Binge
eating disorder is a condition that millions of Americans may have.
People with binge eating disorder often eat large amounts of food and
feel that they can't control their eating.
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.
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.
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.
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.
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.
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.
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.
The following programs are for patients with binge eating disorder or compulsive overeating.
Grilo,
CM. "The assessment and treatment of binge eating disorders."Journal
of Practical Psychiatry and Behavioral Health, 1998: Vol. 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.
Stunkard AJ. "Eating patterns and obesity."
Psychiatric Quarterly, 1959: Vol. 33, pp. 284-295. This classic paper
provides one of the first descriptions of binge eating in obese
individuals.
Wilfley DE, Wilson GT, Agras WS. "The clinical
significance of binge eating disorder." International Journal of Eating
Disorders, 2003: Vol. 34 Suppl., pp. S96-106. This article, written for
health professionals, reviews the literature on binge eating disorder
to examine whether it is serious enough to be classified clinically as
a mental health disorder.
