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Binge Eating Disorder
Binge Eating Disorder

Bipolar and Binge Eating: Are They Connected?

Christine Russell, MS, RD, LD, CDCES
Medical Reviewer: 
Christine Russell, MS, RD, LD, CDCES
|
Author: 
Caitlin Beale, MS, RDN
Published:
April 26, 2023
5
min read

Table of Contents

Are Bipolar Disease and Binge Eating Connected?
What Causes Bipolar and Binge Eating?
Treatment for Bipolar and Binge Eating
Getting Help
Binge Eating Disorder

Key Takeaways

  • People with bipolar disorder may be at higher risk for binge eating behaviors and binge eating disorders.
  • Impulsivity associated with bipolar disorder can influence binge eating.
  • Treatment for bipolar and binge eating may include medication, psychotherapy, and nutritional counseling.

Bipolar disorder (BD) is a mental health condition that causes extreme shifts in mood, energy, and behavior. It affects around 4.4% of U.S. adults and nearly 3% of adolescents. People living with bipolar disorder often experience comorbidities (having two or more medical conditions at the same time)—including binge eating behaviors and binge eating disorder (BED). 

Someone with binge eating behaviors may have a pattern of eating large amounts of food in short periods and feeling out of control during the behavior. Those with a BED diagnosis engage in these behaviors at least once a week for over three months and experience severe distress or shame after binges.

Bipolar disorder and binge eating have more in common than you think, as they share some of the same potential root causes. This article will explore the link between bipolar disorder and binge eating disorder and provide advice on how to find support for both.

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Are Bipolar Disease and Binge Eating Connected?

Studies suggest that people with bipolar disorder are more likely to experience binge eating behaviors, or BED, than those without the condition. 

Research on mood disorders suggests that up to 25% of those living with bipolar have a BED diagnosis, and nearly 30% of people with BD experience binge eating behaviors (with or without the BED diagnosis). A systematic review found that almost 10% of people diagnosed with BED also had bipolar. 

Impulsivity May Help Explain the Connection Between Bipolar and Binge Eating

While the reason for the relationship between bipolar disorder and binge eating is not yet well understood, it is believed to be related to changes in impulse control. Food becomes a way to manage emotions, impulsivity, and anxiety in both conditions. 

The two common types of bipolar are:

  • Bipolar I: Bipolar I is characterized by cycles of depression, hypomania, and manic episodes. Manic episodes are periods of high-energy behavior severe enough to significantly impair day-to-day life, lasting a week or more and often requiring hospitalization. Hypomania is a milder version of a manic episode that’s still characterized by a period of high energy and impulsivity, but it doesn’t last as long.
  • Bipolar II: Like bipolar I, bipolar II is characterized by depression and hypomania but without severe manic episodes. 

Impulse control is a significant challenge for those struggling with binge eating behaviors and BED, where mania causes impulsive actions. Additionally, when someone is in a depressive episode, they may turn to food to cope with or soothe their distress. People with BED are often triggered by emotions, and these feelings can be intensified in those with bipolar disorder.

"Understanding the link between bipolar disorder and binge eating hinges on the role of impulsivity. In both conditions, food becomes a coping mechanism for managing emotions and anxiety. This interplay underscores the importance of addressing impulse control in treatment strategies," explains Dr. Caroline Fenkel, Chief Clinical Officer and Co-Founder at Charlie Health.

Impulsivity and BED are also linked, as someone with BED is often disconnected from hunger or satiety cues and feels out of control while eating.

What Causes Bipolar and Binge Eating?

Bipolar and BED are mental health conditions with complex causes that are not fully understood. 

There’s no single cause for either disorder, and many factors may contribute, including:

  • Emotional regulation: Emotions and food are often closely intertwined for many people. It’s common for anyone—not just those with BED or BD—to eat as a way to self-soothe when feeling overwhelmed or distressed. At a minimum, food represents comfort and distraction from difficult emotions or depression. It also may provide temporary relief by producing brain chemicals that promote feelings of calm or even pleasure. For people with BED, food can become a primary coping mechanism, especially if they don’t have access to appropriate support. But food is also a cause of deep anguish after binging episodes, so the cycle can be particularly destructive. 
  • Genetics: BED and BD are significantly associated with hereditary factors, so individuals may be predisposed to developing either disorder. Research suggests that heritability for BD is estimated at 60–85% and 46–74% for BE. This means someone with a close relative diagnosed with either disorder is more likely to develop it themselves. 

Interestingly, research has found that both conditions may share a specific gene variation. Variations in the PRR5-ARHGA gene have been associated with both BD and BED. At the same time, another study looked at a possible connection between bipolar, binge eating behaviors, and the apoprotein B gene. 

More research is needed to confirm the findings, but they suggest the intriguing possibility of a common genetic link between the two conditions. 

  • Medications: Side effects from some types of medicine used to treat BD can cause weight gain and increase episodes of compulsive eating. In this case, the eating behavior has less to do with impulsivity and more with a disconnect of actual hunger or satiety signals from the brain. It’s important to note that medications can be lifesaving for people with BD, so it’s essential to have a conversation with your doctor if you’re experiencing side effects to explore all your options.
  • Environmental Factors: Trauma and adverse childhood experiences (ACEs) may increase the risk of BD, and some studies suggest these factors also may play a role in the development of BED. Other environmental factors, like parental or peer relationships, hyperfocus on body size and image, or growing up in a home where guardians modeled dieting behavior may influence BED, especially in combination with genetics.

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Treatment for Bipolar and Binge Eating

Treatment for both bipolar and BED differ, but there can be some overlap in treatment approaches. In order to determine the best approach, it is essential to seek professional advice from a medical doctor, therapist, and dietitian who can help diagnose and manage both conditions. 

Bipolar Treatment

Medication, psychotherapy, and lifestyle changes are all cornerstones of treatment for bipolar disorder. Depending on the severity of symptoms, medication may include mood stabilizers, antidepressant medications, antipsychotics, and other medications. 

Psychotherapy for BD can include cognitive behavior therapy, group therapy, and family-based therapy. Each depends on the individual’s needs and preferences. Additionally, lifestyle habits focusing on sleep, diet, exercise, and overall well-being can help manage symptoms of BD, but this requires a close, individualized approach between you and your care team. 

Binge Eating Treatment

BED treatment may include medication, psychotherapy, dietary changes, and lifestyle modifications. 

Psychotherapy, such as cognitive behavior therapy (CBT), can help individuals gain insight into their eating habits and develop new strategies for dealing with difficult emotions. Additionally, addressing underlying issues such as trauma or body image can help individuals manage the symptoms of BED.

Finally, working with a registered dietitian or nutritionist can help create a balanced eating plan and regain insight into hunger, fullness, and healthy eating patterns.

Book an appointment with a binge eating disorder dietitian

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Book an appointment with a binge eating disorder dietitian

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Getting Help

Bipolar and binge eating disorders are closely linked, and the underlying causes are complex and often intertwined. Treatment should take a holistic approach focusing on nutrition, mental health, and lifestyle habits to manage symptoms.

Consider booking an appointment with a nutritionist for binge eating disorder. Visits are covered by most popular insurance providers, and the virtual option makes getting the help you need from anywhere easy.

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References

View all references
  1. Bipolar Disorder. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/bipolar-disorder 
  2. Boulanger, H., Tebeka, S., Girod, C., Lloret-Linares, C., Meheust, J., Scott, J., Guillaume, S., Courtet, P., Bellivier, F., & Delavest, M. (2018). Binge eating behaviours in bipolar disorders. Journal of affective disorders, 225, 482–488.
  3. Berkman, N. D. (n.d.). Table 1, DSM-IV and DSM-5 diagnostic criteria for binge-eating disorder - Management and Outcomes of Binge-Eating Disorder - NCBI Bookshelf. 
  4. Woldeyohannes, H. O., Soczynska, J. K., Maruschak, N. A., Syeda, K., Wium-Andersen, I. K., Lee, Y., Cha, D. S., Xiao, H. X., Gallaugher, L. A., Dale, R. M., Alsuwaidan, M. T., Mansur, R. B., Muzina, D. J., Carvalho, A. F., Jerrell, J., Kennedy, S., & McIntyre, R. S. (2016). Binge eating in adults with mood disorders: Results from the International Mood Disorders Collaborative Project. Obesity research & clinical practice, 10(5), 531–543. 
  5. McElroy, S. L., Crow, S., Blom, T. J., Cuellar-Barboza, A. B., Prieto, M. L., Veldic, M., Winham, S. J., Bobo, W. V., Geske, J., Seymour, L. R., Mori, N., Bond, D. J., Biernacka, J. M., & Frye, M. A. (2016). Clinical features of bipolar spectrum with binge eating behaviour. Journal of affective disorders, 201, 95–98.
  6. Fornaro, M., Daray, F. M., Hunter, F., Anastasia, A., Stubbs, B., De Berardis, D., Shin, J. I., Husain, M. I., Dragioti, E., Fusar-Poli, P., Solmi, M., Berk, M., Vieta, E., & Carvalho, A. F. (2021). The prevalence, odds and predictors of lifespan comorbid eating disorder among people with a primary diagnosis of bipolar disorders, and vice-versa: Systematic review and meta-analysis. Journal of affective disorders, 280(Pt A), 409–431.
  7. Tondo, L., Miola, A., Pinna, M., Contu, M., & Baldessarini, R. J. (2022). Differences between bipolar disorder types 1 and 2 support the DSM two-syndrome concept. International journal of bipolar disorders, 10(1), 21. 
  8. Dingemans, A., Danner, U., & Parks, M. (2017). Emotion Regulation in Binge Eating Disorder: A Review. Nutrients, 9(11), 1274. 
  9. Moore, C. F., Sabino, V., Koob, G. F., & Cottone, P. (2017). Pathological Overeating: Emerging Evidence for a Compulsivity Construct. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 42(7), 1375–1389.
  10. Burton, A. L., & Abbott, M. J. (2019). Processes and pathways to binge eating: development of an integrated cognitive and behavioural model of binge eating. Journal of eating disorders, 7, 18
  11. McElroy, S. L., Winham, S. J., Cuellar-Barboza, A. B., Colby, C. L., Ho, A. M., Sicotte, H., Larrabee, B. R., Crow, S., Frye, M. A., & Biernacka, J. M. (2018). Bipolar disorder with binge eating behavior: a genome-wide association study implicates PRR5-ARHGAP8. Translational psychiatry, 8(1), 40.
  12. Yaramala, S. R., McElroy, S. L., Geske, J., Winham, S., Gao, K., Reilly-Harrington, N. A., Ketter, T. A., Deckersbach, T., Kinrys, G., Kamali, M., Sylvia, L. G., McInnis, M. G., Friedman, E. S., Thase, M. E., Kocsis, J. H., Tohen, M., Calabrese, J. R., Bowden, C. L., Shelton, R. C., Nierenberg, A. A., … Bobo, W. V. (2020). The impact of binge eating behavior on lithium- and quetiapine-associated changes in body weight, body mass index, and waist circumference during 6 months of treatment: Findings from the bipolar CHOICE study. Journal of affective disorders, 266, 772–781. 
  13. Mukherjee, S., Skrede, S., Milbank, E., Andriantsitohaina, R., López, M., & Fernø, J. (2022). Understanding the Effects of Antipsychotics on Appetite Control. Frontiers in nutrition, 8, 815456.
  14. Park, Y. M., Shekhtman, T., & Kelsoe, J. R. (2020). Effect of the Type and Number of Adverse Childhood Experiences and the Timing of Adverse Experiences on Clinical Outcomes in Individuals with Bipolar Disorder. Brain sciences, 10(5), 254. 
  15. Chu, J., Raney, J. H., Ganson, K. T., Wu, K., Rupanagunta, A., Testa, A., Jackson, D. B., Murray, S. B., & Nagata, J. M. (2022). Adverse childhood experiences and binge-eating disorder in early adolescents. Journal of eating disorders, 10(1), 168.
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  19. Bauer, I. E., Gálvez, J. F., Hamilton, J. E., Balanzá-Martínez, V., Zunta-Soares, G. B., Soares, J. C., & Meyer, T. D. (2016). Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review. Journal of psychiatric research, 74, 1–7. 
  20. Brownley, K. A., Berkman, N. D., Peat, C. M., Lohr, K. N., Cullen, K. E., Bann, C. M., & Bulik, C. M. (2016). Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis. Annals of internal medicine, 165(6), 409–420. 
  21. Burton, A. L., & Abbott, M. J. (2019). Processes and pathways to binge eating: development of an integrated cognitive and behavioural model of binge eating. Journal of eating disorders, 7, 18. 

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, 
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Kansas
39.112701, -94.626801
Reno
, 
NV
Nevada
39.529633, -119.813805
Tacoma
, 
WA
Washington
47.258728, -122.465973
Aurora
, 
CO
Colorado
39.7405111, -104.830994
Oxnard
, 
CA
California
34.197659, -119.175949
Amarillo
, 
TX
Texas
35.221996, -101.831299
Henderson
, 
NV
Nevada
36.039524, -114.981720
Vancouver
, 
WA
Washington
45.633331, -122.599998
Gilbert
, 
AZ
Arizona
33.352825, -111.789024
San Bernardino
, 
CA
California
34.115784, -117.302399
Columbus
, 
GA
Georgia
27.800583, -97.396378
Hayward
, 
CA
California
37.668819, -122.080795
Milwaukee
, 
WI
Wisconsin
43.038902, -87.906471
Lubbock
, 
TX
Texas
33.576698, -101.855072
Norfolk
, 
VA
Virginia
36.850769, -76.285873
Tulsa
, 
OK
Oklahoma
36.153980, -95.992775
Garland
, 
TX
Texas
32.914341, -96.636559
Fort Lauderdale
, 
FL
Florida
26.124161, -80.143593
Tucson
, 
AZ
Arizona
32.248814, -110.987419
Salt Lake City
, 
UT
Utah
40.760780, -111.891045
Corona
, 
CA
California
33.875670, -117.568840
Madison
, 
WI
Wisconsin
43.073051, -89.401230
Huntsville
, 
AL
Alabama
34.7014286, -86.6597495
Kansas City
, 
MO
Missouri
39.099728, -94.578568
Irvine
, 
CA
California
33.684566, -117.826508
Chula Vista
, 
CA
California
32.640072, -117.084038
Denton
, 
TX
Texas
33.215530, -97.132446
Aurora
, 
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
, 
LA
Louisiana
30.4494155, -91.1869659
Columbus
, 
OH
Ohio
39.961178, -82.998795
Baltimore
, 
MD
Maryland
39.2908816, -76.610759
Detroit
, 
MI
Michigan
42.331429, -83.045753
Chesapeake
, 
VA
Virginia
36.7183708, -76.2466798
Birmingham
, 
AL
Alabama
33.5206824, -86.8024326
Scottsdale
, 
AZ
Arizona
33.501324, -111.925278
Cincinnati
, 
OH
Ohio
39.103700, -84.513610
North Las Vegas
, 
NV
Nevada
36.201946, -115.120216
Riverside
, 
CA
California
33.980602, -117.375496
Plano
, 
TX
Texas
33.019844, -96.698883
Minneapolis
, 
MN
Minnesota
44.977753, -93.265015
Salinas
, 
CA
California
,
Anaheim
, 
CA
California
33.836594, -117.914299
Springfield
, 
MO
Missouri
37.208958, -93.292297
Fort Wayne
, 
IN
Indiana
41.077469, -85.137489
Phoenix
, 
AZ
Arizona
33.448376, -112.074036
Bakersfield
, 
CA
California
35.3738712, -119.0194639
Garden Grove
, 
CA
California
33.774269, -117.937996
Anchorage
, 
AK
Alaska
61.2163129, -149.894852
Indianapolis
, 
IN
Indiana
39.768402, -86.158066
Nashville
, 
TN
Tennessee
36.162663, -86.781601
Tempe
, 
AZ
Arizona
33.425522, -111.941254
Mobile
, 
AL
Alabama
30.695366, -88.039894
New Orleans
, 
LA
Louisiana
29.951065, -90.071533
Knoxville
, 
TN
Tennessee
35.960636, -83.920738
Grand Rapids
, 
MI
Michigan
42.963360, -85.668083
Fontana
, 
CA
California
34.102890, -117.435760
Elk Grove
, 
CA
California
38.418129, -121.393257
Miami
, 
FL
Florida
25.7825389, -80.3118603
Grand Prairie
, 
TX
Texas
32.745499, -97.003532
Fort Collins
, 
CO
Colorado
40.588970, -105.082458
Killeen
, 
TX
Texas
31.117119, -97.727798
Modesto
, 
CA
California
37.639095, -120.996880
Oklahoma City
, 
OK
Oklahoma
35.468491, -97.521263
Santa Ana
, 
CA
California
33.745571, -117.867836
Ontario
, 
CA
California
34.063343, -117.650887
Brownsville
, 
TX
Texas
25.9015688, -97.4984005
Montgomery
, 
AL
Alabama
32.379223, -86.307739
Hialeah
, 
FL
Florida
25.857595, -80.278107
Springfield
, 
MA
Massachusetts
42.102051, -72.585762
Toledo
, 
OH
Ohio
41.652805, -83.537865
Pembroke Pines
, 
FL
Florida
26.007765, -80.296257
Overland Park
, 
KS
Kansas
38.974819, -94.683601
Little Rock
, 
AR
Arkansas
34.746483, -92.289597
Glendale
, 
CA
California
34.142509, -118.255074
Roseville
, 
CA
California
38.752125, -121.288010
Rancho Cucamonga
, 
CA
California
,
Wichita
, 
KS
Kansas
37.687176, -97.330055
Huntington Beach
, 
CA
California
33.659485, -117.998802
Augusta
, 
GA
Georgia
33.4709714, -81.9748429
Worcester
, 
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
, 
VA
Virginia
36.852924, -75.977982
Oceanside
, 
CA
California
33.1958696, -117.3794834
Santa Clarita
, 
CA
California
34.456043, -118.571335
Philadelphia
, 
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
, 
TX
Texas
27.800583, -97.396378
Portland
, 
OR
Oregon
45.512230, -122.658722
Denver
, 
CO
Colorado
39.739235, -104.990250
Boston
, 
MA
Massachusetts
42.3554334, -71.060511
Atlanta
, 
GA
Georgia
33.7489924, -84.3902644
Chicago
, 
IL
Illinois
41.8755616, -87.6244212
Orlando
, 
FL
Florida
28.538336, -81.379234
Jacksonville
, 
FL
Florida
30.332184, -81.655647
Tampa
, 
FL
Florida
27.950575, -82.457176
Long Island
, 
NY
New York
40.757801, -73.940033
Queens
, 
NY
New York
40.728226, -73.794853
Bronx
, 
NY
New York
40.8466508, -73.8785937
Staten Island
, 
NY
New York
40.643501, -74.076202
Brooklyn
, 
NY
New York
40.6526006, -73.9497211
New York
, 
NY
New York
40.712776, -74.005974
San Jose
, 
CA
California
37.342205, -121.851990
San Francisco
, 
CA
California
37.774929, -122.419418
San Diego
, 
CA
California
32.834686, -117.130775
Los Angeles
, 
CA
California
34.052235, -118.243683
El Paso
, 
TX
Texas
31.761877, -106.485023
San Antonio
, 
TX
Texas
29.387428, -98.496574
Dallas
, 
TX
Texas
32.776665, -96.796989
Fort Worth
, 
TX
Texas
32.755489, -97.330765
Houston
, 
TX
Texas
29.760427, -95.369804
Austin
, 
TX
Texas
30.2711286, -97.7436995
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