Binge Eating: What it is and how to overcome it, thoughts from a PA Non-Diet Registered Dietician
Updated: Oct 25, 2022
By: Rachel Dodson RD, LDN
Binge eating disorder (BED) does not discriminate in regards to its impacted population -
Any gender, body size, age, ethnicity, socioeconomic status, etc can struggle with this disorder. Binge eating disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as recurrent episodes of binge eating which include eating an abnormal (perhaps more than most would eat in a similar amount of time) amount of food in a discrete period of time.
The episodes may feel uncontrollable, like one can’t stop eating, feeling disconnected from the actual eating experience, eating more rapidly than normal, or feeling uncomfortably full after eating.***
***Sometimes eating to satisfaction results in us feeling uncomfortably full and THAT IS OKAY!
Often, there is much distress over the quantity of food, the pace of eating, and/or the type of food consumed.
Binges are associated with at least 3 of the following criteria:
Eating rapidly
Eating until uncomfortably full
Eating larger amounts even though physical hunger is not present
Eating alone due to feeling embarrassed about the nature of the binge
Feeling disgusted, depressed, or guilty after the binge
Binge Eating Diagnosis Changes
Binge eating must occur once/week for 3 months on average with the absence of other compensatory behaviors. Before 2013, binge eating disorder was not formally recognized as an eating disorder, but was a subtype of other specified feeding and eating disorders (OSFED). The change is significant so insurance companies will only cover the care for DSM-diagnosed disorders. Binge eating is often accompanied by feelings of guilt, shame, secrecy, urgency, or dissociation. Both genetic and environmental influences are relevant in the development of binge eating disorders. Here at Recovered and Restored our skilled team of clinicians is made up of individuals who have been there and truly understand this diagnosis and its challenges.
The Dietician's Role in Binge Eating Disorder Treatment
A dietitian's role in the treatment of binge eating disorder is to assess their client’s current eating patterns and create an individualized meal plan that meets their client where they’re at. A meal plan for someone in BED recovery is not like a diet. “A meal plan is simply a tool to teach clients to nourish themselves without the need for a meal plan at all.”
From what I have seen in my personal experience with clients, meal plans that can feel restrictive in nature or resemble past diets client’s have been on do not help those struggling with binge eating disorder break the disordered habits of measuring their food, counting calories, or restricting their intake. They are still relying on external factors to guide them in their eating and a meal plan that does not cater to their individual needs won’t help break the restriction/binge cycle.
The Roll of Access to Food in Binge Eating Disorders
It is also important to point out that someone’s access to food could be playing a role in their eating disorder. For example, someone dealing with food insecurity who relies on a food bank to feed themselves and their families will experience food deprivation not because of a fear of weight gain, but because of a lack of access to food. Our bodies respond to food deprivation no matter the saucer of the undernourishment.
Unfortunately, studies show that the more food insecure someone is, the higher their likelihood of engaging in eating disorder behaviors, who may also lack access to diagnosis and treatment of their eating disorder.
Your Registered Dietitian in recovery should be helping you to find ways to implement their nutrition recommendations, identify harmful thoughts and emotions around food, and help you challenge food rules and harmful beliefs about food.
Kylie Mitchell, RDN, MPH points out 2 factors that contribute to binge eating:
biological reasons (undereating or restricting food intake, mental restriction through food rules… which all trigger our primal drive to eat)
emotional reasons (dissociating from how you’re feeling by binge eating, fullness replaces the feeling you don’t want to be experiencing)
Are you nourishing your physical body -
By consistently eating satisfying meals and snacks regularly throughout the day? The cornerstone of BED recovery is unconditional permission to eat ALL foods. Working with a Registered Dietitian to help you plan fear foods into meals and work on habitation with food can be extremely helpful as you move through recovery.
Are you taking care of yourself emotionally -
Are your meals emotionally satisfying? Do you have multiple tools in your toolbox for coping with emotions? Working with a therapist to help you manage anxiety/loneliness/stress can also be extremely helpful as you move through recovery.
Healthy at Every Size Approach to Binge Eating Disorder Treatment
It is important to have a treatment team who is operating from a health at every size approach. A weight-centric approach to health has unintended consequences such as food and body preoccupation, weight cycling, decreased self-esteem, eating disorders, and weight stigmatization. A weight-inclusive approach assumes everyone can obtain health and well-being independent of weight when able to obtain non-stigmatizing health care.
Practical Tips for Overcoming Binge Eating Disorder
Eat regularly and eat enough for your body.
Don’t skip meals - especially after a binge episode! Continue nourishing your body - not eating after a binge eating episode will only keep you stuck in the restricted/binge cycle. When we eat throughout the day and include carbs/fats/proteins at meals/snacks, our bodies will be reassured they consistently have access to what they need!
Process your emotions with your therapist.
It’s not possible to do the emotional work of recovery if your brain is malnourished. Get curious instead of judging yourself or your behaviors - what are you feeling before/during/after a binge? Remember, you are a human being. You are not perfect and your relationship with food will never be perfect. Give yourself grace as you navigate recovery and work on unlearning messages you’ve been sent your whole life!
Take care of your body in a way that is achievable for you
Prioritize sleep, spend time outside, feed your body in a nourishing way, and avoid external factors that hinder you from listening to your internal needs like calorie counting, measuring your food, and weighing yourself - your value is not in that number and our bodies are dynamic and weight shifts often.
If you are struggling with a binge eating disorder and don't know where to start in the recovery process, don’t hesitate to reach out for help!
References: Sick Enough: A guide to the medical complications of eating disorders
Setnick, J. (2017). Academy of Nutrition and Dietetics Pocket Guide to Eating Disorders (2nd ed.). Academy of Nutrition and Dietetics.
Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R. M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, 1–18. https://doi.org/10.1155/2014/983495
Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(1). https://doi.org/10.1186/1475-2891-10-9
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
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Recovered and Restored is an eating disorder therapy center founded by Gabrielle Morreale. We specialize in helping teens and young women heal from eating disorders such as anorexia, bulimia, orthorexia, and binge eating disorder and treat disordered eating, anxiety, depression, and PTSD. We provide eating disorder therapy in the towns of Horsham, Upper Gwynedd, Lower Gwynedd, North Wales, Lansdale, Hatfield, Blue Bell, Doylestown, and nearby towns with eating disorder therapy. Also providing virtual eating disorder therapy in New Jersey, Delaware, and Florida. Some towns served virtually but are not limited to Pittsburg, Lancaster, Harrisburg, Center City, Cherry Hill, Haddonfield, Mount Laurel, Cape May, Avalon, Brick, Dover, New Castle, Bethany Beach, Marydel, and Oceanview.