Our Society Encourages Excess — Is That Why We Don’t Take Binge Eating Disorder Seriously?

Nichola is a 35-year-old learning designer who lives in Hertfordshire, England. She cannot remember a time in her life when she didn’t have an eating disorder. If she tries to trace the roots of it, she comes back to a few childhood memories.

"There was one incident I remember very vividly," Nichola tells Refinery29. "There was a family celebration and a male family member had hired a bouncy castle. He told me that I couldn't play on the bouncy castle because I would break it. I was seven." Later that evening, after they’d had a few, Nichola saw that family member and his friends on the same bouncy castle. "And I remember it so clearly, watching them on the bouncy castle and thinking, Oh, my goodness, if those grown-up men can be on the bouncy castle and not break it but I'm not allowed because I will break it…I must be a monster."

The shame Nichola felt about her body in that moment has been repeatedly enforced throughout her life. She sees it as one of the factors that led to her developing binge eating disorder. However, because of the nature of her disorder, it took years for her to be properly diagnosed.

Bingeing is a fundamentally misunderstood act. Culturally it is seen as evidence of a lack of willpower or self-control; it’s wrapped up in the idea of 'good' and 'bad' foods and is embedded in the structure of diet culture. And so despite knowing something was going on, medical professionals repeatedly turned Nichola away, and encouraged her to see bingeing as a sign of her failure. As time went on, her behaviors and self-loathing became increasingly deep-rooted.

Binge eating disorder (BED) is defined as someone having recurrent and persistent episodes of binge eating. Unlike overeating or emotional eating, binge eating is driven by emotional distress and a sense of a lack of control. It can take the form of eating much more rapidly, eating until uncomfortably full, eating large amounts of food when not physically hungry, eating alone due to embarrassment, and/or feeling disgusted with yourself afterwards. The disorder is marked by distress around the binge eating and by the absence of compensatory behaviors like purging.

It is important to note these distinctions, as BED is often confused with both emotional overeating and bulimia. Jess Griffiths, clinical training lead at the eating disorder charity Beat, tells Refinery29 that "having an eating disorder means there is a morbid preoccupation with food, weight, and shape. To have BED is different to bingeing due to dieting — it's driven by emotional distress and underlying mental health issues." Unlike bulimia, when bingeing episodes are countered with purging, the restrictive behaviors of people with BED tend to happen in cycles. There will be a bingeing cycle, which might last for weeks, followed by a restrictive cycle as an attempt to 'regain control'.

While the behaviors are distinct, Griffiths points out that the personality traits which underpin anorexia and bulimia also underpin binge eating disorder. "Traits like perfectionism, low self-esteem, and being what we would call 'super feelers' — people who are very intuitive, who have very extreme feelings that they feel they can't tolerate." In each disorder, food is used as a weapon — whether as something denied or something forced, it is a tool for punishment. BED is actually thought to be the most common of the three main eating disorders — a study in 2017 found that BED made up 22% of eating disorder cases, with anorexia accounting for 8% and bulimia 19% of all cases.

Despite how common it is — and the clear connections with other eating disorders like anorexia and bulimia — binge eating disorder is the least understood. It was only recognized as a mental health condition in 2013 so research into and awareness of the condition remains limited, meaning the number of cases could well be higher than reported. Many people with BED may not know they have it simply because they haven’t heard of it. On top of that, our superficial understanding of eating disorders means we associate them primarily with thinness and an obsession with self-control, whereas bingeing is seen as a lack of willpower.

This is not just an issue of public perception but a medical one, too. Over the course of about 20 years, Nichola repeatedly visited the GP but was unable to get someone to take her seriously, let alone treat her. "I was made to feel like I was lazy [by doctors], that I had no willpower, that I just needed to lose weight," she tells Refinery29. "I left doctors’ offices in tears, with discounted Weight Watchers memberships." She says that because she didn’t know there was such a thing as binge eating disorder, she was unable to articulate her symptoms. And the doctors never mentioned eating disorders of any kind, instead telling her to lose weight.

Thanks to Nichola’s extroverted personality, she had the courage to persist despite the repeated dismissals. When she moved to Hertfordshire (where she currently lives) she finally found a doctor who understood her and guided her towards an eating disorder specialist. After years of therapy and treatment she now feels that she is in control of her disorder instead of it controlling her.

Like any eating disorder, binge eating disorder is primarily a psychological issue but there are many factors which reinforce it and inhibit recovery. Getting the right support is a huge factor. Finding an understanding GP, as Nichola finally did, is rare but so is the courage to keep going back when medical bias against people with bigger bodies means you’re repeatedly dismissed. "So often when people try to talk to a health professional about binge eating disorder, they will be given the advice to lose weight," says Griffiths. "We hear from people that if they have a negative encounter with a health professional then it takes so much time, like years, to come back again and ask for help." 

The view that you need to lose weight at any cost pushes people with binge eating disorder to further extremes to absolve themselves of their 'failure' in their binge eating cycle. This extreme behavior is then validated by the people around you as well as the medical establishment. "When you're overweight, and you have an eating disorder, everyone congratulates you," says Nichola. "If you're on the restrictive side and you are using really harmful, unhealthy ways to lose weight, everyone says how inspirational you are, what fantastic progress you've made, how good you look." Consequently when you slip back into a bingeing cycle, the distress and shame around the behavior makes you feel worse, and you punish yourself further.

Our cultural perception of what bingeing is plays a major factor in how we understand people with binge eating disorder and how they understand themselves. We seem incapable of getting away from the idea that to be overweight is the result of an insatiable greed, an inability to resist food (especially if it is high in fat or sugar). This creates an understanding of bingeing as a weakness and your body, if you’re in any way overweight, becomes evidence of your 'failure'. It reinforces a fatphobic view of people’s bodies, while our understanding of fatness further blames and alienates people who reckon with binge eating disorder.

"There is this idea that we should all have self-control and so often people with binge eating disorders have just been labeled greedy," says Griffiths, "and that's not the case at all. People with binge eating disorder will binge on anything, it's not actually a process they necessarily enjoy. It's quite punishing."

This cycle of blame is made more insidious because diet culture doesn’t reject the concept of bingeing. In many ways, it actively reinforces it. With its 12-week plans, diet culture encourages restrictive behavior and cycles of denial; it centers fatness as the ultimate failure of willpower and endeavors to 'melt it away' or 'blast it' off your body. What's more, it does all this while selling us products which have overeating, indulgence or even bingeing built into the marketing. From cheat days to cereal bars encouragingly named Go Ahead and the branding of Halo Top as a 'healthy' ice cream which you can eat a tub of in one sitting, diet culture relies on the idea that you can indulge and restrict simultaneously. The language of eating as much as you want can easily shift into a behavior where you are eating far beyond what you want, further perpetuating the cycle of disordered eating.

It’s important to note that dieting doesn’t automatically lead to binge eating disorder. Dieting for a long time might lead to some bingeing behavior — especially if there has been nutritional deprivation — but that won’t necessarily trigger a binge eating disorder. "It's really important to remember that eating disorders are multifactorial," says Griffiths. "Personality, genetics, and external influences around food and weight and shape also play a major part." If someone who ticks all those boxes also began dieting, it could well trigger BED. 

Diet culture can also make recovery actively harder for people with BED, not only by furthering anti-fat bias and encouraging restriction but also by reinforcing a world view that divides food into 'good' and 'bad' groups without questioning each individual's behaviors with food. Despite what we’re brought up to believe, no food is inherently 'bad' or inherently 'good' — there may be a caloric or sugar disparity between a chocolate bar and its ‘healthier’ version, for example, but the consumption of one over the other isn’t better or worse for you in and of itself. It depends on what motivated that choice, how you've been eating and moving in the run-up to that choice, even the way in which you eat it. What does affect your health (both physical and mental) is your behavior around food. Are you eating a varied diet, choosing your meals intuitively based on your appetite and tastes? Or are you trying to stick to a set of rigid rules which might lead to you overeating something just because it’s on the 'good' list?

Nichola points to Slimming World as a perfect encapsulation of that thinking. "Slimming World, for example, will say that you could eat five whole chickens if you wanted. It puts all the emphasis on the food, not the behavior. But if you were to eat five whole chickens, that's clearly troubling behavior. Why would you choose to do that?"

It is precisely this behavior which is intrinsic to so much diet and even wellness messaging. If you’re eating a huge amount of anything — 'good for you' or otherwise — that might be an indication of disordered eating. If you restrict the ‘bad’ foods until you end up bingeing them, that too might be a troubling sign. But we are not encouraged to see it as such, which leaves many people suffering with binge eating disorders without the understanding or support they need to recover.

As Nichola’s experience shows, recovery from BED is possible. With the right support and messaging she has reached a place where she feels happy in herself and safe in trusting her body to make intuitive decisions. But far more needs to be done to support people with binge eating disorder and prevent people from falling into damaging behaviors. Binge eating needs to be recognized for what it is: a sign of emotional distress and a cry for help. Medical professionals need better understanding of eating disorders and better training to counter the anti-fat bias that actively damages their patients. On a wider scale, disordered behaviors around food need to be questioned too, with empathy and understanding instead of flagellation and shaming. And diet culture (even in its new wellness jacket) needs to be interrogated when it buys into the idea that food is inherently 'good' or 'bad'.

Perhaps most importantly, fatphobia needs to be challenged at all levels. Without shifting cultural attitudes around fatness, the fight to recover from any eating disorder, but particularly binge eating disorder, will be inconceivably harder.

"Now that I've recovered," says Nichola, "I talk a lot about body positivity. But the reality is you can be as positive as you like about your size but you can't stop that idiot shouting something humiliating at you or driving past and screaming abuse at you."

"Self-acceptance is a huge part of recovery," adds Griffiths, "but that's so hard when actually a lot of culture is telling you you're not acceptable the way you are."