Development & Maintenance Causes of Binge Eating Disorder

Binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort). With the binging, a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterward; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.

It is the most common eating disorder in the United States. It’s more common than anorexia and bulimia combined. [1, 2]

Like all eating disorders, causes of binge eating disorder are likely the result of multiple, complex, and interacting factors. These include biological, psychological, and socioenvironmental factors. The degree to which these different factors play a role in the development and maintenance of BED varies tremendously between individuals.

Causes of Binge Eating Disorder

Biological Factors

There are a variety of biological factors that are thought to contribute to BED. There is strong evidence that the disorder is inherited, with a family history of the disorder increasing BED risk. More specifically, researchers have found that variants in a serotonin transporter gene are associated with increased binge eating severity in the general population.

Additionally, evidence supports that differences in brain structures and brain chemistry may play a role in the development and maintenance of binge eating disorder. Preliminary evidence suggests that BED may be associated with increased gray matter volume in frontal brain regions that are involved in reward processing and self-regulation. Furthermore, research has indicated that brain chemistry may interfere with the ability to regulate food intake and create or increase the “wanting” of a particular food.

Research has also suggested that individuals with BED may have lower serotonin levels and increased sensitivity to dopamine — both of which play a role in mood and reward. Additionally, individuals with BED may experience heightened anticipated reward valuation expected from food cues, which makes eating more rewarding and pleasurable than in people without BED.

Furthermore, hormonal differences, particularly those hormones associated with hunger and fullness, are noted to be dysregulated in BED sufferers. This dysregulation likely contributes to the development and maintenance of the disorder. [3, 4, 6, 9, 10]

Psychological

There is a wide range of established psychological risk factors that contribute to the causes of binge eating disorder. These include other psychiatric illnesses or diagnoses, as well as cognitive, behavioral, and emotional factors.

BED often co-exists with mood, anxiety, and impulse-control disorders as well as a range of substance use disorders. Studies have found that body image dissatisfaction plays a role in BED, as does body image distortion.

The personality traits of increased harm avoidance and novelty seeking and lower self-directedness are likely linked to BED. Having a personal history of dieting, especially during childhood or young adulthood, and experiencing feeling a loss of control over eating in childhood are also thought to be contributing psychological factors to BED. [2, 3, 7, 8, 11]

Socioenvironmental

There is a range of both proximal and distal socioenvironmental risk factors for the causes of binge eating disorder. Distal sociocultural factors, such as the thin-cultural ideal, diet-culture, and weight-based stigmatization, all contribute to BED.

While proximal factors such as family overeating, history of being bullied and teased as a child, parental absence or death, and familial disruption or deprivation in the home environment have been shown to confer risk for BED. Additionally, like all eating disorders, a history of trauma, particularly of an interpersonal nature (e.g., abuse, assault), is prevalent among both men and women with eating disorders. [3, 5]

When considering the maintenance and development of BED, it should be emphasized that these biopsychosocial factors rarely, if ever, exist alone. When looking at the causes of binge eating disorder in an individual, it is often found that these factors closely relate to and influence one another.

It is difficult to consider one factor without considering its impact on another. With that said, the development and maintenance of BED are highly individualized.

It is important to note that the biopsychosocial factors provided here are not comprehensive — new contributing factors continue to be researched and found to be significant in the development and maintenance of BED.

In a similar vein, it is also worth mentioning that BED is less researched than other eating disorders. This is partly due to the fact that it’s one of the newest eating disorders formally recognized in the DSM-5 published in 2013.

Prior to this recent edition, BED was listed as a subtype of EDNOS (now referred to as OSFED). Now seen as a more widely recognized eating disorder, more (much needed) research on BED is anticipated.

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Sources:

[1] National Eating Disorders Association. Learn: Binge Eating Disorder. Retrieved from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed on Jan 15, 2020.
[2] Hudson, J. I., Hiripi, E., Pope, H. G., Jr, & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological psychiatry, 61(3), 348–358. doi:10.1016/j.biopsych.2006.03.040
[3] Bakalar, J.L., Shank, L.M., Vannucci, A. et al. Recent Advances in Developmental and Risk Factor Research on Eating Disorders. Curr Psychiatry Rep 17, 42 (2015) doi:10.1007/s11920-015-0585-x
[4] Davis, C. (2015). The epidemiology and genetics of binge eating disorder (BED). CNS Spectrums, 20(6), 522-529. doi:10.1017/S1092852915000462
[5] National Eating Disorders Association. Learn: What are eating disorders? Risk Factors: Weight Stigma Retrieved from https://www.nationaleatingdisorders.org/weight-stigma on Jan 16, 2020.
[6] National Eating Disorders Association. Appetite. Retrieved from https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/appetite on Jan 16. 2020.
[7] Grilo, C. M., & Masheb, R. M. (2005). Correlates of body image dissatisfaction in treatment‐seeking men and women with binge eating disorder. International Journal of Eating Disorders, 38(2), 162-166. DOI: 10.1002/eat.20162
[8] Mussell, M. P., Peterson, C. B., Weller, C. L., Crosby, R. D., Zwaan, M., & Mitchell, J. E. (1996). Differences in body image and depression among obese women with and without binge eating disorder. Obesity Research, 4(5), 431-439. DOI: 10.1002/j.1550-8528.1996.tb00251.x
[9] Haedt-Matt, A. A., & Keel, P. K. (2011). Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment. Psychological bulletin, 137(4), 660. doi: 10.1037/a0023660
[10] Akkermann, K., Nordquist, N., Oreland, L., & Harro, J. (2010). Serotonin transporter gene promoter polymorphism affects the severity of binge eating in general population. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 34(1), 111-114. doi: 10.1016/j.pnpbp.2009.10.008
[11] Grucza, R. A., Przybeck, T. R., & Cloninger, C. R. (2007). Prevalence and correlates of binge eating disorder in a community sample. Comprehensive psychiatry, 48(2), 124-131. doi: 10.1016/j.comppsych.2006.08.002

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About the Author:

Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework.

She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published January 31, 2020, on EatingDisorderHope.com
Reviewed & Approved on January 31, 2020, by Jacquelyn Ekern MS, LPC