How Is Binge Eating Disorder Diagnosed?
Weight is not a criterion for a BED diagnosis. People of any weight or body shape may be diagnosed with the condition. Professionals look at numerous factors when determining how to diagnose binge eating disorder.
BED is a mental health condition listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and there are exams and tests that are also a part of how binge eating is diagnosed.
DSM-5 criteria
For someone to receive a binge eating disorder diagnosis, they must have repeated binge eating episodes that occur once a week on average. A binge episode is characterized by eating a large amount of food during a distinct period of time and having a lack of control while eating.
For a diagnosis, binge eating episodes must be present for at least 3 months and be accompanied by feelings of distress. To meet the diagnostic criteria for a binge eating disorder diagnosis, 3 or more of the behaviors must apply:
- Eating more quickly than normal
- Eating a large amount of food without feeling hungry
- Eating enough food to feel uncomfortably full
- Eating alone due to embarrassment about your behavior
- Feeling guilt, disgust, or depression after a binge episode
“It’s important to remember that even if you don’t fit all the criteria for an official BED diagnosis, the symptoms and behaviors are often challenging and cause distress. You don’t have to struggle alone — support is available. Don’t hesitate to reach out to a licensed mental health professional to discuss your concerns.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
Binge eating can also be a symptom of other eating disorders, like bulimia nervosa. However, people with bulimia nervosa engage in compensatory behavior, like purging, after a binging episode. These behaviors aren’t seen in people with BED. Similarly, people with anorexia nervosa starve themselves, a behavior also not seen with BED.
Tests & exams
While recurrent episodes of binging are linked with binge eating disorder, it’s important to note that it can also be a sign of other issues. For example, many people with attention deficit hyperactivity disorder (ADHD) struggle with inattention and impulse control, which studies show can contribute to overeating. Other medical conditions can also influence a person’s eating habits, such as certain types of anxiety.
For these reasons, an important component of how binge eating is diagnosed is ruling out other potential causes for destructive binging behaviors. Doctors may run a number of exams and tests before a diagnosis is made. Some of them might include:
- Lab work: Blood work and specialized tests, such as a thyroid function test and/or urinalysis, can help identify health issues that might be contributing to binge eating.
- Physical exam:Doctors will look at a patient’s height, body weight, and vital signs to see if there are any indicators of a serious health problem.
- Psychological evaluation: A mental health professional may ask questions about your mood, feelings, and eating habits. You might also be asked to complete a test to screen for BED or other conditions.
At Talkspace, you can connect with a mental health professional online to get a diagnosis. They’ll evaluate your symptoms and provide you with a diagnosis and treatment plan tailored to your condition. Getting a binge eating disorder diagnosis online eliminates many of the barriers that prevent people from getting help. From the comfort of your home, you can work towards bettering your mental health.
“Getting a medical evaluation is important for anyone struggling with any eating disorder symptoms in order to monitor any impact on your physical well-being. Being upfront with your medical provider(s) about your symptoms will ensure you get proper care.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
How to Get a Binge Eating Disorder Diagnosis with Talkspace
Are you concerned that your eating patterns are unhealthy and might qualify for a diagnosis? You can get answers, and a path to healing, quickly and conveniently with Talkspace. We’ll connect with a licensed provider who will evaluate your symptoms, listen to your concerns, and, if appropriate, diagnose you with binge eating disorder or another condition.
Even if you don’t meet the diagnostic criteria for binge eating disorder, a mental health provider can help you address any destructive eating habits and body image issues. BED can make you feel like you’re out of control, but this condition is treatable. At Talkspace, you can connect with a therapist who knows how to diagnose binge eating disorder and provide you with treatment.
Talkspace makes it affordable to receive diagnosis and treatment for binge eating disorder, with online therapy and psychiatry plans that take insurance. Your specific insurance company and health plan will determine your coverage and copays, but covered members typically have a copay of about $25, often less. If your insurance doesn’t cover Talkspace, check with your employer to see if they pay for our mental health services directly (many do), use an FSA/HSA card, or pay out-of-pocket at a cost that’s less than most in-person providers.
Here’s how it works:
- Get started any time by answering a few questions on the Talkspace website or app.
- You’ll be connected with a therapist within about two days or a psychiatric provider within about a week.
- If you choose therapy you can message with your therapist as much as you like or schedule live sessions. If you choose psychiatry you’ll schedule a live video session with your psychiatric provider.
Online therapy provides support for managing binge eating disorder through ongoing conversations, while online psychiatry usually involves a prescription for medication and ongoing medication management. Find out how Talkspace can help you get and manage a binge eating disorder diagnosis.
Types of Treatment for Binge Eating Disorder
Treatment for binge eating disorder (BED) usually begins with psychotherapy but often includes a combination of techniques. The goal is to gain control of your relationship with food using therapy, nutritional counseling, and sometimes medication.
Psychotherapy (or talk therapy) for binge eating disorder
Often, psychotherapy is targeted at treating depression, which is important since research shows us that people with binge eating disorder are 6 times more likely to have depression and 4 times more likely to attempt suicide.
Psychotherapy is usually the first recommended binge eating disorder treatment, as the risks from BED-related depression can be more severe than the physical side effects of BED. Psychotherapy (also known as talk therapy) can help address symptoms and causes of binge eating disorder.
Psychotherapy allows people to identify the aspects of their life that may contribute to their BED-related depression and to deal with the causes effectively. Therapists can work with individuals to identify problems that contribute to their depression and help them set realistic goals for overcoming them. In addition, talk therapy can help people regain a sense of control, lessening the chance of another bout of depression.
Depression can cause someone to feel as if everything is hopeless. Psychotherapy can help change negative thinking patterns like this so someone can achieve a more positive outlook.
How does psychotherapy treat binge eating disorder?
Psychotherapy is commonly the first approach for binge eating disorder treatment, as it can help someone recognize the underlying psychological issues leading them to binge. Once people understand the causes of their binge eating, therapy can help them develop specific coping strategies.
To be successful, BED treatment needs to address the whole person, not just the physical aspects of binge eating disorder. While physical symptoms might be most apparent, the underlying psychological and interpersonal issues need to be addressed to stop the binge eating cycle.
“When I work with clients who are in recovery from binge eating disorder, we first start with a comprehensive intake evaluation to understand more about you and what your eating disorder symptoms are so we can discuss recommendations and next steps. You are incredibly brave for reaching out for support. Know that there are lots of mental health providers who specialize in eating disorders who are here to support you in your recovery.”
— Kate Rosenblat, Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), MA
Various types of psychotherapy are successful for people with BED. Everyone with a binge eating disorder is different, however, and what may work for one person may not work as well for another.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT) is one of the most well-researched forms of therapy in treating binge eating disorder. While it’s historically been a treatment for anxiety and depression, its evidence-based model can help people’s negative behaviors around food be restructured toward more productive behaviors.
Interpersonal therapy (IPT)
Interpersonal psychotherapy (IPT) is an evidence-based treatment that focuses on 4 areas:
- Grief
- Interpersonal disputes
- Role transitions
- Interpersonal deficits
People with BED can learn to improve relationships and communication through IPT, effectively reducing their urge to binge eat.
Healthy relationships can relieve BED symptoms because interpersonal dysfunction is linked to increased negative food behaviors. IPT provides a framework for interpersonal conflict resolution, encouraging healthy relationships.
Mindfulness-based eating awareness training (MB-EAT)
Mindfulness-based eating awareness training (MB-EAT) is a group therapy intervention developed for binge eating disorder.
MB-EAT trains those with BED in guided practices designed to control responses to different emotional states. This awareness training helps someone make better, more conscious food choices, cultivate self-acceptance, and develop an understanding of their hunger and satiety cues.
Family therapy
Family therapy includes all family members, not just the person with BED. Treatment includes re-establishing healthy eating, restoring a healthy weight, and interrupting compensatory behaviors. In addition, family therapy helps to return control of eating to the person with BED.
Group therapy
Group therapy is helpful to individuals with binge eating disorder. Other treatments such as medical management, nutritional counseling, and individual therapy are typically used alongside group therapy to get the most benefits as possible.
Sharing binge eating experiences with a group can foster healing, self-understanding, and community building. In addition, group therapy provides a safe, judgment-free space for people with BED to process food-related behaviors without shame.
Medications for binge eating disorder
Sometimes medication for binge eating disorder combined with therapy can offer a viable treatment solution.
How does medication treat binge eating disorder?
Receptors that modulate hunger and satiety are closely intertwined with the receptors that control emotions, behavior, and cognition. Certain medications can address and help with symptoms of BED by targeting the parts of the brain directly related to food behavior.
Types of medication for binge eating disorder
Currently, there are 3 types of medication that may be used for BED, including:
- Antidepressants: They target chemicals in the brain that help control your mood, which may reduce binges. The antidepressant Fluoxetine is one medication approved for BED treatment. Fluoxetine might help control binge-eating episodes by reducing certain cravings.
- Anti-seizure medications: Anti-seizure medications like Topamax can reduce binge eating for many people by reducing impulsiveness.
- Stimulants: Vyvanse is the first FDA-approved off-label medication used to treat moderate-to-severe BED. While its primary use is for treating ADHD, it’s thought to control the impulsivity that leads to binge eating. It also might help reduce distressing thoughts about excess body weight.
Any medication comes with certain risks. Consult your doctor if you’re interested in learning more.
“Working with a multidisciplinary team of professionals, including a therapist, registered dietitian, psychiatrist, and others is a holistic and effective approach to supporting your recovery from binge eating disorder; feel free to ask them to all collaborate on your care.”
— Kate Rosenblatt, Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), MA
Self-help for binge eating disorder
One strategy for BED treatment is to implement self-help treatments. Self-help may include:
- Monitoring when and what you’re eating so you can recognize and try to change patterns in your eating behavior
- Making realistic meal plans on what to eat and when can help some people control their eating
- Recognizing your triggers, so you can learn the signs and prevent a future binge
- Identifying the underlying emotional causes of binge eating so you can work on your mental health in a positive way
- Finding other ways of coping with your negative feelings, like walking, playing a board game, calling a friend, or pursuing a new hobby
- Understanding how to understand your weight in a healthy way
“If you worry that you or someone you care about is struggling with a binge eating disorder, we encourage you to seek a consultation with an eating disorder specialist immediately. You deserve help, and there are lots of people out there who want to support you. You don’t have to do this alone.”
— Kate Rosenblatt, Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), MA
Nutritional counseling
Many people with BED may struggle with being overweight or obese due to eating abnormally large portions. While it may seem like weight loss is the goal, dieting will not solve any underlying issues with food. Therefore, learning and practicing nutrition basics and how to maintain a healthy relationship with food can be invaluable in your recovery.
Virtually everyone with BED will struggle with fears or unhealthy beliefs about food. Nutritional counseling can support you while providing nutrition education and exploring false eating disorder beliefs, which might overlap with things like traumatic childhood experiences. Treatment will include finding a therapist to help you process and heal from trauma.
“Working with a registered dietitian (RD) who specializes in eating disorders is a crucial part of the recovery process. Set up an initial consultation with an RD to discuss what your work together might look like. You can ask them questions about anything — from their approaches to how they treat binge eating disorder (ask about if they use the intuitive eating approach), or how you will be weighed (you can discuss not knowing your weight if that feels best for you).”
— Kate Rosenblatt, Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), MA
Find Treatment for Binge Eating Disorder
Have you or your loved one experienced any of the below binge eating disorder symptoms?
- Compulsive overeating within a short period
- Still eating even while full
- Eating quickly during binge eating episodes
- Eating more than your stomach can hold
- Frequent recurrent binge
- Feeling guilt about eating a lot
- Sporadic diets but without achieving weight loss
- Feeling self-conscious about being a binge eater
If you notice any of the above, you’re not alone. You can find help today. If you’d like to start from the privacy of your own home, you can call, text, or chat with the National Eating Disorder Association (NEDA) helpline.
In addition, if seeking treatment from the comfort of your personal space appeals to you, you might want to reach out to an online therapy platform like Talkspace. Our experienced therapists are trained in eating disorder treatment.
Regardless of where you start, taking that first step in finding treatment is essential.
