Binge Eating Disorder and Bariatric Surgery
As a registered dietitian specializing in bariatrics, I want to take a moment to address a common concern for many of my clients—binge eating. This can be a significant obstacle to health and weight goals, both before and after weight loss surgery. But with the right strategies and support, it is possible to overcome/manage binge eating.
What is Binge Eating Disorder?
Binge eating disorder (BED) is the most common eating disorder in the United States, affecting About 1.25% of adult women and 0.42% of adult men. Binge eating is a pattern of behavior where a person consumes large quantities of food in a short period of time, often feeling out of control and unable to stop eating. It can be caused by various factors such as physical restriction (restrictive eating/dieting), mental restriction (telling yourself you can’t have certain foods), or emotions (stress, anxiety, depression, etc). However, it can be managed effectively with the right tools.
Binge Eating Disorder Diagnostic Criteria (DSM-5)
The Diagnostic and Statistical Manual of Mental Disorders, uses the following to diagnose binge eating disorder:
Marked distress over binging episodes
Loss of control over the amount of eating
Episodes that occur at least 1x per week for 3 months
In addition, binge eating episodes are associated with three (or more) of the following:
Eating until feeling uncomfortably full
Eating more rapidly than normal (i.e. two hour period)
Feeling depressed, guilty, or disgusted with oneself after overeating
Eating alone because of embarrassment associated with how much one is eating
Eating large amounts of food when not feeling physically hungry
What’s the Difference Between Overeating and Binge Eating?
When individuals with BED start eating, they often feel that they cannot stop eating until they’ve reached a point where they are uncomfortably full. There’s a loss of control, almost a feeling of blacking out or tunnel vision, and you continue to eat large amounts within a short period of time.
Binge eating is often secretive and met with extreme guilt or shame. While overeaters may experience some discomfort and regret after overeating, they are still in control of their behavior.
Overeating is simply when you eat past fullness and it is subjective from person to person. Everyone overeats at some point in their life, whether that be having an extra slice of pizza even if you’re already full, or piling more stuffing on your plate during Thanksgiving dinner because Grandma always makes it the best.
Before bariatric surgery, binge eating can be a common behavior for many individuals struggling with. It's important to address binge eating before surgery so that you can learn to manage this behavior and minimize the risk of it interfering with your weight loss goals.
Symptoms of Overeating after Gastric Bypass
After gastric bypass surgery, your stomach is significantly smaller, which means overeating may cause discomfort much more quickly than before. While occasional overeating happens to everyone, it’s important to recognize the signs after bariatric surgery so you can prevent complications and protect your long-term success.
Common symptoms of overeating after bariatric surgery may include:
Nausea or vomiting: because the stomach pouch is smaller, even a few extra bites can overwhelm the system.
Abdominal pain or pressure: discomfort in the chest or upper abdomen is a common signal you’ve eaten too much.
Dumping syndrome: symptoms like sweating, rapid heartbeat, diarrhea, or dizziness may occur if high-sugar or high-fat foods are eaten in large amounts.
Acid reflux or heartburn: overeating can increase pressure on the digestive tract, leading to reflux.
Fatigue or brain fog: after a large meal, the body works overtime to digest, leaving you feeling sluggish.
Emotional distress: guilt, shame, or frustration often follow overeating, which can reinforce unhealthy eating patterns.
Weight regain or plateau: consistent overeating, even in small amounts, can slow down or stall weight loss progress, and over time, may contribute to regaining weight.
Recognizing these symptoms early is key. If overeating becomes a frequent challenge after bariatric surgery, it may also point to underlying behaviors tied to binge eating disorder or unresolved eating disorders. Addressing these patterns with professional support is just as important as following your nutrition plan.
Tips to Help You Overcome Binge Eating:
Identify Triggers: What are the circumstances or emotions that typically lead to binge eating? Identifying these triggers can help you anticipate and manage them.
Practice Mindful Eating: Pay attention to your body and your feelings while you eat. Mindful eating can help you stay present in the moment and prevent binge eating.
Seek Support: Consider joining a support group, seeing a therapist, or working with a registered dietitian to develop strategies to manage binge eating.
After bariatric surgery, binge eating can also be a concern. While the surgery can help with weight loss, it's important to remember that it's not a magic cure for binge eating. In fact, some studies have shown that binge eating can actually increase after bariatric surgery.
Tips for Overeating after Gastric Sleeve Surgery
If you're struggling with binge eating after bariatric surgery, here are some additional tips:
Follow your post-surgery diet plan: Sticking to your recommended diet plan can help you manage hunger and prevent binge eating.
Slow Down: Take your time to eat slowly and mindfully, savoring each bite and paying attention to your body's hunger and fullness signals. Also, make sure that you’re not eating while distracted. Turning off your phone/TV/computer while you eat can be extremely helpful.
Avoid trigger foods: Identify the foods that trigger your binge eating and avoid keeping them in your house or at work. Instead, stock your kitchen with healthy options that you enjoy and that will help you maintain your weight loss.
Talk to Your Healthcare Team: Don't be afraid to ask for help or seek support from your healthcare team, including your registered dietitian and therapist.
Final Thoughts About Binge Eating and Bariatric Surgeries
As a dietitian specializing in bariatrics, I remind clients that surgery is one piece of the puzzle—it helps limit food intake, but it doesn’t address emotional eating or disordered eating behaviors that you may have had pre-surgery. That’s where professional guidance is essential. If you're struggling please don't hesitate to reach out for support! You can contact me if you’re interested in working together here!
Not sure whether you are displaying signs of Binge-Eating Disorder (BED) and want to reflect on your current eating behaviors? Take this quiz to find out.