The Difference Between Emotional Eating
and Binge Eating Disorder
Emotional Eating is something we all do, when we are stressed, tired or angry, but also when we are happy, relieved or celebrating. Emotional Eating is a very common response to celebrate, commiserate or comfort ourselves with food. So, Emotional Eating is a response to feelings, and we are all susceptible to reaching for food when we feel a certain way.
Binge eating disorder is something completely different. And the problem is that the phrase emotional eating is used when the real issue is actually binge eating disorder.
So what's the difference? And why is it important to know where each category of eating sits on the spectrum of eating and disordered eating?
A bit of history about Binge Eating Disorder
Let's talk about the official diagnosis criteria for Binge Eating, that comes from the DSM V, which is a giant book published by the American Psychiatric Association, and it has every single sort of mental health disorder that you can think of and a lot more that you would never think of in it.
I'm not a big one for official diagnosis, but I do think that it's important for you to understand what binge eating is because it is a real issue, but it has only recently come into the DSM V. It was entered as a specific eating disorder in its own right in 2013. Before that, it was lumped into a category called Eating Disorder Not Otherwise Specified, or EDNOS, which was the category for “anything that is not anorexia or bulimia”.
It is important to understand that tiny little bit of history of the diagnosis because binge eating is relatively new as a diagnosis. What that actually means is a lot of doctors are still not aware of binge eating disorder as an eating disorder in its own right. So binge eating disorder often gets misdiagnosed, or the symptoms of it are treated, but not the underlying problem.
So what IS Binge Eating Disorder?
According to the DSM V, it is:
- eating far more quickly than normal;
- eating until you're uncomfortably full;
- eating large amounts of foods, when you're not actually hungry for food;
and/or
- eating alone or secret eating and that might include night eating.
Now the key criteria is important because we could all eat far more quickly than normal, we could all eat until we are uncomfortably full. Think about Thanksgiving dinner or your Christmas dinner or Hanukkah or a party celebration, a buffet... this could be plain old overeating, or it could be emotional eating.
We can all eat large amounts of food when we are not hungry for food - that may be emotional eating.
And sometimes we eat alone, sometimes we enjoy a secret treat or guilty pleasure, like buying something when you are out in the car, eating it then shoving the wrappers in a bin so nobody ever finds out about it. This is almost definitely emotional eating!
However, for me the key criteria with binge eating disorder is :
- experiencing significant feelings of shame, disgust, guilt, frustration, and anger or hatred of self
... after the event, and these feelings are often rooted in past trauma.
What type of person has Binge Eating Disorder?
People with binge eating disorder often will be 'serial dieters' or 'yo-yo dieters', and this makes sense because binge eating disorder is not that well known or understood by either doctors or by those working in weight loss, so a lot of clients who are struggling with the side effects of binge eating will look for help from their doctor or a weight loss or diet program.
Several very common issues that you will struggle with if you are binge eating are:
- anxiety
- low mood
- gut issues
But if you go to your doctor, you're usually going to say "I think I'm suffering from anxiety", or "I think I have IBS", or "I'm feeling very low at the moment." And the doctor will prescribe a medication for that particular symptom.
But you almost never tell them that you are regularly binge eating. So, the real underlying problem does not get addressed, and doctors, in my opinion, don't ask the right questions to find out this information. They don't know what they don't know.
Binge Eating Disorder (BED) is by far the most common eating disorder there is.
It affects women and men almost equally - 40% of sufferers are male.
30% of adults seeking weight loss support meet the criteria for BED.
40% of adults with T2 Diabetes meet the criteria.
Up to 60% of bariatric patients meet the criteria.
Women who binge eat often have other health issues like endometriosis or PCOS.
Both men and women who binge eat may have other heath issues like fibromyalgia, inflammation, heart issues or need orthopedic surgery due to strain on their hips or knees.
How Does Binge Eating Start?
Binge Eating is a form of comfort eating, but it is linked to a deep discomfort or inability to process strong or difficult feelings. And usually this is something that was learned a long time ago, very often in childhood.
So the purpose of binge eating is distraction, numbing, burying uncomfortable feelings under food or a safe way of discharging anger.
There's often a very deep underlying message of unworthiness. So clients tend to feel undeserving of love or happiness. And again, that's often linked to history of trauma in childhood. The feeling that you don't deserve love, or you don't deserve to be happy is often an unconscious driver of the binge eating behavior.
if you're swinging between constant restriction and binge eating, you're punishing yourself all the time, you're either under feeding or under nourishing yourself by depriving yourself of food, or you're punishing yourself by eating food that isn't nutritious, and that is causing you harm - whether that's physical harm in the form of your gut or other health issues, or emotional harm, because you feel completely crap about yourself afterwards - feeling shame, guilt, remorse, disappointment and anger towards yourself.
The majority of our clients with binge eating disorder are between 35 and 55, and an awful lot are in their 40s and 50s. But binge-eating can start in childhood, and the oldest client I've ever had coming in for the very first time was 68 the first time she contacted me. So it can affect anyone, at any age, and it can be a problem for decades if it's not correctly treated.
Getting the RIGHT help
If your worry is about weight gain - because that's a consequence of binge eating - you are likely to look for help in the form of dieting or a weight loss programs. BUT you're never going to get the correct psychological support you need to properly resolve binge eating on a diet or weight loss program.
Fitness instructors, personal trainers, weight loss group facilitators, and even most Health, Nutrition or Wellness Coaches are not trained in disordered eating.
I recommend you to go to somebody who has a professional qualification in eating disorders, or binge eating disorder in particular. If you're struggling with deep underlying feelings of shame and guilt, if you know your emotional eating started a long time ago in response to a difficult event or trauma in your life, and you know that you also need to work on how you feel about yourself and manage difficult emotions - that is binge eating disorder and that needs to be addressed in a completely different, specific psychological way. No diet or weight loss program will resolve this.
Recently we have had weight loss medication appear on the scene as a response to the 'obesity is a disease' message. Even if your doctor prescribes you this medication, you will still need specialist support to resolve emotional or binge eating. You will also need specific nutritional guidance and important movement/exercise support. The key risks with these new medications are malnutrition, muscle wastage and ironically, developing an eating disorder.
Always get help from the right professional. If it's emotional eating or binge eating disorder - that's us.
Find support from an Eating Freely Coach
If you are a medical or health professional...
As a doctor, if you see a certain type of patient reporting that they are struggling with anxiety or low mood or gut issues, three key questions I would ask them are:
1. "do you ever eat for emotional reasons?
If they answer 'yes', ask:
2. "would you describe it as binge eating?" Then use the DSM V criteria to explore more.
It's also very important to ask:
3. "Do you regularly restrict your food or diet?"
because dieting and restriction are often the reason for low serotonin and high cortisol - anxiety and low mood!
Then, alongside any medication you might prescribe, you can suggest the client also goes to see somebody who can help them actually resolve the underlying issue, which is emotional eating or binge eating disorder.
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