Eating Disorders 101: Binge Eating and Orthorexia


This week Jacqueline, aka Fitarella, is sharing her experience and extensive knowledge of Eating Disorders with the Sisterhood. You can see Part 1 of her series here.

Yesterday we started off the series with an overview of factors that can contribute to the development of an Eating Disorder and a break down of Anorexia Nervosa and Bulimia Nervosa.  The third type of eating disorder is Binge Eating Disorder (BED). In the last five years, BED has been more recognized in the field as a real eating disorder. In the past, it was minimized by professionals and not seen as chronic or severe as AN and BN, but it can be just as debilitating and deadly as the other two disorders. Christopher Fairburn, MD, is one of the leading researchers on BED and he, along with others, are pushing for it to be included in the next DSM edition.  When someone has BED they will be diagnosed with Eating Disorders Not Otherwise Specified (EDNOS). Populations at risk for the development of BED may include people with high levels of anxiety & depression, people with families that focus/criticize weight & shape, and those that received inadequate parenting with minimum of affection in the household. In all these instances, a person may turn to food to comfort themselves or mask anger and hurt.

Binge Eating Disorder

Binge Eating Disorder is characterized by:

  • Frequent episodes of eating large quantities of food in short periods of time.
  • Feeling out of control over eating behavior.
  • Feeling ashamed or disgusted by the behavior.
  • There are also several behavioral indicators of BED including eating when not hungry and eating in secret.

Health Consequences of BED:

The health risks of BED are most commonly those associated with clinical obesity. Some of the potential health consequences of binge eating disorder include:

  • High blood pressure
  • High cholesterol levels
  • Heart disease
  • Diabetes mellitus
  • Gallbladder disease


Orthorexia is a term coined by Steven Bratman, MD, to describe his own experience with food and eating. It’s not an officially recognized disorder and there is no clinical guideline for it, however, it is similar to other EDs – those with AN or BN obsess about calories and weight while orthorexics obsess about healthy eating (not about being ‘thin’ and losing weight). It appears to be motivated by health, but there are underlying motivations, which can include safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.

Orthorexia may be characterized by:

  • A long-term behavior pattern of obsessive behaviors in pursuit of a healthy diet.
  • Obsessive concern over the relationship between food choices & health concerns such as asthma, digestive problems, low mood, anxiety or allergies
  • Increasing avoidance of foods because of food allergies, without medical advice
  • Noticeable increase in consumption of supplements, herbal remedies or probiotics / macrobiotics
  • Drastic reduction in options of “acceptable” food choices, such that the person may eventually consume fewer than 10 foods
  • Irrational concern over food prep techniques, especially food washing or sterilization of utensils

Health Consequences of Orthorexia are:

  • The diet of the orthorexic can actually be unhealthy, with the nutritional problems dependent on the specific diet the person has imposed upon him or herself.
  • Socially, an orthorexic may be isolated often because he/she plans their life around food. There seems to be little room in life for anything other than thinking about and planning food intake.
  • He/she may lose the ability to eat intuitively – to know when they are hungry, how much they need, and when they are full.
  • In the pursuit of such extreme perfect diet, he/she is destined to keep “falling off the wagon” and end up with feelings of shame and guilt.

Please know that this is a safe community for you to share or ask questions.  If you or someone you love needs help, you can find information on treatment providers here.  Feel free to email me anytime at [email protected].  I’ve been there and I want to help.

See Part 1 of this series, Eating Disorders 101: Types, Signs, and Consequences of EDs.

See Part 3 of this series, Diabulimia and Exercise Addiction.

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