Hidden crisis: rising awareness needed for binge eating disorder in the Philippines

Haley’s story highlights the prevalence and stigma of binge eating disorder in the Philippines, underscoring the urgent need for better early screening and recognition within the health system.

In the small hours, Haley finds herself making the same uneasy walk to the kitchen, searching for leftovers, half-finished drinks or anything that will quiet the urge long enough to let her sleep. She is an incoming third-year student at the University of Santo Tomas, but for years her nights were shaped by a binge eating disorder that began when she was 9 and, she says, grew out of a childhood trauma she has chosen not to disclose. Speaking to Rappler, Haley described the feeling as an empty place she did not know how to fill.

The American Psychiatric Association says binge eating disorder, or BED, involves repeated episodes of eating large amounts of food while feeling a loss of control, but without the purging or excessive exercise that typically follows bulimia. That distinction matters, clinicians say, because the shame and distress can be profound even when the condition is less visible to others. Dr. Alyssa Dar Juan, an eating disorder specialist, told Rappler that the defining feature is the inability to stop, often accompanied by intense guilt. The association also says eating disorders can affect people of any body size, age or background and often emerge in adolescence or young adulthood.

Haley’s account shows how easily the disorder can become routine. What began as an attempt to soothe herself turned into an urge that followed her from morning to night, regardless of whether the food was stale, oily or barely enough to count as a meal. She said she was less concerned with taste than with feeling full, and that the compulsion could become so overwhelming she would eat until she retched. In moments of self-loathing, she tried to force herself to vomit or used laxatives, but said those efforts did nothing to break the cycle.

Her experience also points to a larger gap in the Philippine health system. The Department of Health does not routinely track eating disorder cases, making the scope of the problem difficult to measure, according to the agency’s own response to a freedom of information request. That leaves patients like Haley navigating a condition that is serious, under-recognised and often hidden behind stigma. The American Psychiatric Association’s latest guidance stresses early screening, evidence-based treatment and attention to the psychological as well as physical effects of eating disorders, including BED.