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Understanding Compulsive Eating Disorder: Symptoms, Causes, & Treatment
On the surface, compulsive overeating might seem like it’s about hunger. But if we take a deeper look, this eating behavior is about more than that. It’s usually a way to deal with difficult emotions. Compulsive overeating isn’t an official diagnosis that’s found in the DSM-5.
Rather, compulsive overeating is a disordered behavior that can show up in different eating disorders. Just like any disorder, compulsive overeating is a complicated behavior that can have disastrous effects on every aspect of someone’s life.
- Compulsive Eating Disorder Definition
- Compulsive Eating Disorder & the DSM-5
- ICD 10 Code for Compulsive Eating Disorder
- Compulsive Overeating Disorder Facts & Statistics
- Compulsive Overeating Symptoms & Warning Signs
- Long Term Health Risks
- What Causes Compulsive Eating Disorder?
- Getting Help: Compulsive Eating Disorder Treatment
- What's Difference between Binge Eating Disorder and Compulsive Overeating
Compulsive Eating Disorder Definition
For someone to be considered a compulsive overeater, they have to eat large amounts of food whether they’re hungry or not. This can look a few different ways. Some people may eat large amounts of food at one time. Someone who struggles with compulsive overeating may also graze. Grazing is when someone continually snacks throughout the day, even if they aren’t hungry.
Compulsive Eating Disorder & the DSM-5
The DSM-5 is a diagnostic manual that healthcare professionals use to officially diagnose someone with an eating disorder or other mental illness. As mentioned earlier, overeating is a disordered behavior that could appear in a few different eating disorders. Someone with compulsive overeating could be dealing with bulimia nervosa, or binge eating disorder (BED).
ICD 10 Code for Compulsive Eating Disorder
The DSM-5 has very specific requirements for diagnosing someone with an eating disorder. A diagnosis is basically the name given to a set of symptoms. Just like when someone is congested, has a runny nose, and a headache, we diagnose them with a cold. It’s the same process for diagnosing an eating disorder—we look at the symptoms and categorize it.
The DSM-5 requirements for the two diagnoses that could include compulsive overeating are detailed below (these descriptions are taken from the American Psychiatric Association):
F50.2 Bulimia nervosa
- Recurrent episodes of binge eating. In order for something to be considered a binge, the following two things must be true:
- Eating an amount of food in a short period of time that is considerably larger than what most people would eat in the same amount of time
- Feeling out of control while binging
- Ongoing compensatory behaviors in order to prevent weight gain. For example, purging or fasting.
- Binge eating and compensatory behaviors both happen and occur at least once a week for three months
- Significant preoccupation with body image and weight gain
- These behaviors don’t occur when someone is having an episode of anorexia nervosa
F50.8 Binge-Eating Disorder
- Recurrent episodes of binge eating. In order for something to be considered a binge, the following two things must be true:
- Eating an amount of food in a short period of time is considerably larger than what most people would eat in the same amount of time.
- Feeling out of control while binging.
- The binge-eating episodes are associated with at least three of the following:
- Eating more rapidly than normal
- Eating until uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone due to feeling embarrassed by the amount of food
- Feeling disgusted with oneself, depressed, or guilty afterward
- Significant distress about the binge eating
- Binge eating occurs (on average) at least once a week for three months
- Binge eating is not related to the ongoing use of compensatory behaviors that are seen in anorexia nervosa or bulimia nervosa .
Compulsive Overeating Disorder Facts & Statistics
Here are some facts about compulsive overeating and associated eating disorders:
- Binge eating disorder (BED) is three times more common than anorexia or bulimia and is the most common eating disorder [3,4]
- BED is more common than breast cancer, HIV, or schizophrenia 
- About 40% of people with BED are male 
- BED is more common in people who are severely obese. However, people in smaller or average-sized bodies can also struggle with binge eating 
- Painful childhood experiences, such as trauma, are linked with BED 
Compulsive Overeating Symptoms & Warning Signs
There are some signs and symptoms of compulsive overeating. It’s important to know that just one of these signs doesn’t mean that you or your loved one is a compulsive overeater. There are physical, behavioral, and environmental signs of compulsive overeating.
The physical signs of a compulsive eating disorder include:
- Difficulty concentrating
- Noticeable changes in body shape and size. Weight may go up and down
- Gastrointestinal issues, such as acid reflux or diarrhea 
Changes in behavior that might be a sign of compulsive eating disorder include:
- Stealing or hoarding food
- Evidence of binge eating, such as finding a lot of empty wrappers or discovering a bunch of food is missing
- Feeling out of control while eating
- Feeling depressed, disgusted, or guilty after binging
- Fear of eating in public or with other people
- Creating rituals or schedules for binge eating 
Long Term Health Risks
It’s important to be aware of the physical and mental health risks associated with compulsive overeating. Physical health risks are:
- Type 2 diabetes
- Heart disease
- Center types of cancer
- Joint and muscle pain
- Digestive problems 
Emotional health risks:
- Suicidal thoughts 
What Causes Compulsive Eating Disorder?
Several factors might play a role in an individual’s compulsive eating habits. These include biological, psychological, and environmental factors.
Biological factors include things like genetics, hormone levels, and nutrition, and whether someone’s sex. Biological factors that are linked with compulsive overeating include:
- Type 1 diabetes
- Having a close relative with an eating disorder or other mental health condition
- History of dieting 
Psychological factors are things about personality or temperament that affect someone’s mental health. There are a few psychological traits that are linked with disordered eating behaviors, like compulsive overeating. These are:
- Negative body image
- History of other mental health issues, like anxiety
- Rigid thinking patterns 
Environmental factors are social and cultural factors that influence mental health. The environmental factors that are connected to disordered eating behaviors are:
- Weight stigma
- History of teasing of bullying
- Limited social support 
Getting Help: Compulsive Eating Disorder Treatment
Eating disorder treatment can look a bit different depending on how severe someone’s symptoms are. There’s a wide range of treatment options, including:
- Outpatient mental health and nutritional counseling
- Intensive day programs
- Residential treatment
In order to get the treatment process going, it can be helpful to contact your insurance company to see which treatment centers and providers are available to you. Government funded insurance programs also may cover eating disorder treatment. You can also find a treatment provider by using tools like Eating Disorder Hope’s Treatment Finder or by searching, “eating disorder treatment near me” on an online search engine. If you or a loved one needs help, reach out for help.
What’s Difference between Binge Eating Disorder and Compulsive Overeating
Let us examine definitions of both Binge-Eating Disorder and Compulsive Overeating in order to understand these terms better. Compulsive overeating (a.k.a. food addiction) is the most common term referred to in our society for people who identify with this intense urge or compulsion (impulsive behavior) to consume large amounts of food in a relatively short period of time.
This can mean thousands of calories are consumed without the use of compensatory behaviors – such as purging (by means of vomiting, laxative use or excessive exercise) or restricting calories to counteract the binge episode, such as in the case of Anorexia Nervosa and Bulimia. The term Binge Eating Disorder also describes someone who struggles with this type of eating-disordered behavioral pattern.
A person would most likely be diagnosed as having an Eating Disorder Not Otherwise Specified (EDNOS) by clinicians who treat this compulsive overeating behavior. However, the new Diagnostic Statistical Manual of Mental Disorders (DSM-5) will now classify Binge-Eating Disorder under its own diagnosis. “Binge Eating Disorder (BED) is characterized by recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.
This disorder is associated with marked distress and occurs, on average, at least once a week over three months.” (American Psychiatric Association).
The Similar Symptoms of BED and Compulsive Overeating
Binge Eating Disorder and Compulsive Overeating seem almost identical in the description of symptoms expressed by people who struggle with food in this way. According to the National Centre for Eating Disorders, “Definitions of Binge or Compulsive Overeating include some or all of the following features which occur with regularity at least 3 times per week.
- Eating faster than usual
- Eating past the point of fullness
- Eating when not physically hungry
- Eating alone or in secret
- Feeling upset or guilty after overeating
- Feeling that you are abnormal
- Feeling “taken over” or “driven” as if by an other presence in respect of eating
Relationship to Obsessive-Compulsive Disorder
As I mentioned previously, individuals who seek treatment for compulsive eating, also may identify themselves as being a food addict-referring to a preoccupation with the “substance” of food. They will describe their eating episodes much like a person who is addicted to drugs or alcohol.
In a similar way, there was controversy surrounding Binge-Eating Disorder and its placement in the DSM-5. “The urges experienced by those with Binge-Eating Disorder are similar to the urges experienced in some Impulse Control Disorders such as Trichotillomania (compulsive hair pulling) and Pathological Gambling. This would suggest the possibility that Binge-Eating Disorder could potentially be conceptualized as an Impulse-Control Disorder.” 
There was further debate that compulsive overeaters express their challenges with food similarly to those who struggle with Obsessive Compulsive Disorder (OCD), and although BED has compulsive and obsessive features to it, there are too many significant differences that would not warrant Binge-Eating Disorder as a type of OCD.
“Despite the above ambiguities, the APA’s current plan is for Binge Eating Disorder to be listed in the DSM-5 as an Eating Disorder, along with Anorexia and Bulimia. This seems intuitively appropriate, despite the fact that compulsive overeating has characteristics of Impulse Control Disorders, Addiction Disorders, and OCD.” 
Are They Really the Same?
The question of whether or not Compulsive Overeating and Binge-Eating Disorder are the same will probably remain debatable for some. However, as a clinician who works with those who are struggling, it is the severity of the symptoms that concern me the most and how I may help that someone gain more productive coping skills to avoid the urges to binge and compulsively eat.
Psychotherapy and Mindfulness-Based Cognitive Therapy have shown to be highly effective tools to helping someone with this behavior- no matter what we decide to name it.
-  The Emily Program. (2019, May 16). What is Compulsive Overeating? https://www.emilyprogram.com/blog/what-is-compulsive-overeating/
-  American Psychiatric Association. (2013). Feeding and eating disorders. In Diagnostic and Statistical Manual of Mental Disorders. (5th edition, pp. 329-354). American Psychiatric Publishing.
-  National Eating Disorders Association. (n.d). Statistics & Research on Eating Disorders. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders
-  National Eating Disorders Association. (n.d). Binge Eating Disorder. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
-  National Institute of Diabetes and Digestive and Kidney Diseases. (n.d). Definition & Facts for Binge Eating Disorder. https://www.niddk.nih.gov/health-information/weight-management/binge-eating-disorder/definition-facts#who
-  National Eating Disorders Association. (n.d). Risk Factors. https://www.nationaleatingdisorders.org/risk-factors
-  http://www.ocdla.com/blog/binge-eating-compulsive-overeating-treatment-1086
Author: Samantha Bothwell, RDN,LD/N
Article Contributed By: JoAnne Nuccio, LHMC, CAP