Not all binges look the same. And I say that despite the DSM-5 criteria for binge eating disorder.
Binge eating disorder is the most common eating disorder in the US It is characterized by recurrent and persistent bouts of binge eating. The episodes feel out of control. They are also associated with binge anxiety and 3 or more of the following:
• Eating much faster than normal
• Eat until you feel uncomfortably full.
• Eat large amounts of food when you are not physically hungry.
• Eating alone out of embarrassment at the amount of food eaten.
• Feeling disgusted with yourself, depressed, or guilty afterward.
In bulimia, the above behaviors are often followed regularly by a compensatory purge. But purging behaviors are absent or only used sporadically in binge eating disorder.
Okay, diagnostic criteria aside, I have observed different types of binge eating, both in my clients and in the participants in my doctoral research study.
Some episodes fit the criteria with absolute precision. Others vary, perhaps in the amount of food eaten or the “speed” with which it is eaten. Or sometimes in the time it takes to binge.
That last variation allows me to include a phenomenon that I call “binge day.” Participants in my doctoral study kept food records and were instructed to circle anything they considered binge eating. Several of them, on several occasions, circled the food register for the whole day. That was a binge day.
What about binge days?
The amount of food throughout the day of the binge was typically quite large, but at no particular time of the day were they bingeing by standard criteria.
However, these days happen too often and there are too many participants / clients that I cannot ignore.
What do binge days have in common with DSM-5 binge episodes? Eating feels out of control.
And this is what I have observed in my study and in my practice: Binges, “traditional” or otherwise, are often triggered by the consumption of sugar.
Participants in my low-sugar group improved more than the low-fat group or controls in terms of the number of binge episodes, the amount of food eaten, the number of cravings, and the intensity of the cravings.
If you’re having trouble with binge-eating episodes, the best thing to do is to stop eating sugar.
