What is considered a binge eating episode?
An attack is an episode when, in a relatively short period, a volume of food is eaten that is clearly larger than another person would eat under the same circumstances, and at the same time control is lost: it is impossible to stop, even when it is already unpleasant. A disorder is said to occur if such episodes recur regularly over several months and are accompanied by significant suffering. Overeating once at a wedding or at a party is not a disorder, because there is neither a loss of control nor a subsequent feeling of self-loathing.
- Food is much faster than usual
- Continue eating until heaviness and discomfort
- Large volumes without feeling hungry
- Eating alone out of shame
- Guilt, depression, self-loathing after
- Episodes repeat for weeks and months
Why do seizures occur?
Most often there are two mechanisms at work. The first is biological: after periods of restrictions and missed meals, the body demands compensation, and a breakdown becomes almost inevitable. The second is emotional: food quickly reduces anxiety and dulls unpleasant feelings, so the brain remembers it as a way of self-regulation. Over time, any stress becomes a trigger: conflict, deadline, boredom, tiredness in the evening. Lack of sleep, which increases cravings for sweets and fatty foods, and the habit of eating in front of a screen without noticing satiation contribute.
- Strict diets and skipping meals
- Stress, anxiety, low mood
- Lack of sleep and shift work
- Habit of eating in front of TV and phone
- Experience of criticism of appearance and weight in the family
- Loneliness and boredom
Health implications
The disorder itself primarily affects the psyche: shame and isolation increase, self-esteem decreases, and depression and anxiety disorders are often associated. On the body side, the consequences are mainly associated with weight gain and irregular eating: an increased risk of type 2 diabetes, hypertension, high cholesterol, fatty liver disease, sleep apnea and joint pain. Stomach complaints also appear - heaviness, heartburn, bloating after episodes.
- Depression and anxiety
- Weight gain and obesity
- Increased blood sugar, risk of type 2 diabetes
- High cholesterol and blood pressure
- Fatty liver disease
- Heartburn, heaviness, bloating
Diagnostics
The diagnosis is clinical: the doctor asks about the frequency of episodes, a feeling of loss of control, feelings after eating and always checks whether there is vomiting, laxatives and exhausting exercise - this distinguishes the disorder from bulimia. A food diary with mood notes helps: it shows the connection between attacks and emotions and missed meals. Additionally, metabolic parameters are assessed, and if there are complaints of weakness, palpitations and weight fluctuations, the thyroid gland is checked.
- Clinical interview and questionnaires
- Diary of food and emotions
- Blood glucose and glycated hemoglobin
- Lipid spectrum
- TSH for suspected thyroid disease
- Assessing mood and anxiety levels
What helps
The first line treatment is cognitive behavioral therapy: it restores regular eating, removes food inhibitions, and teaches how to cope with emotions without food. Paradoxically, giving up strict diets reduces the number of attacks more than another attempt to limit yourself. Work with weight begins later, when episodes become rare. For severe depression or anxiety, the psychiatrist selects medication support. A sleep schedule, three full meals with snacks, and mindful eating without screens can help.
- Cognitive behavioral therapy
- Regular meals without prohibited foods
- Planning meals in advance rather than by feel
- Alternative ways to relieve tension: walking, breathing, talking
- Normalization of sleep
- Treatment of depression and anxiety as prescribed by a doctor