Compulsive Overeating vs. Binge Eating Disorder

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Binge Eating Disorder Signs

Compulsive overeating vs. binge eating disorder facts

  • While compulsive overeating involves having trouble resisting the urge to consume more calories than are needed to stay healthy, binge eating disorder is a mental illness characterized by compulsions and other symptoms occurring at least weekly for three months.
  • Binge eating disorder is thought to be the result of multiple risk factors. Compulsive overeating tends to occur more in families and in members of the same household as other sufferers.
  • There is no single test to diagnose binge eating disorder, so health practitioners will do so by gathering extensive information.
  • Treatment for binge eating disorder or compulsive overeating usually includes several kinds of interventions, both medical and counseling.
  • Complications of compulsive overeating include obesity and resulting health problems.
  • While most people who purposely lose weight tend to gain it back at some time, up to 80% of people with binge eating disorder recover from the condition.
  • Approaches to drug addiction prevention are thought to be useful in preventing binge eating disorder or compulsive overeating.

What is compulsive overeating? What is binge eating disorder?

While overeating is defined as eating more calories than are necessary to maintain health and can become hard to control the urge to do so (compulsive), binge eating disorder (BED) is a mental health condition that involves recurring episodes of compulsively (uncontrollably) eating far more than normal, often after feeling full or otherwise when not hungry. It leads to physical and emotional discomfort of some kind, like guilt, shame, embarrassment, remorse, and self-disgust. While both binge eating disorder and otherwise compulsive overeating may involve eating in reaction to certain feelings (emotional eating), not everyone who overeats suffers from binge eating or any other eating disorder. However, overeating is a symptom for everyone who has binge eating disorder. BED is understood to be an impulse control disorder and involves compulsive behaviors. It affects about 5% of adults in the United States over their lifetime, more than the number of people who have anorexia nervosa and bulimia combined.

Binge Eating Disorder Symptoms

Binge eating disorder symptoms and signs include recurring episodes of binge eating without purging, excessive exercising, the inappropriate use of medications, or any other unhealthy behaviors that are often used by bulimic individuals to attempt to compensate for the binge episodes. People with this mental illness tend to engage in stress or other emotional eating, take longer to feel full, and are more likely to feel like they are starving when they are not.

What are causes and risk factors for compulsive overeating and binge eating disorder?

Like most mental disorders, binge eating disorder is not directly passed down genetically. Rather, it is the result of a complex group of genetic, psychological, and environmental factors. People with BED are more likely to have family members with this and mood disorders (like depression or anxiety) and impulse control disorders (like gambling or a drug use disorder) and can have differences in brain and brain chemical functioning compared to people who overeat to a lesser degree than in BED or otherwise do not have this illness. As with virtually any behavior that does not rise to the level of illness, overeating tends to occur more often in families where other household members engage in similar behaviors.

What are the signs and symptoms of compulsive overeating and of binge eating disorder?

In contrast to binge eating disorder, compulsive overeating involves consuming more calories than are necessary to maintain health but does not rise to the level of severity of binge eating. Someone may overeat from just once in a lifetime to multiple times per day. To qualify for the diagnosis of binge eating disorder, a person must experience the following:

Recurrent episodes of binge eating, in that the amount of food that is eaten in a specific period of time is clearly more than what most people would eat; as well as having poor control over their ability to stop eating or otherwise regulate what they eat. Episodes of bingeing include a number of the following symptoms:

  • Eating much faster than is normal (rapid eating)
  • Consuming food to the point of becoming physically uncomfortable
  • Eating large amounts of food even when not feeling hungry
  • Eating when alone (secret eating) due to feeling embarrassed by how much food is consumed
  • Feeling disgusted, sad, or very guilty following a binge episode

The binge episodes must occur at least once per week for most weeks over the course of at least three months, and the person who has binge eating disorder feels upset that they engage in bingeing.

How do health care professionals diagnose compulsive overeating and binge eating disorder?

Since there is no one test that determines that someone has binge eating disorder rather than having simple overeating, health care professionals diagnose BED by gathering medical, family, and mental health information. The doctor will also either perform a physical examination or request that the individual's primary care doctor do so, including lab tests to assess the person's general health and whether he or she has mental health symptoms that are due to a physical condition.

What are medications and other treatments for compulsive overeating and binge eating disorder?

People with binge eating disorder or who otherwise engage in compulsive overeating can expect their mental health professionals to consider several interventions, including medications, psychotherapy, and lifestyle (for example, nutritional, exercise, stress management) advice. Mindfulness-based cognitive therapy, which involves combating the ways of thinking that promote BED, has been found to decrease the bingeing episodes but not as effective in resulting in weight loss.

Lisdexamfetamine (Vyvanse), a stimulant medication, is the only medication that is currently approved by the U.S. Food and Drug Administration (FDA) to treat binge eating disorder. It has been found to be effective for decreasing the frequency of bingeing episodes. While not FDA-approved specifically for the treatment of BED, medications that are described as serotonergic treatments can alleviate some of the obsessive-compulsive symptoms that often co-occur with the illness. Examples of those medications include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro), as well as anti-seizure medications like carbamazepine (Tegretol) or divalproex (Depakote).

What are complications and the prognosis of compulsive overeating and binge eating disorder?

Complications of compulsive overeating not rising to the level of an eating disorder include increased weight and all the health problems that being overweight can bring over time, like high blood pressure, high cholesterol, joint problems, and diabetes, just to name a few. Due to the high amounts of food being consumed over short periods of time in binge eating disorder, these individuals may also be more prone to suffering from digestive problems compared to those who overeat but do not qualify for an eating disorder diagnosis.

While most people who purposely lose weight tend to gain it back over time, the prognosis for binge eating disorder tends to be fairly favorable over time, with up to 80% of people with the diagnosis recovering. Binge eating disorder sufferers who have supportive relationships tend to have better outcomes than those who do not.

Is it possible to prevent compulsive overeating and binge eating disorder?

Given the similarities that binge eating disorder has with substance addictions, approaches to prevention of drug addiction may be useful in preventing binge eating disorder or compulsive overeating that does not rise to the level of an eating disorder. Types of prevention programs include those that try to bolster protective factors while minimizing risk factors.

REFERENCES:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Treatment Revision. Washington, D.C.: American Psychiatric Publishing, Inc., 2013.

Berkman, N.D., K.N. Lohr, and C.M. Bulik. "Outcomes of eating disorders: a systematic review of the literature." International Journal of Eating Disorders 40.4 (2007): 293-309.

Brownley, K.A., N.D. Berkman, J.A. Sedway, et al. "Binge eating disorder treatment: A systematic review of randomized controlled trials." International Journal of Eating Disorders 40.4 May 2007: 337-348.

Burgess, E.E., M.D. Sylvester, K.E. Morse, et al. "Effects of transcranial direct current stimulation on binge-eating disorder." International Journal of Eating Disorders May 2016 .

Gearhardt, A.N., M. Phil, M.A. White, and M.N. Potenza. "Binge eating and food addiction." Current Drug Abuse Reviews 4.3 September 2011: 201-207.

Gupta, S. "The difference between binge eating and general overeating." Psychology Today December 2012.

Haines, J., and D. Neumark-Sztainer. "Prevention of obesity and eating disorders: a consideration of shared risk factors." Health Educ Res 21 (2006): 770-782.

Keel, P.K., and T.A. Brown. "Update on course and outcome in eating disorders." International Journal of Eating Disorders 43.3 (2010): 195-204.

Kessler, R.M., P.H. Hutson, B.K. Herman, and M.N. Potenza. "The neurobiological basis of binge-eating disorder." Neuroscience & Biobehavioral Reviews 63 April 2016: 223-238.

"Lisdexamfetamine for Binge Eating Disorder." Current Psychiatry 14.3 March 2015.

McElroy, S.L. "Pharmacologic treatments for binge-eating disorder." The Journal of Clinical Psychiatry 78(supplement 1) 2017: 14-19.

United States. National Institute of Drug Abuse (NIDA). "Drugs, brains and behavior: the science of addiction." July 2014. <https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface>.

Last Editorial Review: 6/14/2017

Reviewed on 6/14/2017
References
REFERENCES:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Treatment Revision. Washington, D.C.: American Psychiatric Publishing, Inc., 2013.

Berkman, N.D., K.N. Lohr, and C.M. Bulik. "Outcomes of eating disorders: a systematic review of the literature." International Journal of Eating Disorders 40.4 (2007): 293-309.

Brownley, K.A., N.D. Berkman, J.A. Sedway, et al. "Binge eating disorder treatment: A systematic review of randomized controlled trials." International Journal of Eating Disorders 40.4 May 2007: 337-348.

Burgess, E.E., M.D. Sylvester, K.E. Morse, et al. "Effects of transcranial direct current stimulation on binge-eating disorder." International Journal of Eating Disorders May 2016 .

Gearhardt, A.N., M. Phil, M.A. White, and M.N. Potenza. "Binge eating and food addiction." Current Drug Abuse Reviews 4.3 September 2011: 201-207.

Gupta, S. "The difference between binge eating and general overeating." Psychology Today December 2012.

Haines, J., and D. Neumark-Sztainer. "Prevention of obesity and eating disorders: a consideration of shared risk factors." Health Educ Res 21 (2006): 770-782.

Keel, P.K., and T.A. Brown. "Update on course and outcome in eating disorders." International Journal of Eating Disorders 43.3 (2010): 195-204.

Kessler, R.M., P.H. Hutson, B.K. Herman, and M.N. Potenza. "The neurobiological basis of binge-eating disorder." Neuroscience & Biobehavioral Reviews 63 April 2016: 223-238.

"Lisdexamfetamine for Binge Eating Disorder." Current Psychiatry 14.3 March 2015.

McElroy, S.L. "Pharmacologic treatments for binge-eating disorder." The Journal of Clinical Psychiatry 78(supplement 1) 2017: 14-19.

United States. National Institute of Drug Abuse (NIDA). "Drugs, brains and behavior: the science of addiction." July 2014. <https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface>.

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