Overcoming Shame: Understanding the Relationship Between Binge Eating and Anxiety Disorders

Binge eating is the most prevalent eating disorder in the United States, far surpassing more highly visible disorders like anorexia nervosa and bulimia. Currently, it is estimated that 2.8% of the adult population suffers from binge eating. For many, like Sarah, bingeing emerges in adolescence in response to developing anxiety disorders, which have one of the earliest ages of onset of all psychiatric illnesses. Research confirms this; multiple studies on adolescent girls and college-aged women have found that experiences of anxiety predicted binge eating behaviors. In part, this may be due to the fact that food is accessible at a time when young people have limited internal and external resources for coping with serious psychological pain. However, both binge eating and anxiety can begin at any point in life, either organically or in response to a specific trigger such as trauma. Binge eating also affects roughly equal proportions of men and women; approximately 40% of those who binge are men.

The relationship between anxiety and binge eating is, on its surface, one of the most understandable connections between a mental health disorder and a co-occurring eating disorder. Many people engage in emotional eating to some extent over the course of their lives; the phenomenon is so common that images of women eating ice cream following break-ups is a cultural punchline and everyone knows what “eating your feelings” means. However, binge eating exists on the extreme end of emotional eating, having crossed the line of benign self-soothing to physical, behavioral, and emotional dysfunction. What may begin as a way to control psychological pain quickly becomes defined by a lack of control more than any other factor. As Dr. Dori Winchell says, “It’s not so much the amount or what you eat, but what it feels like. Is the food in control? After the first bite, can you stop?”

In addition to the very real somatic risks of overeating, using binging as a way to suppress anxious experiences can keep you locked in a cycle of psychological suffering that can both aggravate your anxiety and keep you from seeking help. In a culture that places extreme value on thinness and controlled eating habits, people who engage in binge eating can experience profound shame and isolation, adding new sources of anxiety that coalesce with existing distress to push them further into psychiatric crisis. As one suffer says, “Binge eating is seen as such a shameful and gluttonous behavior that I fear talking to anyone about it and because I’ve begun to put on weight I’m just isolating myself more, which feeds my social anxiety.” Greater recognition of the relationships between anxiety and binge eating may serve to break down the internalized stigma experienced by many and ease the process of seeking help.

While the medical community has firmly established significant links between anxiety and binge eating behavior, what is less clear is the exact mechanism by which this link develops. However, some experts believe that eating disorders and anxiety may share a common biological basis, positing that if you suffer from one, you are inherently predisposed to the other. Anxiety may also induce increased stress hormones that encourage reward-seeking behavior. Binge eating itself can engage the brain’s reward circuitry by producing highly pleasurable neurochemical release in the form of dopamine, particularly when the foods consumed are high in fat and sugar. Nick English of Greatist explains how this can kick off a cycle of bingeing:

Once the brain secretes dopamine during binges, they can become like a physical addiction—we binge more and more because we crave the rush of chemicals. Similarly, low levels of dopamine and serotonin (another happy chemical) can lead to compulsive behavior (like bingeing) and depression.

The result is a kind of addictive drive in which you seek to re-experience the pleasure of bingeing again and again despite its emotionally and physically destructive effects.