Binge Eating Disorder:

1. Eating a larger amount of food than most people would eat within a discreet period of time.
2. A feeling of a lack of control during the episode of eating.
3. Eating extremely rapidly.
4. Eating until feeling uncomfortably full.
5. Eating large amounts of food when not feeling hungry.
6. During the episode, eating alone due to feelings of embarrassment about the amount eaten.
7. A feeling of self-loathing and self-disgust, depression and guilt after the episode.
8. The binge eating occurs at least two days per week for a minimum of six months.
9. There is no use of laxatives or purging as in Bulimia nervosa.

Binge eating shares characteristics in common with addictions. For example, the binge eater experiences a powerful compulsion to binge, similar to the alcoholic’s need to drink. During the period of binging, there is a blissful, almost sensual, feeling of relief parallel to the alcoholic’s sense of intoxication. The outside world is far away, tension is relieved and the individual gains an almost hypnotic sense of pleasure. Prior to the binge, the individual thinks about, anticipates, plans for and fantasizes about the binge. There is no concern or worry about consequences during the episode, regardless of past experience and knowledge of what will be experienced afterwards. Just as the alcoholic suffers from a hangover after a drunken episode, the binge eater experiences extreme self-loathing and massive depression afterward. The sense of despair that is experienced can reach suicidal proportions. In fact, there is something suicidal in nature about the enormous amounts of food ingested at one episode.

The quality or taste of the food is unimportant for most of those with Binge Eating Disorder. What is most important is that the foods are carbohydrates. Therefore, when binging, these patients fill up on muffins, bread, chocolates, ice cream and candy. The food is eaten with great rapidity as the food is stuffed into their mouths and swallowed. Afterwards, there are not only feelings of being overly full or stuffed, but of physical pain and discomfort. One patient describes herself as feeling “disgusting” after a binge.

According to the National Institute of Mental Health, approximately two percent of the adult population has a Binge Eating Disorder. It afflicts both men and women. However, the number of women with this disorder exceeds men by two to one. While those suffering from Bulimia nervosa remain thin, those with a binge disorder gain weight and become obese. Similar to people with Anorexia and Bulimia, those who binge eat are obsessed with being thin and hate themselves for being obese.

Many of those struggling with Binge Eating Disorder have problems with their emotions. Specifically, these are individuals who experience an over-whelming amount of anxiety. The anxieties experienced by binge eaters fall into one of two categories. Binge eaters suffer from either General Anxiety Disorder (GAD) and/or Social Phobia. GAD is characterized by an excessive amount of worry. In fact, it is often referred to as the “worry disease.” On the other hand, a painful type of self-consciousness and low self-esteem, when in the company of other people characterizes Social Phobia. Another emotion experienced by binge eaters is feelings of depression. In some cases, they may suffer from Major Depression, which is extremely debilitating and can result in suicide.

Despite the emotional component to Binge Eating Disorder, many of those with this disorder have great difficulty identifying what they do feel. The term, Alexythymia, means the absence of feelings. With a damaged sense of self, many of these people have difficulty knowing what they feel, believe and want for themselves.

The family backgrounds of women who binge are interesting. Many of these women report mothers who were critical, rejecting and they were eating disordered. For example, one patient in my practice had a mother who was obese. Mother and daughter would engage in eating vast amounts of food when the patient was a child. Binge eating came to be identified with the patient’s mother and represented her love and their private and blissful moments together. Another patient had a mother who was angry, rejecting and unpredictable. The mother would insist on restricting the food her daughter was allowed to eat. This was followed by the inconsistency of the mother taking them both out, in secret, to eat large numbers of donuts. However, the mother was extremely thin and restricted food intake for herself and her daughter most of the time. In both cases, these mothers were experienced as extremely intrusive.

The critical mother experienced by these patients was also filled with rage. The rage was targeted at the daughters in loud and verbally abusive ways. The explosiveness of the verbal attacks was counter balanced by the times when these mothers could be warm and loving. These changing and unpredictable mothers confused their children, and added to their anxiety as well as to their low self-esteem. The fathers in many of these cases are either not present or are weak and ineffective.

Very often, binges occur when these patients are alone. Loneliness creates intolerable feelings of hopelessness, abandonment, despair and anxiety. The only way the individual can reduce these intolerable emotions is by binge eating. One patient describes the sense of numbness she experiences immediately after an episode. It is this numbness that is sought after by the binge eater.

Risks of Binge Eating

Last modified: January 27, 2003