Binge eating is defined as the uncontrolled eating of a large amount of food within a discrete period of time (e.g., within any 2-hour time period). Within the current Diagnostic and Statistical Manual of Mental Disorders, binge eating has two distinguishing characteristics: (1) the consumption of an amount of food that clearly is larger than most people would eat in a similar period of time and under similar circumstances and (2) a lack of control over what or how much is consumed or how long the eating episode lasts. In 1959, Albert Stunkard originally described binge eating as a pattern of eating seen among a subset of obese patients. Currently, binge eating is a cardinal symptom of two eating disorders, bulimia nervosa and binge eating disorder, and it also may be present in a third eating disorder, anorexia nervosa.
Historically, there has been some controversy regarding the definition of a binge episode, particularly with respect to the amount of food and, correspondingly, the number of calories consumed during a binge. This controversy emerged from a literature indicating that individuals who binge often consume an extremely large number of calories during a binge. However, there also was evidence that there was a large range in the caloric content of the food consumed during a binge, with the caloric content of a binge episode comparable to that consumed during a large meal or snack. Findings such as these suggest subjectivity in individuals’ views of what constitutes a binge episode. Consequently, Fairburn (1995) and Fairburn and Wilson (1998) introduced the distinction between objective binges and subjective binges. During an objective binge, the individual engages in the uncontrolled eating of an excessively large amount of food. In contrast, during a subjective binge episode, the individual consumes a relatively normal or even small amount of food, but he/she views the amount of food as excessive and experiences a sense of loss of control.
Binge eating is associated with a variety of emotional consequences. Binge episodes frequently are triggered by negative affect, suggesting that bingeing may serve as a way to manage or avoid negative affect, to self-soothe, to distract oneself from a stressful situation, or to numb or escape painful or distressing emotions, if only temporarily. Binge episodes typically are followed by negative emotions, including guilt and shame. In addition, binge episodes frequently are followed by a fear of weight gain. This fear may lead to purging via self-induced vomiting or the use of laxatives or diuretics and/or severe restriction as a means to counteract the binge and prevent weight gain. When this occurs, binge eating, purging, and restriction may become part of a self-perpetuating cycle.
Binge eating also is associated with impaired interoceptive awareness, a difficulty recognizing and accurately responding to internal states, including sensations of hunger and fullness. Individuals who binge may have difficulty discerning sensations of hunger and fullness. Impaired interoceptive awareness is more likely to emerge if the individual vacillates between periods of strict dietary restraint (during which hunger cues may be ignored) and periods of binge eating (during which satiety signals may be overridden or ignored).
Binge eating is associated with short-term and long-term physical consequences. The short-term physical consequences of binge eating primarily consist of feeling uncomfortably full, which may be associated with abdominal pain or discomfort, stomach distension, and bloating. Less common but more severe long-term consequences of binge eating include gastric dilation or gastric rupture. Binge eating in conjunction with other eating disorder symptomatology, including restriction and/or purging, is associated with health risks such as electrolyte disturbances, cardiovascular abnormalities, decreased bone density, and erosion of dental enamel.
- American Psychiatric (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
- Fairburn, G. (1995). Overcoming binge eating. New York: Guilford.
- Fairburn, C. G., & Wilson, G. T. (1993). Binge eating: Nature, assessment, and treatment. New York: