Binge eating disorder, what it is and how it differs from bulimia

Binge eating disorder, what it is and how it differs from bulimia

Who has not ever opened the fridge at dawn and has begun to eat in an excessive way? Or during the day. Who has not taken a good binge of food even without being hungry? This type of behavior should not lead to any problem if it occurs occasionally. In a moment of stress or anxiety we can eat in quantity without being hungry. The problem arises when this behavior occurs too often. In this case, we could be talking about Binge eating disorder.

In this article we will address this disorder at the same time that the differences with the bulimia. Although this disorder may seem "less serious" because the behavior is that of overeating, eating is not so much the problem but everything that lies behind. In addition to the consequences that may result from bingeing itself.


  • 1 Criteria for Binge Eating Disorder according to DSM-V
  • 2 Who can suffer it and what does it imply?
  • 3 What can favor Binge Eating Disorder?
  • 4 Treatment

Binge Eating Disorder Criteria according to the DSM-V

The DSM-V is a Diagnostic and Statistical Manual of Mental Disorders edited by the American Psychiatric Association (APA). It contains a detailed classification of the different mental disorders as well as a diagnostic description of them. According to the DSM-V, the criteria for the diagnosis of Binge Eating Disorder are as follows:

TO. The occurrence of recurring binge episodes. A binge episode is characterized by the following two facts:

  1. Ingestion, in a given period of an amount of food that is clearly higher than what most people would eat in a similar period in similar circumstances.
  2. Feeling of lack of control about what is ingested during the episode.

B. Binge eating episodes are associated with three (or more) of the following events:

  1. Eat much faster than normal.
  2. Eat until you feel unpleasantly full.
  3. Eat large amounts of food when you do not feel physically hungry.
  4. Eat alone, because of the shame you feel for the amount ingested.
  5. Feeling disgusted with oneself, depressed or very ashamed.

C. Intense discomfort regarding binge eating.

D. Binge eating occurs, on average, at least once a week for three months.

AND. Binge eating is not associated with the recurring presence of inappropriate behavior, such as in bulimia nervosa, and does not occur exclusively in the course of bulimia nervosa or anorexia nervosa.

According to the DSM-V you can also classify binge eating from mild to extreme:

  • Mild: 1-3 bingeing a week.
  • Moderate: 4-7 binge eating a week.
  • Serious: 8-13 binge eating a week.
  • Extreme: 14 or more binge eating a week.

Who can suffer it and what does it imply?

This disorder occurs in a person with normal weight, overweight and obesity. It is not advised to equate obesity to the disorder since most obese people do not carry out this type of behavior frequently. It affects women more and usually occurs in a range of 2% to 5% of the general population.

Its appearance usually makes an appearance in the adolescence or early adulthood. Here we can find a difference with bulimia or anorexia nervosa, since patients with Binge Eating Disorder are usually older than these when they go to the office.

This disorder has an associated noticeable deterioration of the quality of life, social adaptation problems, higher mortality and morbidity and increased risk of developing obesity. It usually presents comorbidity with the Bipolar disorder, depression and anxiety. There is also some comorbidity with substance use, but to a lesser extent.

Another difference between this disorder and bulimia is that those who suffer from it do not control this excess food through the abuse of laxatives, diuretics or vomiting.

What can favor Binge Eating Disorder?

  • Breaking a diet When one of the dietary guidelines is skipped, the feeling of guilt can be such that it triggers a compulsive intake.
  • Negative feelings. Feeling down, alone, irritated, bored ... are factors that can facilitate an excessive intake of food.
  • The hunger of the diet. When someone is on a diet their food intake is significantly reduced compared to their day to day. People with these disorders often take the diet to an extreme such that they eat very little out of binge eating. Thus, this deprivation of food generates such psychological and physiological tension that drives the individual to an excessive intake and with low self-control.
  • Stress, anxiety and / or depression. High levels of stress and anxiety can favor this type of behavior and lead the individual to quench their vital anguish through food.
  • Dysphoria and psychological distress.
  • Ananchastic personality. This type of personality is characterized by a pathological concern for order and perfectionism. Lack of flexibility and mental openness.
  • Panic disorder.
  • Bulimia nervosa.
  • Personality disorder borderline
  • Overestimation of body image. The overestimation of height in this disorder is less important than in people with anorexia or bulimia nervosa.
  • Dissatisfaction with one's body image. There is a positive relationship between binge eating and body dissatisfaction of obese subjects.


In the case of Binge Eating Disorder, psychological treatment will be recommended to offer the person tools to control the impulses that lead him to eat in an excessive way. At the same time, we will work on all the fundamental aspects that lead the subject to perform this type of behavior.

An approach from pharmacology may be recommended in the initial stages of treatment to control anxiety due to lack of food. However, the main job is to solve what causes this type of behavior, so that the need for bingeing disappears.


  • García Palacios, A. (2014). Binge eating disorder in the DSM-V. Notebooks of psychosomatic medicine and liaison psychiatry, 110, 70-74.
  • Guisado, J. and Vaz, F. (2001). Clinical aspects of binge eating disorder. Journal of the Spanish Association of Neuropsychiatry, 21 (77), 27-32.
  • Kupfer, D. J., Regier, D. A., Arango López, C., Ayuso-Mateos, J. L., Vieta Pascual, E., and Bagney Lifante, A. (2014).DSM-5: Diagnostic and statistical manual of mental disorders (5th ed.). Madrid: Pan American Medical Editorial.