Size Diversity within BED Population
Binge eating disorder (BED) is a mental health issue that affects, at a minimum, 9 million Americans though that number is expected to rise significantly as people who have been undiagnosed, or misdiagnosed, get the proper treatment they require.
BED effects men and women almost equally, with women slightly higher in reporting; however, these numbers may change too as treatment providers and general practitioners begin to see more people with questions about their food relationships. Awareness campaigns such as that developed by Shire (www.bingeeatingdisorder.com) in conjunction with the Binge Eating Disorder Association (www.bedaonline.com) and the National Eating Disorder Association (www.nationaleatingdisorders.org) are helping to spread the word that this disorder exists and that it is treatable.
The most common symptoms of BED include a frenzied feeling around food, a loss of control over both the amount and speed with which food is consumed, and food as a source of coping. Usually these episodes are followed by humiliation, shame, a need for secrecy and isolation. For many, a binge is simply part of a cycle that includes anxiety, guilt, depression, shame and the need to sooth again, triggering another binge.
BED is the most common eating disorder affecting more people than anorexia or bulimia combined and yet, until recently, it was among the least common eating disorders discussed.
Why is that? How can an eating disorder, a widely acknowledged and treatable mental health condition, fly under the radar of so many people in today’s information economy?
Part of the answer lies in the fact that more than half of those with BED live in larger bodies and those bodies are often discounted as belonging to lazy, undisciplined and irresponsible people. People don’t often connect fatness, or obesity, to anything more substantial than ‘personal choice’ and as such they don’t look beyond the shape to what may be a significant condition or contributing factor.
Conversely, another important piece of the puzzle is that not all binge eaters are large. Many, in the range of 40 percent, do NOT live in large bodies and so their binges either go unnoticed or they are written off as harmless because the body type is slim and assumed to be healthy.
If for no other reason, this makes BED a significantly more dangerous eating disorder than many people understand. Nobody “looks” like they have BED, but it’s the shameful secret that men, women, children, and thick and thin alike, share.
To complicate matters more, one of the overriding issues for people with eating disorders is a genuine desire to please, succeed and fit in and “fitting in” means not being “fat.” Whether it’s a restrictive eating disorder such as anorexia or a compensatory eating disorder like exercise bulimia, the characteristics of the personality type with an ED often align themselves with a strong desire to be “good enough.” People with BED experience this just as intensely and for those in a larger body, the feelings of shame and failure are amplified due to their size and ‘unacceptability.’
Feelings of failure due to BED that have little to do with body size stem from the ‘evidence’ left behind after a binge. No matter the body type, binge eaters most often isolate when they are engaging in a binge. They feel out of control and often overwhelmed with a need to fill themselves with food in quantities and speeds that would alarm other people. The detritus left in the wake of a binge can be both depressing and fear inducing and usually the binge eater will make every effort to ‘cover their tracks’ so that they can hide the binge itself as well as the extent to which they binged.
Unlike someone who simply overeats or indulges on occasion, binge eaters do not casually experience regret. Whether the binge was planned in advance to ‘treat’ or perform a form of self-care, or it was due to a triggering situation, binge eaters prepare and protect by covering their tracks. They may only binge occasionally, but when they do, it’s not watching TV with friends or at a dinner party – that’s where they are hard wired to be in control – it’s when they are by themselves, away from prying eyes and judgment.
Unfortunately, for those in larger bodies who suffer with BED, the evidence is inescapable that they are struggling to cope and the consequences of self soothing are always out on public display. People with BED who are affected by obesity suffer not only their disordered relationships with food and their body, they suffer the stigma of having a mental health issue and the bias and stigma of existing in a “fat” body.
Though BED is not compensatory (there is no purging or over exercise) symptoms include significant bouts of restriction and starvation. The idea being that somehow the body will regulate the binge over time – a sort of time release digestion and metabolism of the episode. Though this is not effective, it is part of the disordered relationship with food and body and arguably a form of internalized weight stigma. The shame that bingeing brings about often drives people who suffer from BED into additional dangerous behaviors.
There are a significant number of Americans who have BED and not all of them are affected by obesity but some are. Obesity, or living in a large body, is not a symptom of BED but it may be a side effect of the disorder. If you feel that food is your method of coping, that you have no control around food, that you are trying to fill an unfillable void with food, are hiding your eating, are ashamed of your eating you may want to speak with a doctor, even your general practitioner. There are many tools to help work through food relationships, eating disorders and stress management.
If you have questions about BED, the Binge Eating Disorder Association (BEDA) is the only association designed to specifically support people with this disorder. They have information on the disorder, provider information, treatment information, toolkits, events and other resources. Visit www.bedaonline.com if you have further questions.
About the Author:
Lizabeth Wesely-Casella is a weight stigma prevention advocate and a binge eating disorder (BED) expert. She works in Washington, DC as a coalition builder and speaker addressing the impact of size discrimination on communities and industry and the profound effect that weightism has on individuals with eating disorders, especially BED.
As a speaker, Lizabeth blends science, humor, and cultural wisdom to engage her audience, creating a clear understanding of the disconnect between health and body shape and underscoring that shape and size do not reflect personal value or character. She also connects the dots between weight discrimination as a civil rights issue and the negative consequences to our economy, education, and workforce.
Lizabeth’s advocacy has afforded her opportunities to speak in the Senate, on film, and in radio. Her advocacy work has positively influenced program design from college campuses to the White House including the Let’s Move! initiative. Lizabeth lives in Washington DC with her loving husband and delightfully spoiled dog Noodle.
Disclaimer: This blog post does not reflect the views of Salvéo, the OAC, the National Board of Directors, or staff. The OAC does not endorse or support any merchandise, program or hyperlink mentioned in this blog post.