Binge
Eating Disorder
Contents
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. People with binge
eating disorder also may:
- eat much more quickly than usual
during binge episodes
- eat until they are uncomfortably
full
- 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 occurs 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.
How Common Is
Binge Eating Disorder, and Who Is at Risk?
Binge eating disorder is probably
the most common eating disorder. Most people with this problem are
either overweight or obese,* 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.
* 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
What Causes Binge Eating Disorder?
No one knows for sure what causes
binge eating disorder. As many as half of all people with binge
eating disorder are depressed or have been depressed in the past.
Whether depression causes binge eating disorder or whether binge
eating disorder causes depression is not known.
It is also unclear if dieting and
binge eating are related. Some people binge eat after dieting.
Dieting here means skipping meals, not eating enough food each day,
or avoiding certain kinds of food. These are unhealthy ways to try
to change your body shape and weight.
Studies suggest that people with
binge eating may have trouble handling some of their emotions. Many
people who are binge eaters say that being angry, sad, bored,
worried, or stressed can cause them to binge eat.
Certain behaviors and emotional
problems are more common in people with binge eating disorder. These
include abusing alcohol, acting quickly without thinking (impulsive
behavior), not feeling in charge of themselves, not feeling a part
of their communities, and not noticing and talking about their
feelings.
Researchers are looking into how
brain chemicals and metabolism (the way the body uses calories)
affect binge eating disorder. Other research suggests that genes may
be involved in binge eating, since the disorder often occurs in
several members of the same family. This research is still in the
early stages.
What Are the Complications of Binge Eating Disorder?
People with binge eating disorder
are usually very upset by their binge eating and may become
depressed. Research has shown that people with binge eating disorder
report more health problems, stress, trouble sleeping, and suicidal
thoughts than people without an eating disorder do. People with
binge eating disorder often feel bad about themselves and may miss
work, school, or social activities to binge eat.
People with binge eating disorder
may gain weight. Weight gain can lead to obesity, and obesity puts
people at risk for many health problems, including:
- type 2 diabetes
- high blood pressure
- high blood cholesterol levels
- gallbladder disease
- heart disease
- certain types of cancer.
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 do not know they binge eat.
Should People with Binge
Eating Disorder Try to Lose Weight?
Many people with binge eating
disorder are obese and have health problems because of their weight.
They should try to lose weight and keep it off; however, research
shows that long-term weight loss is more likely when a person has
long-term control over his or her binge eating.
People with binge eating disorder
who are obese may benefit from a weight-loss program that also
offers treatment for eating disorders. However, some people with
binge eating disorder may do just as well in a standard weight loss
program as people who do not binge eat.
People who are not overweight
should avoid trying to lose weight, because it sometimes makes their
binge eating worse.
How
can People with Binge Eating Disorder Be Helped?
People with binge eating disorder
should get help from a health professional such as a psychiatrist,
psychologist, or clinical social worker. 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
teaches them how to change the way they act in tough situations.
It also helps them feel better about their body shape and weight.
-
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.
The methods mentioned here seem to
be equally helpful. Researchers are still trying to find the
treatment that is the most helpful in controlling binge eating
disorder. Other therapies being tried include dialectical behavior
therapy, which helps people regulate their emotions; drug therapy
with the anti-seizure medication topiramate; weight loss surgery
(gastrointestinal surgery); exercise used alone or in combination
with cognitive-behavioral therapy; and self-help. Self-help books,
videos, and groups have helped some people to control their binge
eating.
You are not alone
If you think you might have binge
eating disorder, it is 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 for
you. The good news is that most people do well in treatment and can
overcome binge eating.
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