Is Obesity an Eating Disorder?

There are people who think that if you’re obese, then by definition you must have a pathological relationship with food. Just as everyone who has a low body weight does not have anorexia, the notion that all individuals who have a higher body weight have an abnormal relationship with food is false. Weight doesn’t tell you anything about whether or not a person has an eating disorder. So if you’re overweight you may or may not have an eating disorder. One of things we do know is that 1/3 of people who show up to weight loss clinics meet the diagnostic criteria for Binge Eating Disorder. The probability, therefore, is that an overweight individual does not meet criteria for an eating disorder, and their weight may instead be a consequence of an interaction between environment and genetics, or that the individual is eating past the point where they are full.

When we define binge eating we’re talking about eating a large amount of food in a consolidated period of time. This isn’t to say that an individual with a healthy eating pattern doesn't eat past the point they are full once in a while. The differentiation is in the feeling that one has lost control over their eating. That is to say that the person who is binge eating couldn’t have stopped, even if they wanted to. Additionally, along with a loss of control, following a binge a person typically feels a high degree of guilt and shame. One indicator of a normalized eating pattern is eating when you're hungry and stopping when you're full. Its also normal to have variability in your hunger and fullness depending on things like activity, stress, and caloric intake.

Its important to note that while the majority of people who meet criteria for binge eating disorder are overweight, this is not true for all. For some people, their bodies are more efficient in metabolizing and storing caloric energy. If a person is binge eating then it requires different treatment than a person would receive if they were obese without the presence of binge eating. If you have binge eating disorder and you’re overweight, focusing just on the weight will probably not be adequate. There are many empirically founded treatments that are thought to be helpful for binge eating disorder. Cognitive behavioral therapy, Interpersonal Therapy, and Dialectical Behavioral Therapy have all shown to be helpful.

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