When an individual is struggling with bulimia or binge eating disorder (BED), they see their metabolism affected in different ways than someone who is battling anorexia and restricting their calories. For today’s blog post, let’s consider how binge eating impacts the body. 

Before we dive in, it’s important to revisit the differences between a subjective binge and a true binge. A subjective binge is when someone feels like they binged because they ate more than their usual amount of food. A true binge, however, occurs when someone experiences a complete loss of control around food. They consume an exorbitant amount of calories in a discrete period of time.

In this case study, our patient is dealing with true binge eating five to seven days per week.

As dietitian Elaina Efird, RDN, CD, CEDRD, CSSD explains on our YouTube channel, this disordered eating behavior greatly influenced her metabolism and how her body was breaking down carbohydrates and fat. To start, this individual was a 23-year-old female. She was five feet, seven inches tall and weighed 250 pounds. 

She was in a cycle of binging and restricting — something that we often see our patients struggle with at The Kahm Clinic! She wouldn’t eat much for breakfast, grabbing a granola bar around 10 or 11 a.m. Then, she’d eat lunch around 1 p.m. When she got home in the late afternoon, she’d start snacking. She’d grab some chips or crackers from the pantry. From there, her eating progressed so much that she usually skipped dinner. 

As an example of what a true binge looks like, this individual would eat a full pint of ice cream, lasagna leftovers in the fridge, a cheese stick, some more crackers, some more leftovers, and so on. Ultimately, she would consume 5,000 to 7,000 calories in just an hour or two each evening. The next morning, she’d skip breakfast again and repeat the cycle, trapped in this habit of binging and restricting. 

Binge eating manifests differently for each individual.

In this patient’s metabolic test results at her first appointment with The Kahm Clinic, her metabolism was 2,305 calories per day — almost 400 calories higher than expected. Her protein metabolism — or the breakdown of the body’s lean muscle and mass — was normal. “This is happening because of the sheer volume of food that she’s eating each day,” Elaina shares. “She’s eating a lot of calories, which keeps her metabolism high.”

With individuals who battle binge eating, we often see the biggest impact on their body function when it comes to their fat metabolism and carbohydrate metabolism. For this patient, her body was breaking down 15 percent less fat than predicted and 15 percent more carbohydrates than predicted. Note that carbohydrate metabolism measures the breakdown of all food, not just carbohydrates. 

Before completing the metabolism test at The Kahm Clinic, a patient must fast for at least four hours (no food, caffeine, or exercise). This patient completed her test in the morning, so she had been fasting for 12 hours. “What these test results tell me is that her body is still breaking down 15 percent of what she ate the night before,” Elaina says. “That implies the body got way too many calories at night, and it’s taking a really long time to process them.” 

Because her body’s carbohydrate metabolism is so much higher than it should be, her body is not effectively burning fat as a source of fuel. For healthy individuals who haven’t eaten in a few hours, their body relies on fat as their primary source of fuel. Then, they eat, supplying their body with carbohydrates, or glucose. Their body then alternates between carbohydrates and fat for fuel throughout the day.

Because this patient binges almost every night per week, her test results reflect how her metabolism will look most days. 

What we worked on, then, was breaking this binge-restrict cycle. We encouraged her to wake up each morning and eat a high-calorie, high-protein breakfast – around 500 calories with 30 grams of protein. By taking in more calories earlier in the day, she was able to slowly reduce her binges from a hunger standpoint. She also worked on some of the emotional triggers of her binges in therapy. 

Subscribe to our YouTube channel for more video content. To talk to a professional about eating disorder treatment, please reach out to our staff or schedule an appointment at The Kahm Clinic today.