Binge Eating Disorder

BINGE EATING DISORDER

Introduction

An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape. A person with an eating disorder may have started out just eating smaller or larger amounts of food than usual, but at some point, the urge to eat less or more spirals out of control. Eating disorders are very complex, and despite scientific research to understand them, the biological, behavioral and social underpinnings of these illnesses remain elusive.

The two main types of eating disorders are anorexia nervosa and bulimia nervosa. A third category is "eating disorders not otherwise specified (EDNOS)," which includes several variations of eating disorders. Most of these disorders are similar to anorexia or bulimia but with slightly different characteristics. Binge-eating disorder, which has received increasing research and media attention in recent years, is one type of EDNOS. Eating disorders frequently appear during adolescence or young adulthood, but some reports indicate that they can develop during childhood or later in adulthood. Women and girls are much more likely than males to develop an eating disorder. Men and boys account for an estimated 5 to 15 percent of patients with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder.

Binge Eating Disorder

Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes. They frequently coexist with other psychiatric disorders such as depression, substance abuse, or anxiety disorders. People with eating disorders also can suffer from numerous other physical health complications, such as heart conditions or kidney failure, which can lead to death.

Binge Eating Disorder (BED)

Binge eating disorder is characterized by compulsive overeating in which people consume huge amounts of food while feeling out of control and powerless to stop. People with binge eating disorder suffer from this psychological food addiction. Like the alcoholic that can’t say no to a drink, they can’t say no to food. Often, their binge eating is triggered by a depressed or anxious mood, but they may also overeat when they’re tense, lonely, or bored. They eat to feed their feelings, rather than their bodies. A binge eating episode typically lasts around two hours, but some people binge on and off all day long. Binge eaters often eat even when they’re not hungry and continue eating long after they’re full. They may also gorge themselves as fast as they can while barely registering what they’re eating or tasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating. They worry about what the compulsive eating will do to their bodies and beat themselves up for their lack of self-control. They desperately want to stop binge eating, but they feel like they can’t. Obese people with binge-eating disorder often have coexisting psychological illnesses including anxiety, depression, and personality disorders. In addition, links between obesity and cardiovascular disease and hypertension are well documented. Binge eaters use food to cope with stress and other negative emotions, but their compulsive overeating just makes them feel worse. It’s not that people with binge eating disorder don’t care about their bodies; they agonize over their ballooning weight. But the worse they feel about themselves and their appearance, the more they use food to cope. It becomes a vicious cycle: eating to feel better, feeling even worse, and then turning back to food for relief.

Symptoms

Most of us overeat from time to time, and some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean that you have binge eating disorder. Experts generally agree that most people with serious binge eating problems often eat an unusually large amount of food and feel their eating is out of control.

Behavioural Symptoms of Binge Eating and Compulsive Overeating

<![if         i.            Inability to stop eating or control what you’re eating

<![if       ii.            Rapidly eating large amounts of food

<![if     iii.            Eating even when you’re full

<![if      iv.           Hiding or stockpiling food to eat later in secret

<![if        v.           Eating normally around others, but gorging when you’re alone

<![if    vi.            Eating continuously throughout the day, with no planned mealtimes

      Emotional Symptoms of Binge Eating and Compulsive Overeating

<![if         i.            Feeling tension that is only relieved by eating

<!      iii.            Embarrassment over how much you’re eating

<![if     iii.            Feeling numb while bingeing—like you’re not really there or you’re on auto-pilot.

<![if     iv.            Never feeling satisfied, no matter how much you eat

<![if       v.            Feeling guilty, disgusted, or depressed after overeating

<![if      vi.            Desperation to control weight and eating habits

Binge eating also occurs in another eating disorder called bulimia nervosa. But Binge-eating Disorder is different from Bulimia Nervosa in that the persons with bulimia nervosa, usually purge, fast, or do strenuous exercise after they binge eat while in BED they don’t.

Purging means vomiting or using a lot of diuretics (water pills) or laxatives to keep from gaining weight. Fasting is not eating for at least 24 hours. Strenuous exercise, in this case, means exercising for more than an hour just to keep from gaining weight after binge eating.

3.      Causes

Most experts believe that it takes a combination of things to develop an eating disorder –  including a person's genes, emotions, and experience.

      Biological causes of BED

Studies show that biological abnormalities contribute to binge eating. For example, the hypothalamus (the part of the brain that controls appetite) may not be sending correct messages about hunger and fullness. Researchers have also found a genetic mutation that appears to cause food addiction. Finally, there is evidence that low levels of the brain chemical serotonin play a role in compulsive eating.

      Psychological causes of BED

Depression and binge eating are strongly linked. According to the U.S. Department of Health and Human Services, up to half of all binge eaters are either depressed or have been before. There is further evidence that low self-esteem, loneliness, and body dissatisfaction are involved in compulsive overeating. People with binge eating disorder may also have trouble with impulse control and managing and expressing their feelings.

     Social and cultural causes of BED

Social pressure to be thin can add to the shame binge eaters feel and fuel their emotional eating. The way one is raised can also increase the risk for binge eating disorder. Some parents unwittingly set the stage for bingeing by using food to comfort, dismiss, or reward their children. Children who are exposed to frequent critical comments about their bodies and weight are also vulnerable. Another factor which has been linked to binge eating is sexual abuse in childhood.

4.     Effects

Binge eating leads to a wide variety of physical, emotional, and social problems. People with binge eating disorder report more health issues, stress, insomnia, and suicidal thoughts than people without an eating disorder. Depression, anxiety, and substance abuse are common side effects as well. Binge eating also interferes with a person’s relationships and career. For example, you may skip work, school, or social activities in order to binge eat. But the most prominent effect of binge eating disorder is weight gain.

     Obesity and binge eating

Over time, compulsive overeating usually leads to obesity. Obesity, in turn, causes numerous medical complications.

Common physical effects of binge eating disorder include:

¨    Type 2 diabetes

¨      Gallbladder disease

¨      High cholesterol

¨      High blood pressure

¨     Heart disease

¨      Certain types of cancer

¨      Osteoarthritis

¨     Joint and muscle pain

¨      Gastrointestinal problems

¨     Sleep apnea

The higher the body mass index (BMI), the greater the risk for health problems. BMI is a measure of body fat, based on weight and height.

5.    Treatment

While there are many things you can do to help yourself stop binge eating, it’s also important to seek professional support and treatment. Health professionals who offer treatment for binge eating disorder include psychiatrists, nutritionists, therapists, and eating disorder and obesity specialists.

The goal of treatment for binge eating disorder is to reduce compulsive overeating and bingeing episodes.

    Therapy for Binge Eating Disorder

Binge eating disorder can be successfully treated in therapy. Therapy can teach you how to fight the compulsion to binge, exchange unhealthy habits for healthy ones, monitor your eating and moods, and develop effective stress-busting skills.

Three types of therapy are particularly helpful in the treatment of binge eating disorder and compulsive overeating:

<![if         i.            Cognitive-behavioral therapy – Cognitive-behavioral therapy focuses on the dysfunctional thoughts and behaviors involved in binge eating. One of the main goals is for to become more self-aware of how food is used to deal with emotions. This can be done by maintaining a food diary or a journal of ones thoughts about eating, weight and food. The binge eating triggers are recognized and learnt to avoid or combat them. Cognitive-behavioral therapy for binge eating disorder also involves education about nutrition, healthy weight loss, and relaxation techniques.

<       ii.            Interpersonal psychotherapy - Interpersonal psychotherapy for binge eating disorder focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. The therapy involves improving communication skills and developing healthier relationships with family members and friends. As relationship is bettered and  emotional support is obtained, the compulsion to binge becomes more infrequent and easier to resist.

<![if      iii.            Dialectical behavior therapy – Dialectical behavior therapy combines cognitive-behavioral techniques with mindfulness meditation. The emphasis of therapy is on teaching binge eaters how to accept themselves, tolerate stress better, and regulate their emotions. The therapy will also address unhealthy attitudes about eating, shape, and weight. Dialectical behavior therapy typically includes both individual treatment sessions and weekly group therapy sessions.

     Support for binge eating

Breaking the old pattern of binge eating is hard, and so one may slip from time to time. This is where the support of others can really come in handy. Family, friends, and therapists can all be part of the support team. Therefore joining a group for binge eaters is helpful. Sharing ones experience with other compulsive eaters can go a long way towards reducing the stigma and loneliness one may feel. There are many group options, including self-help support groups and more formal therapy groups.

<![if i.         Group therapy - Group therapy sessions are led by a trained psychotherapist, and may cover everything from healthy eating to coping with the urge to binge.

<![if    ii.            Support groups – Support groups for binge eating are led by trained volunteers or health professionals. Group members give and receive advice and support each other. Overeaters Anonymous is a Twelve-Step support group for compulsive overeaters.

      Medications for binge eating disorder

A number of medications may be helpful in binge eating disorder treatment. Some studies have shown that medication can reduce the frequency of binge eating episodes, improve body mass index, and speed weight loss. Drug research for binge eating is still in its early stages, however, and more studies are needed.

The medications that show promise for binge eating disorder include:

<![if        i.            Antidepressants – Research shows that antidepressants decrease binge eating in people with bulimia. Antidepressants may also help people with binge eating disorder, but studies also show that relapse rates are high when the drug is discontinued.

<![if       ii.            Appetite suppressants – Studies on the appetite-suppressing drug sibutramine, known by the brand name Meridia, indicate that it reduces the number of binge eating episodes and promotes weight loss.

<     iii.            Topamax – The seizure drug topiramate, or Topamax, may decrease binge eating and increase weight loss. However, Topamax can cause serious side effects, including fatigue, dizziness, and burning or tingling sensations.

Conclusion

In conclusion we can say that Binge Eating Disorder is not an incurable disease but is curable and like all patients they too need encouragement and support from others and with personal effort and supporting groups one can easily get over this disorder and resume normal life.

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