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The Differences Between Emotional Eating and Binge Eating Disorder

Emotional-Eating-and-Binge-Eating-Disorder

It’s not always easy for people outside professional eating disorder treatment circles to draw the line between borderline disordered eating behaviors and full-blown eating disorders. In many cases, the line is blurred – one can lead to another very easily. It’s common for the underlying causes for these kinds of behaviors to be similar, or even identical.

One thing to remember about eating disorders is that they’re not really about food for the people suffering from them. They’re not even about body size or weight in the deepest sense, although some eating disorders center around behaviors that cause weight loss. Disordered eating behaviors are more about regaining a sense of control over a person’s life. They are, in essence, stress management techniques, although the result is harmful.

One form of disordered coping behavior is engaging in binge eating episodes. These are situations where a person eats a large amount of food in a short period. The food eating is often a “comfort food” like pizza, candy, or potato chips – what some people call “junk food.” These episodes are usually conducted in secret and spur feelings of guilt and shame in the person. When these negative feelings cause stress, they can lead to repeated binge eating episodes, becoming a dangerous pattern known as Binge Eating Disorder (BED). Contrary to popular belief, binge eating disorder is more common than anorexia nervosa and bulimia nervosa combined.

Many people, who may not develop the repeated, compulsive need to binge eat, still “eat their feelings” or emotionally eat to cope to control negative feelings like loss, stress, or sadness. Food cravings often hit when a person is experiencing negative emotions. They may use food to provide comfort against stress and negative emotional states by releasing dopamine and serotonin in the brain. These are chemicals that regulate mood, making people feel happy, calmer and removing stress. When relied upon to cope with stress by releasing these chemicals, a disorder like binge eating disorder can become akin to an addiction.

Emotional eating can sometimes be considered a precursor or symptom of an eating disorder. Despite this, emotional eating is relatively common and people who aren’t at risk for developing an eating disorder like BED might emotionally eat from time to time.

If emotional eating leads to a full-blown case of BED, binge eating disorder treatment can help a person with an eating disorder gain control over emotional eating. There are a variety of treatment options available at binge eating treatment centers to help a person achieve emotional and nutritional balance. There are lots of options for treatment, ranging from levels of care like inpatient and residential care to day treatment and PHP (partial hospitalization programs).

What Is Emotional Eating, Exactly?

Emotional eating refers to situations when a person eats to deal with the emotions they are feeling. Occasionally this can mean eating to celebrate or when a person feels good, but it’s far more common for emotional eating to occur when they’re experiencing negative emotions like stress, depression, or fear. Stress can affect eating habits. Some people eat less when they are upset, and others eat more when they’re feeling stressed. Emotional eating typically does not encompass feelings of body dysmorphia, in which a person feels pathologically negative about their body, or experiences a distorted perception of their body.

Although emotional eating can sabotage a person’s health and lifestyle goals, it does not necessarily indicate that the person has an eating disorder. To officially make a diagnosis of an eating disorder, an individual has to meet certain criteria laid out by the DSM-V (the psychiatric illness manual used by mental health professionals). Although it’s not listed as an eating disorder on the DSM-V, emotional eating often occurs as a symptom or part of certain eating disorders, particularly binge eating disorder and bulimia nervosa. For example, research has found that people with binge eating disorder are more likely to have a binge eating episode after experiencing negative emotions or facing a distressing situation. However, to be diagnosed with an eating disorder, signs and symptoms other than emotional eating must be present, as well.

Emotional eating can be a slippery slope, and loss of control over urges to eat when negative emotions arise can be a sign of a developing eating disorder. Ironically, a behavior that a person undertakes to assert a semblance of control over their emotions can cause a feeling that they are losing control. One of the major known symptoms of binge eating disorder is a sense that the person is incapable of stopping their disordered eating behaviors, followed by a sense of guilt that they can’t control their eating behaviors.

When Does Emotional Eating Become an Eating Disorder?

Binge-eating disorder is a serious mental health disorder that involves eating large amounts of food in a short period. It was added to the DSM-V in 2013. BED is a growing cause for concern among the mental health treatment community in the United States, and it’s become recognized as the most frequently occurring form of eating disorder.

Binge eating disorder often begins with dissatisfaction with a person’s weight, and the binge eating episodes are triggered by their attempts to diet or publicly restrict the food they eat. After binge eating episodes have become routine, the person feels out of control and unable to stop eating during the binge episodes. Emotional eating does not necessarily mean that a person has a binge eating disorder. However, emotional eating combined with the following symptoms could be a sign of a binge-eating disorder.

  • Frequent and repeated binge eating episodes during which much larger amounts of food are eaten – usually twice a week for several months
  • Eating past the point of being full or eating when not hungry
  • Eating much more quickly than normal during the binge-eating episodes
  • Eating past the point of being full or feeling pain
  • A feeling of loss of control during the binge eating episode
  • Eating secretly or hiding food to be eaten in secret
  • Feeling ashamed or embarrassed during or after binge eating episodes
  • Feelings of shame or embarrassment surrounding the binge-eating episodes.

When a person who might occasionally eat too much when feeling down or stressed begins to feel a compulsion to binge-eat regularly, it’s a clear sign that binge eating disorder is possible. The physical consequence of BED are many; left untreated, binge eating disorder can cause many of the complications of obesity such as heart disease, diabetes, high blood pressure. People with BED are also at higher risk for other mental health illnesses, like self-harm, depression, and substance abuse.

Although emotional eating isn’t an eating disorder itself, it can be a sign a person is at risk for one and might be a symptom of an eating disorder that requires professional treatment.

What Are The Treatments For Binge-Eating Disorder?

Binge-eating disorder treatment centers offer multi-faceted treatment to address both the emotional and physical aspects of an eating disorder. As we mentioned, there may be very different levels of care depending on a person’s treatment needs. No matter the level of care, there are certain aspects of treatment that remain constant. Components of binge eating disorder treatment may include:

  • Full assessment and psychiatric care -Starting with the initial discussion with an admissions counselor and before officially beginning binge eating disorder treatment, the incoming client will have a psychiatric assessment and meet with a psychiatrist to address emotional needs. For residential and inpatient treatment, there will more than likely be a medical consultation as well.
  • Co-occurring disorders treatment–Very many people with eating disorders also experience another kind of mental illness like anxiety or PTSD, which is known as a dual diagnosis. These disorders, if left untreated, can also contribute to emotional eating. Eating disorder treatment programs that deal with a dual diagnosis treat both the eating disorder and the co-occurring mental disorder at the same time. Addressing both disorders increases the likelihood that the person will become fully recovered from their disorder and maintain that recovery in the long run.
  • Nutritional education and programming – Nutritional restoration helps meet the person’s nutritional needs if they have become malnourished or experienced an imbalance because of their disordered eating behaviors. Sessions with a registered nutritionist or dietitian can help the person learn and practice using balanced meal planning approaches to nutrition. This is another important aspect of maintaining recovery from an eating disorder in the long term.
  • Individual psychotherapy sessions – Binge eating disorder therapy helps address the emotional aspects the client is undergoing. The person may learn to identify thoughts and emotions that contribute to binge eating episodes using cognitive retraining techniques like CBT (Cognitive Behavioral Therapy and DBT (Dialectical Behavior Therapy). They also are taught more adaptive ways to cope with negative emotional states.
  • Group therapy sessions – Many alumni of eating disorder treatment programs point to group therapy as the most useful and meaningful form of therapy they receive. It can be freeing and cathartic to discuss a disorder among people and peers who understand precisely what they’ve experienced. Group therapy is normally available at all levels of care.

Binge eating disorder recovery is possible. Binge eating disorder treatment can help reduce emotional eating, improve self-esteem and make it easier for a person to achieve a balanced approach to nutrition and wellness.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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