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At this time of year, there is a big focus on food – including well-meaning advice for how to avoid overeating during the holidays. As people are paying more attention to what and how much they’re eating, some may wonder – is how I’m eating a problem?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard text used by mental health professionals for assessment, diagnosis and treatment. In some cases through managed care, people can only receive treatment if their illness is formally recognized in the DSM.
When the DSM-5 was released in May 2013, it was the first time that binge eating disorder (BED) was included as a specific diagnosis. Before that, it was in a catch-all category called ED-NOS (eating disorders not otherwise specified).
The Binge Eating Disorder Association was instrumental in advocating for the change in the DSM-5, and they provide a wealth of valuable information about binge eating disorder. You can find them online at http://bedaonline.com/.
The BED diagnosis was incredibly validating for the many people who suffer from this disorder. BED is actually the most common eating disorder in the U.S., affecting 3.5% of women, 2% of men, and up to 1.6% of adolescents (source: Archives of General Psychiatry via National Eating Disorders Association).
A diagnosis shows people with this disorder that they’re not alone, and that this is a valid medical and mental health condition. While there is a component of willingness versus willfulness, the DSM-5 gives credibility to the person who says they just cannot stop. This is not just “bad” behavior or habits. It’s a “can’t,” not a “won’t.”
This is important because people with binge eating disorder often have a history of dieting, may be very knowledgeable about food and nutrition, and may be highly intelligent and accomplished in other areas of their life. Yet they just can’t overcome this “eating thing.”
So how do you know if you have this disorder, or if you simply overeat from time to time? Here is a quote from the American Psychiatric Association, publishers of the DSM-5: “While overeating is a challenge for many Americans, recurrent binge eating is much less common, far more severe, and is associated with significant physical and psychological problems.”
Some people may overeat during the holidays, and even gain some weight, but then are able to immediately return to their regular eating habits. They enjoy their food, friends, and holiday fun. These people likely do not have an eating disorder.
The purpose of the BED diagnosis is not to invent problems, or turn something into a problem that isn’t one. It exists to help people who are suffering – repeatedly engaging in harmful behaviors that affect the body and the mind.
For someone who feels an incredible amount of shame about how they eat, and rarely enjoys their life, overeating has likely crossed over to binge eating and a potential diagnosis of this eating disorder.
You can review the DMS-5 criteria for binge eating disorder on the BEDA website.