I'm often asked by patients how they can know whether or not they have Binge Eating Disorder, Food Addiction or Emotional Eating?  So the question is:  What's the difference?  Let me share some patient stories to help you understand the differences?

Melinda, a patient of mine, says: "I eat and eat and I know that I should stop, but I can’t. I eat so much that I want to throw up, my stomach hurts, and I have to lie down. Sometimes, I feel like if I don’t eat everything I can get my hands on, I’ll explode." Her words highlight the anguish that many people feel when food controls their lives. Melinda often felt powerless, hopeless that she could change her behavior.   Her struggle with food is an example of binge eating disorder.

Let’s start with some definitions and information about binge eating disorder (BED):

If you have periods in which you eat large quantities of food in one sitting (the definition of a binge) you may have binge eating disorder. Other symptoms of BED include difficulty in controlling how much you eat and feeling powerless to stop eating, even though you may no longer be hungry or may feel too full. After a binge, you may suffer from emotions of disgust, shame, or embarrassment about your behavior.  People with BED often eat in secret because of embarrassment about how much they are eating.  BED criteria include episodes of binge eating that are associated with 3 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

A hallmark of BED is a history of exposure to negative messages about shape, eating, and weight.

BED is three times more common than anorexia nervosa and bulimia nervosa combined and is the most common ED in the US.  It affects both men and women and is the most common eating disorder among adults in the United States.

Jenn was another patient and when we discussed her relationship with food, Jenn became very animated. She was a self-described food addict. She talked about how her heart rate would increase and her mouth would water when she was in the chip aisle of the grocery store. She talked about trying to avoid going shopping because she knew she wouldn’t be able to resist buying the large bag of chips that was her "downfall." But she also described her anticipation of getting the chips. She described the feeling as being like a drug addict going to score crack cocaine.

There are no criteria currently in medicine for FA but there is research using the Yale Food Addiction Scale (YFAS) which uses the same criteria for diagnosing substance use disorders.  The YFAS have found that 5 to 10 percent of the general population test positive on the YFAS, including 7 percent of children. The YFAS also shows that food addiction (FA) is 15 to 25 percent higher in those who are living in larger bodies. Even higher rates of FA are found in those who are seeking bariatric surgery or in individuals in larger bodies with binge eating disorder (BED) (30 to 50 percent).

One of the markers in research on FA is that 100% of those taking the test report "the desire to cut back or stop" their eating behavior.

If you have FA you likely have more intense and frequent food cravings than someone without FA. when people with food addiction see highly palatable foods or comfort foods, their brains light up in a way that is different from people without food addiction. This pattern is similar to how the brain responds to drugs of abuse or to hugging your child or doing any other pleasurable activity. If you have food addiction, you may be more likely to engage in emotional eating.

Emotional eating can be defined as eating in response to emotional cues or eating to make yourself feel better or change your mood, as opposed to eating in response to being physically hungry.

Here is a patient who represents Emotional Eating (EE):

Maryann just turned sixty years old.  When she feels happy, she overeats. When she’s sad or angry, she overeats. When her husband has to work late and she’s home alone, she overeats. She describes food as "my best friend." Even though she has read many diet books and has been on numerous fad diets, she can’t seem to stop herself from having a "few more cookies." A few more always leads to half a bag or a whole bag. Then the guilt comes, and she feels ashamed at having so little control. She really believes that if her life were just less stressful, she could stop overeating. Or if her husband were more affectionate, she wouldn’t turn to food for comfort.

Learning to identify your emotions, to put a name to what you are feeling, is the first step to being able to express emotions in a healthy and safe way. Emotional expression is important because it allows you to be the individual you are, with your own perceptions, emotions, and viewpoints. Emotional expression also is a necessary part of what it means to be human.

The bottom line is that if you’ve been struggling for a while with either BED, FA or EE, there is help and support available.

As you know, I’ve written a book on each of these topics and I also run the Anchor Program that offers you expert help to get to the root cause of your eating behaviors and learn new skills to deal with your emotions besides food.  

Don't forget, I'm also offering a free copy of my book, "The Food Addiction Recovery Workbook." I will pay for the book, you pay for postage.

All the best,

Dr. Carolyn

We have an Anchor Program beginning very soon so if you’re interested, please sign up for the free Consult to see if you’d be a food fit for the program.