Did you know the most common eating disorder among Americans?

If you guessed anorexia or bulimia, you’re incorrect.

In what may come as a surprise to many, the most common eating disorder is binge eating disorder, which affects an estimated 6-8 million Americans. According to the Centers for Disease Control, those figures account for around 2% of the overall US population.

Despite its widespread prevalence, binge eating disorder became an “official” clinical diagnosis only four years ago, when it was formally recognized by the American Psychiatric Association’s release of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It’s an often misunderstood disorder that flies under the radar, lacking proper awareness among those personally impacted, their loved ones and even the healthcare community. Many individuals meeting the clinical criteria for binge eating disorder don’t even recognize or identify their symptoms.

Let’s break down some common misconceptions around this complex condition:

“Binge eating disorder isn’t a big deal.” Let’s be very clear: like other eating disorders, binge eating disorder is a serious mental health condition that requires timely and appropriate treatment. It can significantly affect one’s overall health and quality of life, commonly resulting in psychological concerns like depression, anxiety and intense feelings of low self-worth, as well as physical risks such as heart disease, cholesterol issues and high blood pressure. Binge eating disorder can affect one’s motivation, attention, concentration, relationships, work productivity, energy level and self-esteem. Living with binge eating disorder is very hard.

“Binge eating disorder is the same as overeating.” These two terms are commonly used interchangeably, but carry distinct meanings. Getting a second or third helping of your favorite meal, or eating more cookies than you planned, doesn’t mean you have binge eating disorder. Binge eating disorder transcends one meal or sitting. While both overeating and binge eating involve some form of eating past physical fullness, individuals with binge eating disorder experience an extreme loss of control while they are eating, and this happens at least once per week. During a binge eating episode, they are no longer choosing the foods they are consuming and are unable to stop eating, even if they want to. Another important characteristic is the subsequent feelings of intense shame and guilt that accompany those eating episodes. See more defining characteristics of binge eating disorder here.

“Binge eating disorder impacts only overweight individuals.” Absolute fiction. Individuals of all body sizes are impacted by binge eating disorder. The disorder can be related to a person’s intense focus on weight and shape and the importance of appearance; however this is distinct from actual weight. Recurrent binge eating can lead to weight gain, but not necessarily. It may be the case that those individuals who have not gained weight are less apt to identify that they have an eating disorder, and less likely to be assessed for an eating disorder by their healthcare providers.

“There’s an easy fix for binge eating disorder – just eat less.” Binge eating disorder cannot be fully resolved by altering the type or amount of food an individual consumes. It is a complex disorder in which food has gained significant power. The foods that a person are most likely to binge eat are usually the foods they are trying to avoid. We know that assigning labels, such as “junk food,” “bad food,” or “trigger food” can actually increase the likelihood that you will overeat or binge eat those foods. Binge eating is often triggered by emotional urges and difficult life events. Reducing (and ultimately eliminating) binge eating episodes requires significant behavioral change. This can be an intensive process that often requires guidance from a team of specialized providers.

“Weight loss or dieting will stop you from binge eating.” It can actually be quite the opposite. We see many cases of binge eating disorder rooted amid long histories of weight loss attempts and dieting. Occasionally people experience a break from binge eating while they are following a diet. However, we know that restricting intake – a common behavior among diets – leaves the brain and body craving food. Because diets are unsustainable in the long-term, “breaking” the diet rules often leads to a binge eating episode. Learn more here.

“Binge eating disorder only involves high-fat food.” The exact types of food can vary between individuals. While many people have cravings for certain foods, people also consume foods that they do not like or would never choose to eat. The foods most commonly reported in binge eating are often part of a fad diet. The person is restricting certain foods or food groups and it’s these types of foods that they are more susceptible to binge eat. Recently it’s processed foods. 5 years ago, it was fats. A decade ago it was carbohydrates, and so on.

“Binge eating disorder only affects adults.” While most cases of binge eating disorder take shape in adulthood, the affected age range is much broader than most realize. Binge eating disorder impacts approximately 1.6% of youth age 6-18 years. A more common phenomena is called loss of control eating where the quantity consumed is not necessarily excessive. Loss of control eating is estimated to affect 10% of children and adolescents and is associated with greater risk of depression, anxiety and later development of eating disorders.

“Binge eating disorder only impacts women.” There is a common misconception that eating disorders generally only affect women – we know this to be untrue for all eating disorder diagnoses. Estimates suggest one-third to one-half of all binge eating disorder cases occur in men. It affects all ages, races, sexual orientations and ethnicities.

There is nothing insignificant about binge eating disorder. As the clinical community and the public deepens its understanding around this highly complex condition, it is our hope those impacted will more easily recognize the symptoms and seek proper help when needed.

To learn more about binge eating disorder and available treatment offerings, click here.

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Dr. Kate Craigen is the clinical director of binge eating and bariatric support services. She is responsible for the clinical development and consistent implementation of binge eating disorder programming across Walden’s inpatient, residential, partial hospitalization, intensive outpatient and outpatient levels. Additionally, Dr. Craigen collaborates with various bariatric providers and partners throughout New England, ensuring both pre- and post-bariatric surgery patients gain the proper behavioral skills to enhance long-term outcomes. Previously, she was a clinician in Walden’s partial hospitalization and intensive outpatient programs in Waltham. She also served as a postdoctoral fellow and clinical instructor at the Eating and Weight Disorders Program in the Department of Psychiatry at the Mount Sinai School of Medicine. Dr. Craigen received her doctorate in clinical psychology from Fairleigh Dickinson University. Her professional interests include the role of supervision and training in the field of eating disorders and the role of gender in the diagnosis and treatment of eating disorders.