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Binge Eating Disorder

Symptoms, Causes, Treatment, and Help

Almost everyone overeats from time to time— taking a third helping at Thanksgiving dinner, for example, or downing a whole package of cookies during a late-night study session. But if overeating is a regular and uncontrollable habit, you may be suffering from binge eating disorder. Binge eaters use food to cope with stress and other negative emotions, but their compulsive overeating just makes them feel worse. The good news is that binge eating disorder is treatable. With professional help and support, you can learn to stop binge eating.

Steve’s Story

Steve has struggled with weight problems for as long as he can remember. But over the past six months, he’s been bingeing more and more frequently and has packed on another 50 pounds. Steve is really anxious about the weight gain. He hates the way he looks and he’s worried about developing diabetes, which his doctor tells him is a very real risk. But he doesn’t know how to stop his out-of-control eating. Steve tries to eat normally, but as the day goes on, the compulsion to binge gets stronger and stronger. On the way home from work, Steve usually gives in to the urge. First he goes through two different fast food drive-ins, ordering two cheeseburgers, a large order of fries, a chocolate shake, coleslaw, and a bucket of fried chicken. Then he pulls into a secluded parking spot and wolfs everything down in his car. Next, he heads to the grocery store to grab donuts, cookies, and chips. Once he’s home alone, Steve starts in on the snacks. He doesn’t stop until the food is gone or he’s so stuffed that he feels sick. Afterwards, he berates himself for being such a pig, but he knows it won’t be long until he binges again.

What is binge eating?

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.

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.

The key features of binge eating disorder are:

• Frequent episodes of uncontrollable binge eating

• Feeling extremely distressed or upset during or after bingeing

• No regular attempts to “make up” for the binges through vomiting, fasting, or over-exercising.

People with binge eating disorder struggle with feelings of guilt, disgust, and depression. 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.

According to the National Institutes of Health, 2 percent of all U.S. adults suffer from compulsive overeating—making binge eating disorder more common than bulimia or anorexia. Unlike other eating disorders, which primarily occur in women, binge eating disorder also affects a significant number of men. Binge eating usually begins in late adolescence or early adulthood, often after a major diet. But most people don’t seek help until much later when weight gain from their binge eating is causing health problems. 

|DO I NEED HELP FOR BINGE EATING? |

|Ask yourself the following questions. The more “yes” answers, the more likely it is that you have binge eating disorder. |

|Do you feel out of control when you’re eating? |

|Do you think about food all the time? |

|Do you eat in secret? |

|Do you eat until you feel sick? |

|Do you eat to escape from worries or to comfort yourself? |

|Do you feel disgusted or ashamed after eating? |

|Do you feel powerless to stop eating, even though you want to? |

Emotional eating and food addiction

It’s common to turn to food for comfort: unwinding after a long day with a hot bowl of soup, for instance, or digging into a pint of Rocky Road after a fight with your significant other. But when eating becomes the main strategy for managing emotions and dealing with stress, it can develop into an unhealthy and uncontrollable food “addiction.”

Signs of Emotional Eating

Using food to:

• fill a void in your life

• feel better or cheer yourself up

• calm down or soothe your nerves

• escape from problems

• cope with stress and worries

• reward yourself

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.

The problem is that emotional eating doesn’t solve anything. It may be comforting for a brief moment, but then reality sets back in, along with regret and self-loathing. Emotional eating also leads to problems of its own—including weight gain and obesity.

Unfortunately, weight gain only reinforces compulsive eating. 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.

Signs and symptoms of binge eating disorder

People with binge eating disorder are embarrassed and ashamed of their eating habits, so they often try to hide their symptoms and eat in secret. Many binge eaters are overweight or obese, but some are of normal weight.  

Behavioral symptoms of binge eating and compulsive overeating

• Inability to stop eating or control what you’re eating

• Rapidly eating large amounts of food

• Eating even when you’re full

• Hiding or stockpiling food to eat later in secret

• Eating normally around others, but gorging when you’re alone

• Eating continuously throughout the day, with no planned mealtimes

Emotional symptoms of binge eating and compulsive overeating

• Feeling tension that is only relieved by eating

• Embarrassment over how much you’re eating

• Feeling numb while bingeing—like you’re not really there or you’re on auto-pilot.

• Never feeling satisfied, no matter how much you eat

• Feeling guilty, disgusted, or depressed after overeating

• Desperation to control weight and eating habits

The difference between binge eating disorder and bulimia

Binge eating disorder is similar to bulimia in that both eating disorders involve consuming massive amounts of food in a short time period. But unlike bulimics, binge eaters DO NOT regularly try to purge or work off the extra calories consumed. People with binge eating disorder may occasionally try to fast or restrict calories, but many have given up all dieting efforts due to a long history of repeated failure.

Causes of binge eating and compulsive overeating

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 binge eating disorder

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 binge eating disorder

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 binge eating disorder

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.

Effects of binge eating disorder

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 |Certain types of cancer |

|Gallbladder disease |Osteoarthritis |

|High cholesterol |Joint and muscle pain |

|High blood pressure |Gastrointestinal problems |

|Heart disease   |Sleep apnea |

The higher your body mass index (BMI), the greater your risk for health problems. Your BMI is a measure of body fat, based on your weight and height. See the chart below to determine your BMI and assess your risk.

[pic]

Source: National Institutes of Health

Other aspects of compulsive eating can also negatively affect your health. If you’re embarrassed by your body, you may be reluctant to exercise in public or go to the gym. But a lack of physical activity will only lead to more weight gain and health issues. And while you may be consuming thousands of extra calories while bingeing, they may be in the form of “empty calories” from sweets and junk food. In fact, you may not be getting the vitamins and nutrients you need to stay healthy.

How to stop binge eating

It can be difficult to overcome binge eating and food addiction. Unlike other addictions, your “drug” is necessary for survival, so you don’t have the option of avoiding it. Instead, you must develop a healthier relationship with food—a relationship that’s based on meeting your nutritional needs, not your emotional ones.

Learning how to eat right

In order to stop the unhealthy pattern of binge eating, it’s important to start eating for health and nutrition. Healthy eating involves making balanced meal plans, choosing healthy foods when eating out, and making sure you’re getting the right vitamins and minerals in your diet.

Overcoming binge eating disorder also involves getting emotional eating under control. Eating right and listening to your body is an essential step in stopping binge eating. Other strategies that help include practicing relaxation techniques, staying connected to family and friends, and making time for things you enjoy as part of your daily schedule.

Tips for Overcoming Binge Eating

• Eat breakfast. Skipping breakfast often leads to overeating later in the day, so start your day right with a healthy meal. Eating breakfast also jump starts your metabolism in the morning. Studies show that people who eat breakfast are thinner than those who don’t.

• Avoid temptation. You’re much more likely to overeat if you have junk food, desserts, and unhealthy snacks in the house. Remove the temptation by clearing your fridge and cupboards of your favorite binge foods.

• Stop dieting. The deprivation and hunger of strict dieting can trigger food cravings and the urge to overeat. Instead of dieting, focus on eating in moderation. Find nutritious foods that you enjoy and avoid labeling foods as “good” or “bad.”

• Exercise. Not only will exercise help you lost weight in a healthy way, but it also lifts depression, improves overall health, and reduces stress. The natural mood-boosting effects of exercise can help put a stop to emotional eating.

• Destress. Learn how to cope with stress in healthy ways that don’t involve food.

Treatment and help for binge eating disorder

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. If obesity is endangering your health, weight loss may be another goal. However, dieting can contribute to binge eating, so any weight loss efforts should be carefully monitored by your treatment team.

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:

• Cognitive-behavioral therapy – Cognitive-behavioral therapy focuses on the dysfunctional thoughts and behaviors involved in binge eating. One of the main goals is for you to become more self-aware of how you use food to deal with emotions. Your therapist may ask you to keep a food diary or a journal of your thoughts about eating, weight, and food. The therapist will also help you recognize your binge eating triggers and learn how to avoid or combat them. Cognitive-behavioral therapy for binge eating disorder also involves education about nutrition, healthy weight loss, and relaxation techniques.

• Interpersonal psychotherapy - Interpersonal psychotherapy for binge eating disorder focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. Your therapist will also help you improve your communication skills and develop healthier relationships with family members and friends. As you learn how to relate better to others and get the emotional support you need, the compulsion to binge becomes more infrequent and easier to resist.

• 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. Your therapist will also address unhealthy attitudes you may have about eating, shape, and weight. Dialectical behavior therapy typically includes both individual treatment sessions and weekly group therapy sessions.

Support for binge eating

|[pic]Overeaters Anonymous is a |

|Twelve-Step support group for compulsive |

|overeaters. Go to to find a |

|meeting in your area. |

Breaking the old pattern of binge eating is hard, and you 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 your support team. You may also find that joining a group for binge eaters is helpful. Sharing your experience with other compulsive eaters can go a long way towards reducing the stigma and loneliness you may feel.

There are many group options, including self-help support groups and more formal therapy groups.

• 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.

• 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.

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:

• 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.

• 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.

• 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.

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