Binge Eating Linked to Risk for Irritable Bowel Syndrome

Binge eating is defined as the recurrent rapid consumption of high calorie meals accompanied by a feeling that eating is out of control.

Bulimia nervosa is an eating disorder characterized by binge eating paired with a purging behavior such as self-induced vomiting.

Binge eating without purging is receiving increased clinical and research attention.

Binge eating is a relative common component in elevated body mass index and obesity. Successful behavior and drug treatment for obesity often includes a significant reduction in the frequency of binge eating.

Binge eating is frequently accompanied by symptoms of gastrointestinal disorders such as gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). However, these GI symptoms and disorders are also increased in obesity. 

These relationships have made it difficult to determine the specific effects of binge eating on GI symptoms as it is possible these effects may occur through an obesity mechanism.

Christine Peat along with colleagues from the University of North Carolina and Sweden recently published a study teasing out relationships between binge eating, BMI and GI symptoms.

This study used data from the Swedish Twin Study of Adults: Genes and Environment (STAGE). For the current study, over 23,000 twin pairs were interviewed for presence of lifetime history of binge eating, weight history and presence of gastrointestinal symptoms.

The key findings from this study included the following:

• Gastrointestinal reflux symptoms were present in 15.7% of men and 28.9% of women
• Irritable bowel syndrome (broad definition) was present in 3.7% of men and 8.1% of women
• Binge eating was linked to to higher rates of GERD and IBS
• However, when BMI was controlled binge eating was independently related to IBS but not related to GERD

The authors propose three potential mechanisms for this link between binge eating and IBS.

1. Stress may be a common factor as it is known that stress can precipitate bingeing episodes and increase IBS symptoms
2. IBS may cause dietary restriction including periods of fasting. Fasting is known to increase later risk for binge eating as the body attempts to compensate via a strong hunger mechanism
3. Binge eating of large quantities of high fat foods may directly produce IBS symptoms as the GI system responds to a feeding load

The take home message for clinicians treating IBS is that it is important to assess for the presence of binge eating. Successful reduction in the frequency of binge eating may contribute to a successful reduction in IBS symptoms. 

Readers with more interest in this study can access the free full-text manuscript by clicking on the PMID link in the citation below.

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Peat CM, Huang L, Thornton LM, Von Holle AF, Trace SE, Lichtenstein P, Pedersen NL, Overby DW, & Bulik CM (2013). Binge eating, body mass index, and gastrointestinal symptoms. Journal of psychosomatic research, 75 (5), 456-61 PMID: 24182635