Compulsive eating, or binge eating, is a disorder characterized by rapidly consuming large amounts of food and being unable to control this impulse. If left untreated, it can have serious health consequences.

Here’s what binge eating means, how it manifests, and what the treatment entails.

What is compulsive eating?

Compulsive eating, also known as binge eating, is an eating behavior disorder defined by frequent, chronic episodes of overeating—consuming very large amounts of food in short periods of time. A specific characteristic of this disorder is the lack of control or the inability of the patient to stop eating, as presented by Mayo Clinic. Compulsive eating is also associated with feelings of shame or guilt after overeating episodes.

The exact cause of binge eating is unknown. The disorder can be triggered by a combination of factors, such as genetics, learned eating behaviors in the family, hormonal fluctuations or psycho-emotional states.

Foods with a delicious taste (hyperpalatable) can activate the brain’s reward system and favor the production of hormones associated with pleasure (serotonin, dopamine). Thus, they can trigger addictive behavior (dependency), as presented by Cleveland Clinic. Additionally, some people with binge eating find refuge in food in the context of negative emotions or to compensate for other emotional needs.

Risk factors for compulsive eating include:

• Adolescence and young adulthood - Although it can appear at any stage of life, binge eating is more common among teenagers and young adults, around the age of 20;

• Female gender - The disorder is more common among women;

• Family history - If a family member has struggled with an eating behavior disorder, specific genetic information can be inherited;

• History of restrictive diets - People who undergo strict weight loss regimens without specialist guidance are more prone to developing eating disorders. Prolonged starvation can trigger a strong and uncontrollable need to overeat;

• History of psycho-emotional disorders: Anxiety, depression, history of abuse, bullying or emotional trauma, chronic stress, low self-esteem, presence of other addictions (substance abuse), ADHD (attention deficit hyperactivity disorder), perfectionism, rigid thinking are risk factors for binge eating.

Compulsive eating can also be an integrated manifestation of other eating behavior disorders, such as bulimia nervosa, as shown by Eating Disorders Hope. This is defined by episodes of binge eating followed by purging behaviors, such as induced vomiting, taking diuretics, laxatives, weight loss products, starvation, excessive exercise or severely restrictive diets.

Read also... bulimia nervosa

Symptoms of binge eating

According to the sources mentioned, compulsive eating can be recognized by the following manifestations and characteristics:

• Frequent episodes of overeating: The patient eats very quickly, consuming excessive amounts of food until feeling uncomfortably full. These episodes occur at least once a week for at least 3 consecutive months;

• Feeling out of control during overeating - The patient cannot stop eating and does not recognize the body's signals of satiety and fullness;

• Eating is not triggered by hunger. On the contrary, binge eating episodes can occur right after a meal;

• Binge eating episodes can be triggered by negative emotions and stress;

• Feelings of disgust, shame, guilt, stress, depression and remorse after compulsive eating;

• Organizing daily activities around binge eating episodes;

• Eating occurs in secret, and the patient avoids eating in public;

• Hiding food to consume later;

• Persistent thoughts about specific foods and cravings;

• Affected self-image: The patient is dissatisfied with their weight or body shape;

• Frequent "snacking" throughout the day without feeling hungry;

• Reducing the amount of food consumed at other meals or regularly adopting weight loss diets, leading to starvation, weight fluctuations, and later exacerbating compulsive eating symptoms.

Body weight is not a diagnostic criterion, as a patient with binge eating can have any body mass index – for example, they can be of normal weight, overweight or obese.

Binge eating episodes can persist for years without treatment. They may temporarily disappear, only to reappear later.

Consequences of compulsive eating on health

Binge eating is a disorder that significantly affects the quality of life, as it interferes with all daily activities. Patients who eat compulsively become socially isolated, cannot truly enjoy life, and face professional problems.

In the long term, compulsive eating increases the risk of developing the following medical conditions:

• Weight-related conditions: type 2 diabetes, joint disorders, gastroesophageal reflux disease, malnutrition, sleep apnea, cardiovascular diseases, digestive disorders;

• Anxiety;

• Depression and suicidal tendencies;

• Substance addiction.

Therapy against binge eating

Patients with binge eating require a multidisciplinary therapeutic approach aimed at improving eating behavior and combating negative emotions (low self-esteem, feelings of shame), stress, anxiety and depression.

The psychotherapist will determine which type of psychotherapy is more suitable for you. For example, cognitive-behavioral therapy involves adopting strategies that help you cope with the emotions or negative thoughts that can trigger binge eating episodes.

Another treatment method is dialectical behavior therapy, which consists of modifying behavior to better manage stress, emotions and relationships with others. This reduces the need to eat compulsively.

When necessary, the psychiatrist may recommend, along with psychotherapy, the administration of medications, such as anxiolytics for treating anxiety or antidepressants.

Lastly, a licensed nutritionist-dietitian provides a dietary plan and counseling for nutritional education so that you can develop healthy eating habits tailored to your needs (such as choosing nutritious foods, improving meal schedules, balanced portions).

Here are some general recommendations for managing compulsive eating:

• Avoid compensating for binge eating episodes with restrictive diets or starvation, as this only worsens compulsive eating;

• Organize your meals into smaller portions, taken every 2-3 hours, to prevent the vicious cycle of restrictions and overeating episodes;

• Include a variety of nutritious, natural foods in your daily menu, such as fruits and vegetables, whole grains, lean meat, fish, raw nuts and seeds, dairy products, while reducing the consumption of highly processed foods. Even if you overeat, this doesn't mean your body is receiving enough nutrients, such as vitamins and minerals;

• Stay connected with others – avoid isolating yourself and choose instead to interact more with loved ones who can offer support;

• Engage in enjoyable physical activities every day;

• Stop eating before feeling overly full. Learn to recognize your body’s signals of fullness, satiety and hunger. To identify these signals, eat slowly, mindfully and chew your food well;

• Keep a journal of the moments when binge eating episodes occur, along with the events, thoughts or emotions that preceded them. This way, you can identify potential triggers and eliminate them.

In conclusion, compulsive eating is a serious disorder that can be associated with severe health complications. Like other eating disorders, binge eating is not easy to manage without specialist guidance. Seek professional help to benefit from appropriate solutions.