Binge eating disorder is an eating disorder characterized by binge eating. During an episode, large amounts of food are eaten. Sufferers often experience loss of control (the feeling of not being able to stop eating or not being in control of what amounts are eaten). The eating episodes typically occur in the absence of witnesses.
Binge Eating Disorder
Eating is usually rapid, without a sense of hunger, and indiscriminate, consuming a far greater amount of food in a short period of time than healthy individuals would eat under similar conditions. This is often followed by feelings of guilt, shame, and depressed moods. Binge eating differs from bulimia nervosa in the absence of the compensatory behaviors typical of the latter (for example, self-induced vomiting, misuse of laxatives and/or dehydrators) after the binge. Binge eating affects about two percent of the population. Most people with this eating disorder are overweight. However, binge eating can also occur in people of normal weight. Approximately twenty to forty percent of moderately to severely obese people who see a therapist for obesity have binge eating disorder. Binge eating occurs slightly more often in women than in men (ratio approximately 3:2). Obese people with binge eating disorder are often overweight earlier (as early as childhood) than “normal” obese people. They also usually go through more phases of weight gain and loss (yo-yo effect).
Binge eating: causes
The causes of binge eating are as yet unclear. About half of those affected have suffered from depression at some point in their lives. However, it is unclear whether the depression is a cause or consequence of the eating disorder. Nor is there necessarily a connection. Many sufferers report that feelings of anxiety, sadness, anger, boredom or other negative feelings trigger an eating attack. The effect of dieting on the development of binge eating disorder is also still unclear. Several studies suggest that repeated strict dieting (rigid control) can trigger binge eating. However, about half of those affected already suffer from binge eating before they start dieting.
Binge eating: symptoms and signs
Many people overeat at times, and many repeatedly feel that they have eaten more than they should. However, just eating large amounts of food does not mean that someone is also suffering from binge eating disorder. The following signs belong to binge eating disorder:
- Regular episodes of binge eating, in which a much larger amount of food is eaten in a short period of time than other people would eat under similar circumstances.
- During binge eating episodes, frequent feelings of loss of control (unable to control what or how much is eaten).
- Several of the following behaviors or feelings: eating significantly faster than usual. Eating to the point of an uncomfortable feeling of fullness. Taking large amounts of food even though there is no physiological hunger. Eating alone, out of shame about the quantities ingested. After overeating, disgust with oneself, dejection and/or guilt.
Binge eating also occurs in bulimia nervosa. Unlike people suffering from binge eating, bulimics exhibit purging behaviors, fasting or exercise excessively. These behaviors are “countermeasures” to increased caloric intake and are intended to counteract weight gain. Such countermeasures are absent in binge eating.
Binge eating: consequences and complications
The main physical complications are secondary to obesity: type II diabetes mellitus, hypertension, cardiovascular disease, and dyslipidemia. Binge eating can also produce psychological complications. Affected individuals are greatly burdened by the condition. Many have already tried independently to reduce binge eating, often succeeding only in the short term. The stress and suffering due to the eating disorder can lead to sufferers no longer being able to fulfill their work or social obligations. Overweight people with binge eating disorder often feel bad about their eating behavior, are overly preoccupied with their weight and figure, and avoid social contacts. This withdrawal can lead to isolation.Most feel ashamed and try to hide their disorder from other people.
Binge eating: therapy and treatment
Individuals with binge eating disorder who are not overweight or only moderately overweight should avoid weight loss diets, as strict dieting can exacerbate the eating disorder. However, many are significantly overweight and suffer from secondary physical illnesses. For these people, losing weight and stabilizing weight are important treatment goals. For most individuals – whether they want to lose weight or not – treatment specifically targeted to their eating disorder is recommended. Weight loss, if any, can be accomplished after treatment for the eating disorder. Several studies have shown that it is more difficult for people with binge eating to stay in a weight loss program than it is for overweight people without the eating disorder. They also tend to gain weight back more quickly if the binge eating is not treated first. Therefore, the eating disorder should be specifically treated before weight loss is attempted.
Different approaches to treatment
There are several approaches to treatment. Previous research shows that cognitive-behavioral therapy and interpersonal therapy can lead to a reduction in binge eating. In cognitive-behavioral therapy, individuals learn techniques and strategies to monitor and change their eating behavior, and they learn how to respond to difficult situations (as an alternative to binge eating). Interpersonal therapy focuses on current interpersonal (interpersonal) relationships without specifically addressing eating behavior. Medication treatment with antidepressants can also be helpful and cause a decrease in binge eating. However, medications are less effective when used alone than psychotherapeutic approaches. They should be used only in combination.
Preventive measures
Avoiding rigid diets: The range of diets is continuously increasing. Many seem quite logical; it is understandable that overweight individuals are willing to go on appropriate diets. However, many of the starvation diets do not work in the long run. Their weakness is that they do not take into account the set point, emotional reactions to dieting, individual differences in normal weight, and the unreasonableness of the slimming ideal. Rigid diets that produce relatively high weight loss in a short period of time based on an unbalanced diet pose a health risk. Binge eating can be a direct result of hunger. The more attempts are made to limit food intake, the greater the tendency to binge eat. Often the mistake of skipping a meal (in the sense of making up for it) is started after a binge eating episode. This automatically preprograms the next loss of control. Compare to flexible control of eating behavior. Individuals with binge eating disorder who are not overweight or only moderately overweight should avoid dieting, as strict dieting can exacerbate the eating disorder. However, many people with binge eating disorder are also significantly overweight and suffer from its physical consequences. For them, weight loss and subsequent stabilization is sometimes an important treatment goal. Weight loss can follow specific treatment for the eating disorder. Acknowledging excess weight: The set-point theory describes that all people have a normal weight. This is determined by a combination of genetic and dietary factors. Set-point weight is maintained by the interaction of a variety of biological factors. These factors mean that it is only possible for a given person to be comfortable and functional within a limited weight range. There is much evidence in the literature that obesity is not the result of a lack of willpower, but for some is genetically predetermined. This does not mean that obesity as such is unchangeable: based on changes in eating and nutritional behavior and lifestyle, weight reduction is possible. The margin within which this is possible appears limited.
