Eating disorders combined with bipolar disorder are common. Up to 26% of people with eating disorders also have bipolar disorder. These eating disorders include anorexia nervosa, bulimia nervosa and binge eating disorder. Binge eating disorder is the most common eating disorder in people with bipolar disorder. The estimated that the amount of people with both bipolar disorder and binge eating disorder is 15%, with 17% of people with bipolar disorder also having repeated episodes of binge eating behavior. The frequency in the general population is 2-5%. With the frequency of binge eating disorder being so high, it’s important to understand what could be causing the behavior. A new study looked at binge eating disorder behaviors and their associations with illness characteristics of bipolar disorder.
Binge eating consists of eating abnormally large quantities of food in a short time. It can cause physical pain, psychological distress and resulting feelings of guilt. The Diagnostic and Statistical Manual of Mental Disorders describes symptoms of binge eating disorder this way:
-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 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A 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).
-The 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 feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
-Marked distress regarding binge eating is present.
-The binge eating occurs, on average, at least once a week for 3 months.
-The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
A new study, led by Hortense Boulanger of the Departement de Psychiatrie et de Médecine Addictologique in Paris,France and published in the Journal of Affective Disorders looked at interviews with 145 outpatients with bipolar I disorder. They were given questionnaires that surveyed their experiences with bipolar disorder including illness duration, history of substance use disorder, suicide attempts and previous eating disorders. They were also screened for depressive and manic symptoms.
To establish binge eating behavior, they were surveyed about behavioral symptoms like eating large amounts of food quickly and cognitive symptoms such as feelings of guilt or loss of control.
Out of the 145 patients, 18.6% showed symptoms of binge eating behavior. Seventy-four percent of those patients were women.
The main findings of the study were that people with both binge eating behaviors and bipolar disorder had a shorter duration of illness and high levels of anxiety and emotional reactivity.
The researchers hypothesized that the shorter duration of illness factor may be due to the fact that binge eating behaviors typically begin to occur in late adolescence and early adulthood. Those that were younger at the time of the interview may have influenced that factor.
High levels of anxiety are common in bipolar disorder. More than half of people with bipolar disorder have at least one accompanying anxiety disorder. It can also be related to high emotional reactivity. People with bipolar disorder tend to have a higher emotional response to stimuli and it can tend to be more negative as well. Negative emotions can be a trigger for binge eating behavior.
Other, less significant findings in the research included increased impulsivity in those with binge eating behaviors as well as twice the amount of emotional eating tendencies.
If you are experiencing increased amounts of emotional eating or any signs of an eating disorder, speak to your doctor or psychiatrist. Eating disorders are treatable and recovery is possible.
Image credit: Amy