Binge Eating Tops Anorexia

Study’s author blames nation's cultural environment for the disorder's prevalence

While some Americans might only stuff their faces at the Super Bowl, a small percentage struggle with the problem every day. Binge eating is the most common eating disorder in the nation, according researchers at the Harvard-affiliated McLean Hospital.

The results released last week are significant in light of current public policy debates about obesity, said the study’s lead author James I. Hudson, professor of psychiatry at Harvard Medical School and director of the Psychiatric Epidemiology Research Program at McLean Hospital.

“Of the many pathways to obesity, there seems to be a connection with binge eating,” he said.

And at Harvard, binge eating also seems to be more prevalent than other eating disorders, according to Harvard University Health Services (UHS) Chief Clinical Dietitian Barbara E. Boothby.

“It likely attracts less attention and may go unnoticed, at least in the early stages,” Boothby wrote in an e-mail, adding that the unique social and academic pressures of college may cause binge eating in certain individuals.

Binge eating is not yet included in the Diagnostic and Statistical Manual (DSM) of Mental Disorders, Boothby wrote, but UHS acknowledges the problem as a disorder.

The study, which surveyed 9,282 adults over two years, concluded that the lifetime prevalence of binge eating outweighs that of anorexia nervosa and bulimia nervosa combined. Binge eaters comprised 3.5 percent of the female sample and two percent of the male, while the incidence of anorexia nervosa and bulimia nervosa afflicted less than two percent of women and less than one percent of men.

Scientists began suspecting that binge eating was a mental health problem in the late 1980s, according to Hudson.

“I think [binge eating] has been strikingly under-appreciated,” Hudson said.

He added that unearthing the roots of binge eating is an arduous task because it is unclear how environment and genetics factor into the disorder.

“You don’t just want to be creating disorders out of nothing,” he said.

Hudson said that the nation’s cultural environment is “toxic,” referring to the prevalence of desk-job careers, Hollywood waifs, and fatty snacks. But it is unclear whether such an environment solely causes binge eating, which is habitual and associated with a “sense of loss of control,” Hudson said.

Binge eaters gorge on more than 1500 calories in a sitting twice a week amidst a sense of emotional despair, according to Hudson.

In fact, 36.6 percent of binge-eaters in the study had sought treatment for other emotional problems. Hudson said that binge eating has “a high association with other medical disorders and forms of social impairment,” adding that a binge eater’s behavior can be similar to that of an alcoholic who cannot stop after the first drink.

“When you are stressed, there are changes in your eating behavior. People who are born with a greater liability to eating disorders will...have more extremes during that time,” added Hudson.

—Staff writer Erin F. Riley can be reached at eriley@fas.harvard.edu.