Binge eating disorder
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Binge eating disorder is a medical syndrome in which, according to currently accepted definitions, people:
- feel their eating is out of control;
- eat what most people would think is an unusually large amount of food;
- eat much more quickly than usual during binge episodes;
- eat until so full they are uncomfortable;
- eat large amounts of food, even when they are not really hungry;
- eat alone because they are embarrassed about the amount of food they eat;
- feel disgusted, depressed, or guilty after overeating.
Binge eating also takes place in another eating disorder called bulimia nervosa. Persons with bulimia nervosa, however, usually purge, fast, or do strenuous exercise after they binge eat. 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. Purging, fasting, and overexercising are dangerous ways to try to control your weight.
While binge eating is similar in nature, it is different than being a compulsive overeater.
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Occurrence and risk factors
Binge eating disorder is probably the most common eating disorder. Most people with this problem are either overweight or obese (see note), but normal-weight people also can have the disorder.
About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.
Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder affects blacks as often as whites. No one knows how often it affects people in other ethnic groups.
People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight (yo-yo diet) more often.
- Note: The 1998 NIH Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults define overweight as a body mass index (BMI) of 25 to 29.9 and obesity as a BMI of 30 or more. BMI is calculated by dividing weight (in kilograms) by height (in meters) squared.
Causes
No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known.
Many people who are binge eaters say that being angry, sad, bored, or worried can cause them to binge eat. Impulsive behavior (acting quickly without thinking) and certain other emotional problems can be more common in people with binge eating disorder.
It is also unclear if dieting and binge eating are related. Some studies show that about half of all people with binge eating disorder had binge episodes before they started to diet.
Researchers also are looking into how brain chemicals and metabolism (the way the body uses food energy) affect binge eating disorder. This research is still in the early stages.
Complications
People with binge eating disorder can get sick because they may not be getting the right nutrients. They usually eat large amounts of fats and sugars, which don't have a lot of vitamins or minerals.
People with binge eating disorder are usually very upset by their binge eating and may become very depressed.
People who are obese and also have binge eating disorder are at risk for
- diabetes
- high blood pressure
- high blood cholesterol levels
- gallbladder disease
- heart disease
- certain types of cancer.
Most people with binge eating disorder have tried to control it on their own, but have not been able to control it for very long. Some people miss work, school, or social activities to binge eat. Persons who are obese with binge eating disorder often feel bad about themselves and may avoid social gatherings.
Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members don't know they binge eat.
Dieting
People who are not overweight should avoid dieting because it sometimes makes their binge eating worse. Dieting here means skipping meals, not eating enough food each day, or avoiding certain kinds of food (such as carbohydrates). These are unhealthy ways to try to change your body shape and weight. Many people with binge eating disorder are obese and have health problems because of their weight. These people should try to lose weight and keep it off. People with binge eating disorder who are obese may find it harder to stay in a weight-loss program. They also may lose less weight than other people, and may regain weight more quickly. (This can be worse when they also have problems like depression, trouble controlling their behavior, and problems dealing with other people.) These people may need treatment for binge eating disorder before they try to lose weight.
Treatment
People with binge eating disorder, whether or not they want to lose weight, should get help from a health professional such as a psychiatrist, psychologist, or clinical social worker for their eating behavior. Even those who are not overweight are usually upset by their binge eating, and treatment can help them. There are several different ways to treat binge eating disorder. Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in tough situations. Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas. Drug therapy, such as antidepressants, may be helpful for some people.
Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. The methods mentioned here seem to be equally helpful. For people who are overweight, a weight-loss program that also offers treatment for eating disorders might be the best choice.
If you think you might have binge eating disorder, it's important to know that you are not alone. Most people who have the disorder have tried but failed to control it on their own. You may want to get professional help. Talk to your health care provider about the type of help that may be best. The good news is that most people do well in treatment and can overcome binge eating.
References
- Fairburn, C.G. (1995). Overcoming Binge Eating. New York: Guilford Press. This book discusses who binges and why, how bingeing differs from overeating, and how a binge eater can gain control. It presents a step-by-step program for overcoming binge eating.
- Grilo, C.M. (1998). "The Assessment and Treatment of Binge Eating Disorder." Journal of Practical Psychiatry and Behavioral Health 4 pp. 191–201. This article, written for health professionals, reviews the literature on binge eating disorder with a particular focus on its assessment and treatment. Implications for practice and future research are discussed.
- Siegel, M.; Brisman, J.; & Weinshel, M. (1997). Surviving an Eating Disorder: New Perspectives and Strategies for Family and Friends. New York: HarperCollins. This book discusses family therapy, psychopharmacology, hospitalization policies, insurance coverage, and support services for binge eating disorder patients and their families.
- Stunkard, A.J. (1959). "Eating Patterns and Obesity." Psychiatric Quarterly 33 pp. 284–295. This classic paper provides one of the first descriptions of binge eating in obese individuals.
- Yanovski, S.Z. (1993). "Binge Eating Disorder: Current Knowledge and Future Directions." Obesity Research 1 (4) pp. 306–323. This review of existing research on binge eating disorder, geared to health professionals, describes treatment methods, discusses their effectiveness, and recommends that doctors treating obese patients be aware of the disorder.
See also
External links
- National Institute of Health page on binge eating disorder (http://www.niddk.nih.gov/health/nutrit/pubs/binge.htm)
- Mental Health Matters: Binge Eating Disorder (http://www.mental-health-matters.com/disorders/dis_details.php?disID=14)
- Psych Forums: Binge Eating Forum (http://www.psychforums.com/forums/viewforum.php?f=167)
- This article is taken from the public domain NIH Publication No. 99-3589, updated February 2001.nl:Eetbuienstoornis