Binge Eating Disorder (Part 2)

What causes binge eating disorder?

Researchers are not sure exactly what causes binge eating disorder and other eating disorders. They think that eating disorders might happen because of a combination of a person's biology and life events. This combination includes having specific genes, a person's biology, body image and self-esteem, social experiences, family health history, and sometimes other mental health illnesses. Studies suggest that people with binge eating disorder may use overeating as a way to deal with anger, sadness, boredom, anxiety, or stress.^1,2

Researchers are studying how changing levels of brain chemicals may affect eating habits. Neuroimaging, or pictures of the brain, may lead to a better understanding of binge eating disorder.³

How does binge eating disorder affect a woman's health?

Many, but not all, women people with binge eating disorder are overweight or obese. Obesity raises your risk for many serious health problems:⁴

• Type 2 diabetes
• Heart disease
• High blood pressure
• High cholesterol
• Gallbladder disease
• Certain types of cancer, including breast, endometrial (a type of uterine cancer), colorectal, kidney, esophageal, pancreatic, thyroid, and gallbladder cancer⁵
• Problems with your menstrual cycle, including preventing ovulation, which can make it harder to get pregnant

People with binge eating disorder often have other serious mental health illnesses such as depression, anxiety, or substance abuse. These problems can seriously affect a woman's everyday life and can be treated.

How is binge eating disorder diagnosed?

Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. However, doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.

Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder.

How is binge eating disorder treated?

Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better. Treatment plans may include one or more of the following:

• Psychotherapy—Sometimes called "talk therapy," psychotherapy is counseling to help you change any harmful thoughts or behaviors. This therapy may focus on the importance of talking about your feelings and how they affect what you do. For example, you might talk about how stress triggers a binge. You may work one-on-one with a therapist or in a group with others who have binge eating disorder.
• Nutritional counseling—A registered dietitian can help you eat in a healthier way.
• Medicine, such as appetite suppressants or antidepressants prescribed by a doctor—Antidepressants may help some people with binge eating disorder who also have anxiety or depression.

Most people do get better with treatment and are able to eat in healthy ways again.⁶ Some may get better after the first treatment. Others get well but may relapse and need treatment again.

How does binge eating disorder affect pregnancy?

Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder.

Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control.

Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for the following:

• Gestational hypertension (high blood pressure during pregnancy) and preeclampsia (high blood pressure and kidney problems during pregnancy)—If not controlled, both problems can threaten the life of the mother and the baby.
• Gestational diabetes (diabetes that starts during pregnancy)—If not controlled, gestational diabetes can cause you to have a large baby. This raises your risk for a C-section.⁷

Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by⁸

• Worry over pregnancy weight gain (Women may binge because they feel a loss of control over their bodies because of the pregnancy weight.)
• Greater stress during pregnancy
• Depression
• History of smoking and alcohol abuse
• Lack of social support

After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.⁹

If I had an eating disorder in the past, can I still get pregnant?

Yes. Women who have recovered from binge eating disorder, are at a healthy weight, and have normal menstrual cycles have a better chance of getting pregnant and having a safe and healthy pregnancy. Tell your doctor if you had an eating disorder in the past and are trying to become pregnant.

If I take medicine to treat binge eating disorder, can I breastfeed my baby?

Maybe. Some medicines used to treat binge eating disorder can pass through breastmilk. Certain antidepressants can be used safely during breastfeeding.

Talk to your doctor to find out which medicine works best for you. You can enter a medicine into the LactMed® database (Link opens in a new windowhttps://www.ncbi.nlm.nih.gov/books/NBK501922) to find out if the medicine passes through breastmilk and about any possible side effects for your nursing baby.

References

1. Joke, V., Vansteenkiste, M., Soenens, B., Boone, L., & Mouratidis, A. (2013). Daily ups and downs in women's binge eating symptoms: The role of basic psychological needs, general self-control, and emotional eating. Journal of Social and Clinical Psychology, 32(3), 335–361.
2. Kelly, N.R., Lydecker, J.A., & Mazzeo, S.E. (2012). Positive cognitive coping strategies and binge eating in college women. Eating Behaviors, 13(3), 289–292.
3. Rikani, A.A., Choudhry, Z., Choudhry, A.M., Ikram, H., Asghar, M.W., Kajal, D., et al. (2013). A critique of the literature on etiology of eating disorders. Annals of Neurosciences, 20(4), 157–161.
4. National Heart, Lung, and Blood Institute (NHLBI). (n.d.). Overweight and obesity: Risk factors. Retrieved November 19, 2021, from https://www.nhlbi.nih.gov
5. National Cancer Institute (NCI). (2017, January). Obesity and cancer. Retrieved November 19, 2021, from https://www.cancer.gov
6. Fairburn, C.G., Cooper, Z., Doll, H.A., Norman, P., & O'Connor, M. (2000). The natural course of bulimia nervosa and binge eating disorder in young women. Archives Of General Psychiatry, 57(7), 659–665.
7. U.S. National Institutes of Health (NIH), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHHD). (2012). NIH obesity research featured in HBO's The Weight of the Nation. Retrieved November 19, 2021, from https://www.nichd.nih.gov
8. Berg, C.K., Torgersen, L., Von Holle, A., Hamer, A., Bulik, C.M., & Reichborn-Kjennerud, T. (2011). Factors associated with binge eating disorder in pregnancy. International Journal of Eating Disorders, 44(2), 124–133.
9. Knoph, C., Von Holle, A., Zerwas, S., Torgersen, L., Tambs, K., Stoltenberg, C., et al. (2013). Course and predictors of maternal eating disorders in the postpartum period. International Journal of Eating Disorders, 46(4), 355–368.