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When you have binge-eating disorder you often have numerous behavioral and emotional signs and symptoms, such as:

• Eating large amounts of food
• Eating even when you're full
• Eating rapidly during binge episodes
• Feeling that your eating behavior is out of control
• Eating a lot even though you're not hungry
• Depression
• Anxiety
• Frequent dieting, possibly without weight loss
• Frequently eating alone
• Feeling depressed, disgusted or upset about your eating

After a binge, you may try to diet or eat normal meals. But restricting your eating may simply lead to more binge eating, creating a vicious cycle.

You may have no obvious physical signs or symptoms when you have binge-eating disorder. You may be overweight or obese, or you may be of a normal weight.

When to see a doctor
If you have any binge-eating disorder symptoms, seek medical help as soon as possible. Binge-eating disorder usually doesn't get better by itself, and it may even get worse if left untreated.

If you have a primary care doctor, talk to him or her about your binge-eating symptoms and feelings. Or seek help directly from a mental health provider. If you're reluctant to seek treatment, try to work up the courage to talk to someone about what you're going through, whether it's a friend or loved one, a health care professional, a teacher, a faith leader or someone else you trust. They can help you take the first steps to successful binge-eating disorder treatment.

Helping a loved one with binge-eating disorder symptoms
If you have a loved one you think may have symptoms of binge-eating disorder, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You may even be able to go to an appointment with him or her.

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The cause of binge-eating disorder is unknown. As with many mental illnesses, it's thought that a variety of factors are at play in binge-eating disorder, such as:

• Biological factors. People with binge-eating disorder may have inherited genes that made them more susceptible to developing an eating disorder. In addition, brain chemicals may be altered in people with binge-eating disorder.
• Psychological factors. Psychological and emotional factors may also play a role in binge-eating disorder. You may have low self-worth and trouble controlling impulsive behaviors, managing moods or expressing anger.
• Environmental factors. Modern Western culture often cultivates and reinforces a desire for thinness. Although most people who have binge-eating disorder are overweight, they are probably acutely aware of their appearance and may get angry with themselves after eating binges.

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Factors that can increase the risk of developing binge-eating disorder are:

• Being female. Women are slightly more likely than men to develop binge-eating disorder.
• Your age. Although people of any age can have binge-eating disorder, it often begins when people are in late adolescence or their early 20s.
• Family history. If you have close relatives — siblings or parents — who've had an eating disorder, you have an increased risk of developing an eating disorder yourself.
• Dieting. People with binge-eating disorder have a mixed history of dieting — some have dieted to excess dating back to childhood, while others haven't dieted. Dieting may trigger an urge to binge eat.
• Psychological issues. Certain behaviors and emotional problems are more common when you have binge-eating disorder. As with bulimia, you may act impulsively and feel a lack of control over your behavior. You may have a history of depression or substance abuse. Binge eaters may have trouble coping with stressful situations, anger, sadness, boredom and worry.

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Generally, people with binge-eating disorder don't enjoy eating to excess. And you may even develop psychological and physical problems related to binge eating, making you even more miserable and further reducing your quality of life.

Some of these complications can arise from being overweight as a result of frequent bingeing. Other complications may occur because of unhealthy yo-yo eating habits — binging followed by harsh dieting. In addition, food consumed during a binge is often high in fat and low in protein and other nutrients, which could lead to health problems.

Complications that binge-eating disorder may cause or be associated with include:

• Depression
• Suicidal thoughts
• Insomnia
• Obesity
• High blood pressure
• Type 2 diabetes
• High blood cholesterol
• Gallbladder disease and other digestive problems
• Heart disease
• Joint pain
• Muscle pain
• Headache

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Treatment of binge-eating disorder may require a team approach that includes medical providers, as well as mental health providers and dietitians with experience in eating disorders.

Here's some information to help you get ready for your appointments, and what to expect from your doctor and other health providers.

What you can do

• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Ask a family member or friend to come with you, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot. A family member may also be able to give your doctor a fuller picture of your home life.
• Write down questions to ask your doctor so you'll remember to cover everything you wanted to.

Some potential questions you might want to ask your doctor or other health care provider include:

• What kinds of tests do I need? Do these tests require any special preparation?
• Is this condition temporary or long lasting?
• What treatments are available, and which do you recommend?
• If medication is a part of treatment, is a generic drug available?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?

In addition to the questions that you've prepared to ask, don't hesitate to ask questions of any of your providers anytime that you don't understand something.

What to expect from your doctor
Your doctor or other health care provider is likely to ask you a number of questions, such as:

• How long have you been worried about your weight?
• Do you exercise? How often do you exercise?
• Have you found any other ways to lose weight?
• Are you having any physical symptoms?
• Have you ever vomited because you were uncomfortably full?
• Have you ever taken medications for weight loss?
• Do you think about food often?
• Do you ever eat in secret?
• Have any of your family members ever had symptoms of an eating disorder or have any been diagnosed with an eating disorder?

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Binge-eating disorder isn't yet officially classified as a mental disorder, and not all experts agree on whether or not it should be. Binge eating is similar to bulimia nervosa, another eating disorder, and some experts think it may be a form of bulimia. But unlike people with bulimia who try to rid themselves of the extra calories after a binge through vomiting, exercise or other means, people with binge-eating disorder don't attempt to purge themselves of the extra calories they consume. That's why many people with binge-eating disorder are overweight.

In any case, when doctors suspect someone has an eating disorder, they typically run a number of tests including:

• A physical exam
• Blood and urine tests
• A psychological evaluation, including discussion of your eating habits

Your doctor may want you to undergo other tests to check for health consequences of binge-eating disorder, such as heart problems or gallbladder disease.

Criteria for diagnosis
All these evaluations help doctors determine if you meet the criteria for binge-eating disorder or if you may have another eating disorder, such as bulimia. The criteria to diagnose mental health conditions are set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association.

DSM diagnostic criteria for binge-eating disorder include:

• Recurrent episodes of binge eating, including eating an abnormally large amount of food and feeling a lack of control over eating
• Binge eating that's associated with at least three of these factors: eating rapidly; eating until you're uncomfortably full; eating large amounts when you're not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating
• Concern about your binge eating
• Binge eating occurs at least twice a week for at least six months
• Binge eating isn't associated with inappropriate methods to compensate for overeating, such as self-induced vomiting

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The goals for treatment of binge-eating disorder are to reduce eating binges, to improve your emotional well-being and, when necessary, to lose weight. Because binge eating is so entwined with shame, poor self-image, self-disgust and other negative emotions, treatment needs to address these and other psychological issues.

There are four main types of treatment for binge-eating disorder.

Psychotherapy
Psychotherapy, whether in individual or group sessions, can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes. Examples of the types of psychotherapy that may be helpful include:

• Cognitive behavioral therapy. Cognitive behavioral therapy may help you cope better with issues that may trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and eating patterns. However, cognitive behavioral therapy hasn't been shown helpful in reducing weight. So if you're overweight, you may need additional treatment.
• Interpersonal therapy. Interpersonal therapy focuses on your current relationships with other people. This may help reduce binge eating that's triggered by poor relationships and unhealthy communication skills. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and colleagues. You learn how to evaluate the way you interact with others and develop strategies for dealing with relationship and communication problems.
• Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.

Medications
There's no medication specifically designed to treat binge-eating disorder. But, several types of medication have been found to be helpful in reducing the symptoms of binge-eating disorder. Combining therapy with medications may be more effective than either treatment alone. The types of medications that may be helpful for binge-eating disorder include:

• Antidepressants. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may be helpful for binge eating. It's not clear how these can reduce binge eating, but it may be related to how they affect certain brain chemicals associated with mood.
• The anticonvulsant topiramate (Topamax). Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, it can cause serious side effects, including a numb, burning or tingling sensation, and trouble in thinking.

Behavioral weight-loss programs
Weight-loss programs typically aren't recommended until the binge-eating disorder is treated, because very low calorie diets may trigger more binge-eating episodes.

However, when necessary, weight-loss programs for people with binge-eating disorder are generally done under medical supervision to ensure that your nutritional requirements are met. Some programs are known as very low calorie diet programs because they include an initial period of strict calorie restriction for fast weight loss.

Weight-loss programs may also address issues that tend to trigger binges, but generally to a lesser extent than psychotherapy does. However, weight-loss programs, especially those that are not medically supervised, may not be appropriate for everyone with binge-eating disorder.

Self-help strategies
Some people with binge-eating disorder find self-help books, videos and support groups effective. Some eating disorder programs offer self-help manuals that you can use on your own or with guidance from mental health experts. Self-help strategies may not be effective on their own, though. You still may need professional treatment with psychotherapy or medications.

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Binge-eating disorder generally isn't an illness that you can treat on your own. But you can do some things for yourself that will build on your treatment plan. In addition to professional treatment, follow these self-care steps for binge eating:

• Stick to your treatment. Don't skip therapy sessions. If you have meal plans, do your best to stick to them and don't let setbacks derail your overall efforts.
• Avoid dieting. Trying to diet can trigger more binge episodes, leading to a vicious cycle that's hard to break.
• Eat breakfast. Many people with binge-eating disorder skip breakfast. But, if you eat breakfast, you may be less prone to eating higher calorie meals later in the day.
• Don't stock up. Keep less food in your home than you normally do. That may mean more-frequent trips to the grocery store, but it may also take away the temptation and ability to binge eat.
• Get the right nutrients. Just because you may be eating a lot during binges doesn't mean you're eating the kinds of food that supply all of your essential nutrients. Talk to your doctor about vitamin and mineral supplements.
• Stay connected. Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
• Get active. Talk to your health care providers about what kind of exercise is appropriate for you, especially if you have health problems related to being overweight.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Although yoga has not yet been well studied as a treatment for people with eating disorders, some research has found that yoga may be beneficial as an additional treatment. It may help people with eating disorders by increasing a sense of well-being and promoting relaxation.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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When living with an eating disorder you may face an especially difficult struggle to cope, since food is essential to survival. There's no avoiding it — you have to deal with food on a daily basis. Having an eating disorder and being overweight is a double whammy. Here are some tips to help you cope:

• Ease up on yourself. Don't buy into your own self-criticism.
• Identify situations that may trigger destructive eating behavior so that you can develop a plan of action to deal with them.
• Look for positive role models who can help lift your self-esteem, even if they're not easy to find. Remind yourself that the ultrathin models or actresses showcased in women's magazines or gossip magazines often don't represent healthy, realistic bodies.
• Try to find a trusted confidant you can talk to about what's going on. Together, you may be able to come up with some treatment options.
• Try to find someone who can be your partner in the battle against binge eating — someone you can call on for support instead of bingeing.
• Find healthy ways to nurture yourself by doing something just for fun or to relax, such as yoga, photography, meditation or simply a walk.
• Consider journaling about your feelings and behaviors. Journaling can make you more aware of your feelings and actions, and how they're intertwined.

Get Support
Some people find support groups helpful. Support group members can truly understand what you're going through because they've been there themselves. They can also offer encouragement, hope and advice on coping. If you're interested in joining a support group, you can ask your doctor if he or she knows if there's a group in your area, or you can call the National Association of Anorexia Nervosa and Associated Eating Disorders (ANAD) helpline at 630-577-1330. (This is not a free phone call.) You can also find information on its Web site. Overeater's Anonymous (OA) also offers support groups. You can contact OA through its Web site, or by calling 505-891-2664. (This is not a free phone call.)

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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There's no sure way to prevent binge-eating disorder. But, if you notice a family member or friend with low self-esteem, severe dieting, frequent overeating, hoarding of food or dissatisfaction with appearance, consider talking to him or her about these issues. Although you may not be able to prevent binge-eating disorder or another eating disorder from developing, you can talk about healthier behavior or treatment options.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.