Eating Disorders and Depression go Hand in Hand

Binge eating and depression a reflexive relationship for teen girls

/ Author:  / Reviewed by: Joseph V. Madia, MD

Teenage girls who feel depressed are twice as likely to exhibit binge eating disorder than other girls. Conversely, girls who regularly binge eat have double the risk of depression.

Researchers say that girls who exhibit signs of either should be screened for both depressive and eating disorders, as the teen years are when most eating disorders surface.

“Binge Eating Disorder (BED) is the most common eating disorder," says Shannon Kolakowski, Psy.D. "It’s defined by frequent episodes of eating large amounts of food in a short period of time. BED and depression regularly occur together, and the relationship is complex.

The act of binge eating often leads to feeling ashamed, depressed and self-critical. Adolescent girls are in a crucial and vulnerable period of identity development, and so much societal focus is placed on body size and appearance."

Alison Field, Sc.D., with Harvard Medical School and the Harvard School of Public Health, led the largest study to look at the relationship between depression and binge eating in adolescent girls, who are much more likely to have the disorders than males.

Field and her team analyzed data from 4,798 females aged 12 to 18 between 1999 and 2003. Questioning eating habits, researchers classified the girls into normal eaters, overeaters (those who ate large amounts of food but did not experience a loss of control), and binge eaters (those who ate large amounts in a short time and felt a loss of control over it).

Kolakowski says that this loss of control is an important factor in determining binge eating. "The person feels out of control in their eating behavior, so this is not a matter of willpower, and the feeling of being out of control is disturbing.

They feel ashamed or disgusted by the behavior, and will eat when not hungry and often in secret."

The team also assessed depressive symptoms using the McKnight Risk Factor Survey; analyses were adjusted for current age, age at menarche, body mass index and follow up time. Participants who reported in the first survey that they always or usually felt depressed were twice as likely as others to start overeating or binge eating within the next two years.

Field said the study could provide important opportunities to address the obesity epidemic in the U.S., adding that binge and over eaters can be very secretive. The published study recommends the medical community screen for eating disorders when an adolescent female reports depression, and vice versa. Kolakowski says that doctors should also ask about any family history of eating disorders, and that family members can help by encouraging realistic expectations in young girls about appearance. "De-emphasizing appearance as the sole factor of self-esteem is really important,” she adds.

"Research is suggesting that the link between binge-eating and depression in women may be related to both hormonal and neurotransmitter systems that regulate mood," says Barbara Long, M.D., Ph.D. "Exercise and diet, especially limiting consumption of complex carbohydrates in favor of protein, can help stabilize the hunger and mood cycles that lead to bingeing."

Long, a psychiatrist in Atlanta and author of Keep Your Eye on the Prize—a Young Person’s Guidebook to Adulthood, offers the following tools to help young girls control their eating and build body image and confidence.

Get Comfortable with your Body

Accept that a big component of your basic physical constitution is genetically ordained. The only part you can really impact is environmental; that means calorie intake and physical activity. If you are prone to overweight due to genes and want to maintain a weight below what your genes dictate, you may always struggle with this issue.

Set a Baseline Weight

Figure out your “set point,” a reasonable baseline weight that permits you to function with adequate energy but avoids the health risks associated with being significantly overweight (like elevated blood pressure, cholesterol, heart disease, overweight-related diabetes) or underweight (loss of menstrual periods, endocrine abnormalities, osteoporosis). Note that research has suggested that for some people, 10 pounds over what has been called ideal in the past is associated with good health. Whatever weight you decide, try to maintain it plus or minus a few pounds. When over or under this weight, adjust your intake or exercise to return to baseline.

Find ways to Relieve Stress without Overeating

Get out with people. Exercise, look into a hobby, community or religious involvement, consider volunteer work to help others in need. All are great ways to get the focus off weight and onto something useful. Avoid destructive ways of escaping, such as with drugs or alcohol.

Learn to Enjoy Eating

Learn to enjoy the total experience of eating, especially the companionship of others. Focus on conversation, rather than food. If at a party or buffet, station yourself on the other side of the room away from the food and limit calorie-laden drinks, especially alcohol.

Watch out for Complex Carbohydrates

Limit starches like bread, pasta, rice, potatoes, and chips. In some people, such foods can produce blood sugar cycles in which they feel full then voraciously hungry. Go easy at parties. Snacks, in conjunction with alcohol, can really pack on the pounds.

Seek Moderation in all Things

If anxious about your eating, remember there will always be another meal, so slow down and relax. Aim for portion control and balance and try not to obsess about food and your weight. Remember that the physical dimension is just one of four compass points of life along with the mental, spiritual, and emotional, so re-balance your focus to include the other three.

Take Advantage of Free Resources

There are many resources for help with eating disorders. Try the National Eating Disorders website (, Take Off Pounds Sensibly ( and Keep Off Pounds Sensibly (

Take Trouble Signs Seriously

If you find yourself stuck in an unhealthy cycle of bingeing, purging, and/or starving, don’t fool yourself into thinking that all is okay. You are subjecting your body to unhealthy stress that can have long-term serious health consequences. Now is the time to understand what weight means to you emotionally and get a healthier approach to this life-long challenge. Are you a perfectionist? If so, how did you get to be that way and why? Is it tied to fear of rejection or abandonment by others? Here’s a thought: Dare to be normal, not perfect! No one is perfect anyway, so chasing it is an illusion. If we get ill or are under duress, maybe we will gain or lose a large amount of weight, but inside we are still the same person. Those who truly care for us accept us, weight and all. Give yourself the same love.

Get Help when Things spin out of Control

If you cannot seem to get a handle on it, see this as a symptom of a deeper issue, like depression, that needs to be addressed and soon. Get help from the counseling center, family doctor, or mental health professional to address the symptoms as well as underlying emotional issues. If out of control, don’t delay. The problem may become chronic. And its ravages on the body can be fatal.

Photo credit: Some rights reserved by Corie Howell

Review Date: 
December 21, 2011