Is Binge Eating Disorder a Lack of Willpower?

The New Year is a common time when people put a renewed focus on self-discipline, goal setting and willpower. But Binge Eating Disorder (BED) has nothing to do with a person's "self-control" or "willpower." It's a complex mental disorder that's three times more common than anorexia nervosa and bulimia nervosa combined. It affects roughly 3.5 percent of women and 2 percent of men in the United States each year. Early recognition and intervention are key in helping people manage it.

I think it's hard for people to recognize they have BED because of the stigma, bias and shame that surrounds both mental health diagnoses and weight. I find most patients are relieved to learn they've done nothing wrong because they've spent their whole lives believing they have. People generally don't recognize their eating is problematic and think it's their fault rather than a complex mental disorder.

What is Binge Eating Disorder?

BED is quite different from the occasional overeating and indulging. Often patients with BED will describe what they're feeling as not being able to stop eating even if they wanted to. It's a total loss of control. Some say they feel like they're going through the motions on "autopilot." They're often consumed by thoughts about food or urges to binge to the point that it interferes with their ability to be present at home or work or find time for self-care.

BED is diagnosed when a person is eating a large quantity of food in a short amount of time — feeling out of control during an eating episode. A person with BED will experience at least three of the five symptoms:

• Eating rapidly
• Feeling uncomfortably full
• Feeling emotionally disgusted, angry or sad
• Eating alone out of embarrassment
• Eating when not hungry

Additionally, BED is diagnosed when it occurs at least one time per week for three months. People with these symptoms should seek help.

Who is most likely to get Binge Eating Disorder?

Common personality characteristics observed with BED include an increased likelihood of harm avoidance, impulsivity, black-and-white thinking, and sudden changes in emotion. Some co-existing conditions include depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder and borderline personality disorder (BPD).

A popular misconception about BED is that it only affects people who have obesity. This is a mental disorder that can occur in any body shape or size. Sometimes binge eating results in obesity, diabetes and hypertension.

How do you know if someone has Binge Eating Disorder?

If you are concerned someone in your life is suffering from BED, there are signs to look for.

• The person will avoid eating in public situations or with others at home because they don't want people to see what they are eating. This may lead them to decline social invitations.
• They will tend to hide food.
• Large amounts of food will go missing.
• You may discover food wrappers.

It's important to remember that people with BED often feel significant shame, disgust, and anger toward themselves. They are led to believe by society, friends and family that their behaviors are something they should just "stop" doing. We wouldn't tell someone with depression to "just stop being sad," so we don't tell someone with an eating disorder to "just stop." This mental health diagnosis is highly complex.

Can you cure Binge Eating Disorder?

The good news is recovery is possible. The best place to start is often with your primary care provider. This person can refer you to a psychologist, dietitian or providers who specializes in BED. Some medications can treat all ranges of symptoms and complications related to BED.

I encourage all my patients to advocate for themselves whenever possible. If you feel you may have an eating disorder, do whatever you can to access the right kind of care.