When Ed Sheeran recently revealed to Rolling Stone that he has “a real eating problem,” his words were more impactful than he may have realized. For one thing, men have historically been left out of the eating disorder conversation (despite the fact that about 10 million individuals who identify as male in the United States will experience an ED at some point in their life). But Sheeran’s comments also put the spotlight on a specific issue that is often ignored, overlooked, and misunderstood—even though it’s widely considered the most common ED in adults: binge eating disorder (BED).
What is binge eating disorder (BED)?
While many have seen media depictions of anorexia and bulimia and heard the myriad dangers of restricting and purging, far fewer are familiar with BED, which is characterized by regular binges (eating a large amount of food in a short amount of time) where the person feels out of control. BED was added to the Diagnostic and Statistical Manual of Mental Disorders as a clinical diagnosis in 2013 and is defined by “recurrent and persistent episodes of binge eating” as well as several other criteria, like “eating until feeling uncomfortably full” and “feeling disgusted with oneself, depressed, or very guilty after overeating”. While BED is currently estimated to affect about 1.5% of women and 0.3% of men worldwide (including about 3% of U.S. adults or up to 4 million people), countless others may still be struggling with undiagnosed disorders or “subclinical” symptoms that don’t meet the diagnostic criteria but still wreak havoc on their lives.
How does BED differ from other disorders?
Sheeran didn’t explicitly name his diagnosis, and described seeing his own experience reflected in Elton John’s memoir. “I found myself doing what Elton talks about in his book—gorging, and then it would come up again.” While those symptoms are more closely associated with bulimia (characterized by binges and subsequent purges), the two diagnoses share important similarities, and more awareness is needed around the physical and psychological risks associated with binging in general.
“Eating disorders are complex, brain-based mental illnesses and can be influenced by genetic vulnerabilities and social components,” says Erin Parks,Ph.D., chief clinical officer, chief operating officer, and co-founder of online recovery platform, Equip. “All eating disorders are rooted in restriction, so despite their different manifestations, the behaviors associated with BED, bulimia, and anorexia all tend to stem from that.”
Although anorexia is typically considered the disorder defined by food deprivation, Parks is clear that bulimia and BED also tend to start from a place of restriction. “I think of it like a circle,” she says. “People restrict, and at some point the biological need for fuel will override everything in the environment and compel them to eat and it will usually be a larger quantity of food than they’d normally eat in one setting. But more importantly, while eating, they feel out of control, shameful, and guilty.”
Those with bulimia address those intense post-binge feelings with “compensatory behaviors,” i.e. vomiting, excessive exercise, laxatives, or another form of calorie “purging.” Those with BED don’t typically engage in those compensatory behaviors, but Parks says the two are otherwise more alike than not.
“The main eating disorder behaviors are restricting, binging, and compensatory behaviors, or purging—and all three of those exist in pretty much all eating disorders,” Parks says. “Sometimes there are biological motives for binging—like being in a starvation state and your body wants and needs calories. Sometimes the psychological motives around bingeing are around numbing out—the same way that people who self-harm say they cut to feel numb, people also often describe binge eating as a way to numb out.” Along with the mental health risks associated with BED, like depression, the illness can lead to a number of physical complications, including increased risks for high cholesterol, heart disease, diabetes, and more.
