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June 01, 2015

Binge Eating: Does the Size of a Binge Matter?

Young women outside talkingResearch tries to better understand binge eating

For many in the public, their imagined picture of a binge eating episode looks something like a scene from Animal House – food wrappers strewn across a room, empty pizza boxes lining dirty tables, and cookie crumbs covering every surface.

Those who struggle with binge eating, which occurs in several different eating disorders, can tell you that this image doesn’t quite reflect the reality for most individuals. In fact, binge eating might look very different for different people.

While the public often has a limited view of binge eating, one seemingly universal belief is that binge eating means a very large amount of food. Even the diagnostic manual that helps clinicians treat eating disorders previously defined binge eating as eating an amount of food that is “definitely larger than most people would eat (APA, 2000).” The more current revisions to this manual (DSM-5) define a binge as eating an “abnormally large” amount of food. But how do we define what is “larger than what most people would eat”? Or, what is an “abnormally large” amount? Those references are quite vague, and have left room for substantial variation in definition.

Some choose to define a binge eating episode by the amount of calories one has consumed, and others by the number and quantity of items. Clinicians evaluating patients with binge eating are encouraged to consider other factors as well, such as cultural and biological aspects or whether we’re talking about a random Tuesday morning or a Thanksgiving Day dinner. It turns out, however, that the amount of food – in whatever way that amount is defined – actually might not matter so much.

The other part of the definition in the previous diagnostic manual was that the binge episode is accompanied by a sense of lack of control. The new DSM includes the fact that these episodes are distressing to individuals who engage in them. And it turns out that these factors are likely much more important than the amount of food consumed.

Study says amount food in a binge episode may not be as important as once thought

A recent study published in the International Journal of Eating Disorders (Brownstone et al., 2013) looked more closely at this issue by dividing individuals with binge eating into three groups:
  • those who objectively binged (ate a substantially large amount)
  • those who subjectively binged (ate a more normal amount, but considered it too much or to be out of control)
  • those who did both
What the researchers found was that these two groups did not show significant differences in whether they used compensatory behaviors (like purging). They also did not differ in terms of their concerns about eating, weight, and shape and did not have different levels of depression.

What this suggests is that the amount of food may not be particularly meaningful in considering binge eating. Whether the binge was defined by others or the individual as large doesn’t seem to matter because in either case the individual feels distressed about it. This is quite significant when it comes to how we think about binge eating.

It’s important to remember that feeling out of control or distressed about your eating patterns means it’s important to talk to a trained professional. If you need help for an eating disorder, please reach out to a professional. Programs specifically designed to address the needs of individuals with binge eating are available in many cities across the U.S.
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