I was recently at a conference presenting research on binge eating disorder (BED). A handful of people stopped by to discuss my findings, but very few had an actual interest in BED. This lack of interest in, and understanding of, BED is evidenced not only within the research community but also within society at large. BED is the most frequent eating disorder, 2-3 times more common than anorexia and bulimia (Hudson et al., 2007). Yet I have never met someone outside of the eating disorder field who actually knew that BED is a formal eating disorder. So I have been asking myself lately, why the stigma around binge eating disorder?
I think that understanding the shame around BED starts by understanding its key diagnostic feature: binge eating. Binge eating is defined as objective overeating, accompanied by a sense of loss of control (APA, 2013). This is not overeating at Thanksgiving where it is socially accepted, and indeed expected, to do so. For these individuals, overeating happens at times where it seems (and feels) inappropriate or unnecessary. Individuals with BED often say that they cannot control the amount or type of food that they are eating despite not feeling hungry or feeling uncomfortably full.
The stigma around BED is rooted in our fear of challenging long-held beliefs regarding overeating. As a society, we have developed the idea that worth is defined by self-control, and even self-deprivation. Weight loss is seen as some great accomplishment, while weight gain is considered to be a failure. When someone has a “smaller” or “healthier” lunch, we praise their control. When someone brings fast food, a little part of us judges the composition of that meal. To continue this narrative, and preserve our own sense of control, we adopt the position that overeating indicates a lack of willpower. Doing so, allows us to refrain from challenging our own belief that we are worthy because of our ability to “control” our food intake and/or weight.
The reality, however, is that individuals with BED are not lacking in willpower. Binge eating often serves a multitude of purposes including emotion regulation and coping. For some, binge eating provides an escape from unbearably intense emotions. For others, there are biological reasons why they are more sensitive to the taste and smell of food. These individuals have developed skills to manage intense sensations in the face of extreme adversity, emotions, and compulsions. When we think of it this way, binge eating actually makes sense. It is a way to survive. So just like with other eating disorders, treatment for BED requires unlearning of these old behaviours, and the development of new coping skills. And since individuals with BED often seek treatment at an older age than those with anorexia and bulimia, there are many more years of unlearning to do.
In order to overcome the stigma and shame associated with BED, we need to challenge our own beliefs about weight and eating. Overcoming stigma involves all of us, to some degree, embracing that worth cannot be determined by the number on a scale or what we put in our body. Only once we have started to challenge predominant societal messages around weight and worth, can we start to undo the shame and stigma around BED.
For more information about binge eating disorder you can visit https://bedaonline.com/.
By: Therese Kenny, MSc, MA Candidate Clinical Psychology: Applied Developmental Emphasis