Eating far more than you meant to, feeling unable to stop, then shame afterwards. If that happens again and again, it may be binge eating disorder: a recognised, treatable condition, not a lack of willpower.
Binge eating disorder means repeatedly eating a large amount in a short time while feeling out of control, at least weekly for months, with distress afterwards and without regularly purging. It’s more common than bulimia, affects people of every size, and CBT-based treatment works.
What it is
Doctors use criteria like these:
- Repeated binges: eating much more than most people would in a similar time, such as within two hours, while feeling you can’t stop or control what or how much you eat.
- At least three of these: eating much faster than normal; eating until uncomfortably full; eating large amounts when you’re not hungry; eating alone because you’re embarrassed; feeling disgusted, low or very guilty afterwards.
- Real distress about the binges.
- At least once a week for three months.
- No regular purging, such as vomiting, laxatives, fasting or over-exercising. If binges are regularly followed by these, it’s more likely bulimia.
The WHO’s classification is a little broader: a binge can be eating “notably more or differently than usual”, and losing control is the core of it.
Feasting at Christmas, Sallah or a wedding isn’t binge eating disorder, and neither is the odd big meal. Comfort eating that doesn’t feel out of control or leave you distressed isn’t either.
How common it is
In World Health Organization surveys across 14 countries, about 2 in 100 adults had binge eating disorder at some point in their lives, nearly twice as many as had bulimia. Women had higher odds than men, but men get it too. It typically starts in the late teens or early twenties.
Nigeria wasn’t part of that analysis, and there’s no national Nigerian figure. Small surveys of Nigerian students have screened for disordered eating, but a screening questionnaire can’t diagnose.
Binge eating disorder affects people of every size. In the WHO surveys, about 1 in 3 people with it were in the “normal” weight range. And only about 4 in 10 had ever had treatment for their eating.
Signs to look out for
- eating very fast, or until you feel uncomfortably full
- eating large amounts when you’re not hungry
- eating alone or in secret, and hiding food or wrappers
- feeling out of control while you eat
- guilt, shame or disgust afterwards
- cycles of strict dieting and bingeing
- binges triggered by feeling low, stressed, bored, angry or anxious
Why it happens
There’s no single cause, but some patterns are well known:
- Dieting. Strict diets and food rules can lead to bingeing through hunger and deprivation. That’s why diets and slimming products can feed the cycle; our piece on slimming teas explains more.
- Feelings. Binges often follow low mood, stress or other strong emotions.
- Shame about weight. Being shamed about your weight is linked with more binge eating, and it stops people asking for help. In a culture of “orobo” jokes and comments at family gatherings, that matters.
It affects more than eating
Most people with binge eating disorder also have another mental health condition, most often depression: in the WHO surveys, about 8 in 10 did. Binge eating disorder that came first was also linked with later diabetes and high blood pressure, so it’s worth seeing a doctor for a health check.
Suggested read: Cyclothymia: The Milder Mood Swing
Thoughts of suicide are more common in people with binge eating disorder, especially alongside depression. If that’s you, help is available today.
In immediate danger, call 112, or 767 in Lagos. To talk to someone at any hour, Safe Place Nigeria is on 0800 800 2000. It’s toll-free and answered 24 hours a day.
Treatment that works
The UK’s NICE guideline recommends a step-by-step approach:
- Guided self-help first: a structured self-help programme based on cognitive behavioural therapy (CBT), with short support sessions.
- Group CBT for eating disorders, usually 16 weekly sessions, if self-help isn’t enough after about four weeks.
- One-to-one CBT for eating disorders if group therapy isn’t available or right for you.
It works. In a US trial, about 2 in 3 people who had eight sessions of guided self-help were binge-free a year later, compared with about 4 in 10 who had usual care.
Treatment aims to stop the binges, not to make you lose weight. Dieting during treatment can trigger more binges, so it’s best put on hold, though some people do lose weight over time once bingeing stops.
Medicine shouldn’t be the only treatment. A doctor may offer it for depression or anxiety alongside therapy.
What you can start now
These are the building blocks of CBT for binge eating:
- Eat regularly: regular meals and planned snacks, so you never get very hungry.
- Keep a simple food-and-mood record: what you ate, when, and how you felt. It helps you spot your triggers.
- Stop dieting while you recover.
- Plan for risky moments, such as a stressful evening alone, with something else to do or someone to call.
- Treat setbacks as information, not failure.
The self-help book used in many trials, Overcoming Binge Eating by Christopher Fairburn, follows these steps; in trials it was paired with short support sessions.
Getting help
You can find a therapist who works with eating disorders and body image by video, voice or chat. Read more about eating disorders in Nigeria, see our eating disorders page, or look up binge eating disorder in our glossary.
Frequently asked questions
What’s the difference between binge eating and overeating?
Overeating now and then, like at a wedding or at Christmas, is normal. Binge eating disorder means repeated binges, at least weekly for months, with a sense of losing control and real distress.
Suggested read: Chronic Pain and Depression
Can you have binge eating disorder if you’re not overweight?
Yes. In WHO surveys, about 1 in 3 people with binge eating disorder were in the “normal” weight range.
Is binge eating disorder the same as bulimia?
No. In bulimia, binges are regularly followed by trying to get rid of the food, such as vomiting, laxatives or fasting. In binge eating disorder, they usually aren’t.
How do I stop binge eating?
Eat regular meals and snacks, stop dieting, keep a food-and-mood record to spot triggers, and get help. CBT-based treatment, starting with guided self-help, has the strongest evidence.
Will treatment make me lose weight?
Weight loss isn’t the goal. Stopping the binges comes first, and dieting during treatment can trigger more of them. Some people lose weight over time once bingeing stops.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
