How Binge Eating Disorder Is Diagnosed

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Binge eating disorder—sometimes referred to as compulsive overeating—is an eating disorder that involves a person eating large amounts of food in a short period of time, and feeling out of control when it comes to food and eating.

Binge eating disorder is considered the most common eating and feeding disorder in the United States, affecting about 3% of Americans—three times more common than anorexia and bulimia combined.

Binge eating disorder is diagnosed primarily through a discussion and evaluation of symptoms, but can involve physical examinations and diagnostic testing.

This article covers how binge eating disorder is diagnosed.

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Professional Screenings

The process for determining if a person has binge eating disorder usually begins with a primary healthcare provider. The provider will use a number of tools to make a diagnosis and determine next steps.

DSM-5 Criteria

Binge eating disorder began to be recognized as a unique disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

To be diagnosed with binge eating disorder, a person must meet the following criteria:

1 . Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any two-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
  • The sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

2 . Binge-eating episodes are associated with three (or more) of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty after overeating

3 . Marked distress regarding binge eating is present.

4 . The binge eating occurs, on average, at least one day a week for three months.

5 . The binge eating is not associated with the regular use of inappropriate compensatory behavior (e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

How Is the Severity of Binge Eating Disorder Determined?

Severity is categorized as:

  • Mild: 1 to 3 episodes per week
  • Moderate: 4 to 7 episodes per week
  • Severe: 8 to 13 episodes per week
  • Extreme: 14 or more episodes per week

In plainer terms, this means a person with binge eating disorder:

  • Eats a large amount of food in a short amount of time, at least once a week for three months
  • Feels out of control of their eating during the episodes
  • Feels distressed about their binge-eating behavior
  • Experiences at least three of the following: Eating very quickly; eating to the point of being uncomfortable; eating a lot of food while not hungry; embarrassment about the amount they are eating; feeling guilty or negatively about themselves after overeating
  • Doesn’t do things to compensate for overeating such as purging or fasting, or only binge-eat as part of anorexia or bulimia

Physical Examination

While binge eating disorder is primarily diagnosed by a person’s descriptions of their symptoms, there are a number of reasons a healthcare provider may do a physical examination.

People with binge eating disorder are not necessarily obese, and people who are obese do not necessarily have binge eating disorder. About half of people with binge eating disorder are considered obese.

It is impossible to determine if someone has binge eating disorder simply from their body shape, and the health complications from binge eating are not always obvious at a glance.

Health complications caused by binge eating disorder a healthcare provider might look for include:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Heart disease and stroke
  • Certain cancers
  • Gallbladder disease
  • Depression, anxiety, and other mood disorders

A physical health exam may also involve:

  • Getting a medical history, including mental health
  • Discussing family medical history, including eating disorders, mental health disorders, or substance use disorders
  • Reviewing symptoms or concerns
  • Noting current medications being taken
  • Calculating height and weight
  • Checking vital signs (such as heart rate, blood pressure, and temperature)
  • Examining skin and nails
  • Listening to the heart and lungs
  • Feeling the abdomen
  • Asking about diet and eating habits, as well as compensatory behaviors such as self-induced vomiting, over-exercising, and fasting
  • Discussing substance use

If necessary, a primary healthcare provider may give a referral to a mental health professional for further screening and/or treatment.

What’s the Difference Between Overeating and Binge Eating?

While it is normal to occasionally eat more food than is considered typical, such as at a buffet dinner or a special occasion, people with binge eating disorder tend to have episodes of overeating more often than other people.

They also feel that they are not in control of their eating, versus someone who is overeating simply because they are enjoying their meal.

Labs and Tests

There are no tests used specifically for diagnosing binge eating disorder. If a healthcare provider orders lab work or testing, it is usually for the purpose of checking the person’s general health or for conditions that may have developed from or been made worse by binge eating disorder.

These tests might include:

Men and Binge Eating

While 40% of people with binge eating disorder are male, men and boys are often left out of the discussion when it comes to eating disorders.

A 2019 study highlighted the need for more research into how eating disorders present in men, and how they can be better diagnosed and treated by healthcare providers.

Self/At-Home Testing

While not a substitute for a professional assessment, there are at-home screening tools that can help determine if binge eating disorder is likely and if an appointment with a healthcare provider should be made to discuss further.

PsyCom has an online questionnaire that involves answering questions with a rating on a scale from “never” to “very often.” Once the test is completed, it is submitted with one click for an instant result calculation.

Mind Diagnostics offers a similar online test.

The National Eating Disorders Association has a more indepth online questionnaire used to determine if someone has or is at risk for an eating disorder.

If any of these tools indicate you may be experiencing binge eating disorder, book an appointment to discuss your symptoms with a healthcare provider.

Getting Help

If you or a loved one is coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237

For more mental health resources, see our National Helpline Database.

Summary

Binge eating disorder is diagnosed primarily through a discussion and evaluation of symptoms, but can involve physical examinations and diagnostic testing.

A Word From Verywell

While binge eating disorder is the most common eating and feeding disorder in the United States, it is still not well understood.

Criteria for diagnosing binge eating disorder may seem unclear to you. If your eating behavior and your feelings surrounding food and eating are negatively impacting you, see your healthcare provider, even if you don’t appear to meet the formal criteria for binge eating disorder.

Binge eating disorder can be managed, and getting a diagnosis is the first step.

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