Comparison between persistent eating excessively (compulsive overeating) and recurrent episodes of excessive food consumption with a loss of control (binge eating disorder)
Compulsive overeating and Binge Eating Disorder (BED) are two distinct conditions that share some similarities but have key differences in frequency, symptoms, causes, diagnosis criteria, and treatment approaches.
Compulsive Overeating
Compulsive overeating is a behavior characterized by chronic, impulsive overeating, often due to emotional distress. It may involve eating quickly, eating large amounts even when not hungry, and avoiding eating in public. People with compulsive overeating may experience rapid fluctuations in weight and gastrointestinal issues. Although it shares some symptoms with BED, compulsive overeating is not a formally recognized mental disorder and diagnosis is based more on behavioral patterns and clinical judgment [1][2].
Binge Eating Disorder (BED)
BED is a clinically recognized eating disorder, formally recognized in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) [3]. It involves recurrent episodes of binge eating, at least once a week for three months, with a sense of loss of control. A binge episode is characterized by eating an unusually large amount of food in a discrete period, eating rapidly, often alone, and followed by distress, guilt, or shame. Unlike compulsive overeating, BED does not involve compensatory behaviors like purging [2].
| Aspect | Compulsive Overeating | Binge Eating Disorder (BED) | |------------------|--------------------------------------------------------|----------------------------------------------------------| | Frequency | May be more chronic and generalized; ongoing habitual overeating without a strict frequency criterion. | Characterized by recurrent episodes (at least once a week for 3 months) of binge eating. | | Symptoms | Impulsive, uncontrolled eating often when not hungry, but not necessarily involving large amounts in a short time. Psychological triggers include stress, boredom, low self-esteem. May not involve a discrete binge episode with loss of control. | Defined by eating an unusually large amount of food in a discrete period (e.g., within 2 hours), feeling a loss of control during the episode, eating rapidly, often alone, and followed by distress, guilt, or shame. No compensatory behaviors like purging. | | Causes | Often linked to psychological distress, emotional regulation difficulties, stress, and sometimes associated with ADHD; eating as a coping mechanism. | Complex condition with psychological, genetic, and neurobiological factors. Frequently triggered by negative emotions; often comorbid with depression, ADHD, and other mental health issues. | | Diagnosis | Not formally recognized as a specific mental disorder; diagnosis is more informal and based on behavioral patterns and clinical judgment. | Diagnosed according to DSM-5 criteria: recurrent binge episodes at least weekly for 3 months, accompanied by distress and lack of compensatory behaviors. Presence of at least three additional symptoms like eating rapidly or eating when not hungry. | | Treatment | Treatment typically addresses underlying emotional or psychological issues, including therapy for impulse control and emotional regulation. May be supported by nutritional counseling and behavioral interventions. | Evidence-based treatments include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and sometimes medications. Focuses on breaking binge cycles and managing emotional triggers; professional support is essential. |
Treatment Approaches
For BED, psychotherapy is usually the first-line treatment, with cognitive behavioral therapy (CBT) being a common type. Support for BED can help people find other ways to relieve negative feelings, identify triggers with a food and mood diary, learn to manage triggers, learn to manage cravings, maintain healthy lifestyle habits such as regular exercise, better sleep, social connection, and stress management.
People experiencing compulsive overeating or BED may seek support from loved ones or friends, medical professionals and therapists, online or physical support groups, or a registered dietitian. Several organizations, such as the National Alliance for Eating Disorders and Overeaters Anonymous, may be able to offer support to a person with BED.
If you have any symptoms of compulsive overeating or BED, it is important to speak with a doctor for support and to help address the symptoms.
[1] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Publishing.
[2] Wade, T. D., & Grilo, C. M. (2010). Binge eating disorder. The Lancet, 376(9742), 491-498.
[3] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, text revision. Arlington, VA: American Psychiatric Publishing.
[4] Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of binge eating disorder in the National Comorbidity Survey Replication. Biological Psychiatry, 62(3), 348-354.
[5] Walsh, B. T., & Fairburn, C. G. (2013). The relationship between attention-deficit/hyperactivity disorder and eating disorders: A systematic review and meta-analysis. Psychological Medicine, 43(11), 2251-2262.
- Incorporating research from the fields of health-and-wellness, mental-health, and nutrition, psychotherapy, particularly cognitive behavioral therapy (CBT), is often a recommended treatment approach for both compulsive overeating and Binge Eating Disorder (BED).
- A comprehensive approach to managing conditions like compulsive overeating and BED may additionally involve education on science-based nutrition and practices that promote health and wellness, such as sleep management, exercise, and social connection.
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