Binge-Eating Disorder

Binge eating disorder is compulsive overeating. People who binge use food as a way to cope with unwanted emotions or stress. Available treatments for binge eating include individual counselling, nutrition counselling, group/family therapy, and sometimes medication.

SYMPTOMS OF BINGE EATING DISORDER

Most people overeat from time to time, and many people believe they frequently eat more than they should. Eating large amounts of food, however, does not mean that a person has binge eating disorder. Most people with serious binge eating problems have some of the following symptoms that occur at least once a week for at least three months:

  • Frequent episodes of eating what others would consider an abnormally large amount of food
  • Frequent feelings of being unable to control what or how much is being eaten
  • Eating much more rapidly than usual
  • Eating until uncomfortably full
  • Eating large amounts of food, even when not physically hungry
  • Eating alone out of embarrassment at the quantity of food being eaten
  • Feelings of disgust, depression, or guilt after overeating
  • Fluctuations in weight
  • Feelings of low self-esteem
  • Frequent dieting

CAUSES

The exact cause of binge eating disorder is still unknown, but researchers are beginning to understand the factors that lead to its development. Like other eating disorders, binge eating disorder seems to result from a combination of psychological, biological, and environmental factors. Binge eating disorder has been linked to other mental health disorders. Nearly half of all people with binge eating disorder have a history of depression, although the exact nature of the link is unclear. Many people report that anger, sadness, boredom, anxiety, or other negative emotions can trigger an episode of binge eating. Impulsive behaviour and other psychological problems also seem to be more common in people with binge eating disorder.

Eating disorders, including binge eating disorder, can sometimes run in families, suggesting that susceptibility to eating disorders might be inherited. Researchers also are looking into the possible abnormal functioning of chemical messages to the brain involving hormones that regulate appetite (such as leptin and ghrelin) and proteins that regulate blood sugar and body metabolism (such as adiponectin). People with binge eating disorder often come from families that overeat or put an unnatural emphasis on food; for example, they may use food as a reward or as a way to soothe or comfort, leading to binge eating as a learned behavioural response to stress.

Binge eating also sometimes can be an undesirable side effect of certain psychiatric or other medications that stimulate appetite and may interfere with people being able to sense when they are full after eating a meal.

Can Binge Eating Disorder Be Prevented?

Although it might not be possible to prevent all cases of binge eating disorder, it is helpful to begin treatment in people as soon as they begin to have symptoms. Also, teaching and encouraging healthy eating habits and realistic attitudes about food and body image also might be helpful in preventing the development or worsening of eating disorders.

COMPLICATIONS

When you overeat, you wind up with a sore, stuffed belly. Everyone feels like this from time to time. But if you have binge eating disorder, your eating habits could lead to serious problems that might last a lifetime. Here are four major health issues you should watch for. Learn what you can do about each one.

Weight Gain and Obesity

Weight gain is common when you binge eat. Two-thirds of those with the disorder are overweight. You put on extra pounds by eating lots of food in a short period and not burning the calories off with exercise. A lot of people who binge feel bad about their weight, too. This leads to low self-esteem, which can cause more overeating. Being overweight or obese can also raise your chances of getting long-term health problems such as:

  • Breathing that stops many times during the night (sleep apnoea)
  • Cancer
  • Heart disease
  • High blood pressure
  • Type 2 diabetes
  • Arthritis

Your clothes will start to feel snug. The numbers on your bathroom scale will go up. Your doctor will check to see how much body fat you have by measuring:

  • The ratio of your weight to your height (body mass index, or BMI)
  • How big your belly is using a tape measure placed above your hips and around the middle of your body (waist circumference)

You will get tests to check your blood pressure, blood sugar, and cholesterol levels — all of which can be harmed by weight gain.

What to Do About It

Treatment for binge eating starts with figuring out why you’re overeating. You need to do this before you try to lose weight. Your doctor and therapist can help you get started. Next, plan to talk to a dietitian to come up with a diet and exercise programme you can stick with. Ask them for tips on how you can stay at a healthy weight.

Heart Disease

Being overweight makes it harder for your heart to pump blood to the lungs and body. Having a lot of fat, especially around the belly, raises your risk of high blood pressure, high cholesterol, and high blood sugar. All of these things boost your risk for heart attack and stroke. 

How to Watch for It

Sometimes heart disease doesn’t have symptoms, so it’s hard to know that you have it. Here are a few warning signs:

  • Chest pain
  • Dizziness or fainting
  • Fast heartbeat
  • Shortness of breath
  • Sweating

Always call 911 or go to an emergency room if you have sudden chest pain or other symptoms of a heart attack.

What to Do About It

Eat a healthy diet and get regular exercise. These things protect your heart from damage and lower your risk of heart disease. Ask your doctor or dietitian for ways to eat better and exercise safely. You might also need medicine to lower your blood pressure, cholesterol, and blood sugar.

Type 2 Diabetes

People who binge eat are more likely to get type 2 diabetes, studies show. Diabetes can be a lifelong disease that requires ongoing treatment. If you have this condition, binge eating can make your blood sugar harder to control.

How to Watch for It

Look for these symptoms of type 2 diabetes:

  • Blurry vision
  • Extreme hunger or thirst
  • Fatigue
  • Need to pee more often than usual
  • Numbness or tingling in your hands and feet

What to Do About It

Check your blood sugar as often as your doctor suggests. If you don’t know how to do this at home, ask your doctor to show you. Also, ask her to tell you’re your blood sugar goal should be. Here are some ways to control your blood sugar:

  • Eat more fruits, vegetables, and whole grains. Eat less fat and sugar.
  • Drink water instead of fruit juice or soda.
  • Exercise on most days of the week.
  • Take any diabetes medicines your doctor recommends.

Depression and Other Mood Problems

Depression and anxiety are more common in people with binge eating disorder. A lot of people who binge eat do so to boost their mood. This can lead to guilty feelings that just make you binge more.

How to Watch for It

Eating too much when you’re not hungry might be a sign that you’re trying to numb your emotions. You might also feel:

  • Hopeless or helpless
  • Guilty
  • Like you have no interest in activities you once loved
  • Sad or empty all the time
  • Tired, or like you have no energy

What to Do About It

Some treatments for binge eating disorder can stop both the unhealthy eating and the sad mood that sometimes comes with it. These include:

  • Cognitive behavioural therapy, which helps you feel better about yourself and stops the negative feelings that lead you to binge
  • Antidepressants, which can improve your mood and might also help against bingeing

When You Need to Go to the Hospital

Rarely, health problems from binge eating disorder can be serious enough that you need to get treated in a hospital. Here are some signs you need medical help right away:

  • You’ve suddenly gained or lost a lot of weight in a very short period.
  • You’ve thought about hurting yourself.
  • You can’t change the way you eat, even with help from doctors, family, and friends.
  • You feel depressed or anxious.
  • You’ve been using drugs or alcohol to cope with your emotions.

DIAGNOSIS

Diagnosing eating disorders can be challenging, because secrecy, shame, and denial are characteristics of the conditions. As a result, the illness can go undetected for long periods of time. In most cases, binge eating disorder is discovered when a person requests professional help with weight loss or seeks treatment for an obesity-related health problem, or an associated mental health problem like depression or anxiety. If binge eating disorder is suspected, the doctor will likely begin an evaluation by performing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose eating disorders, the doctor might use various diagnostic tests, such as blood and urine tests and other laboratory measures, to rule out physical illness as the cause of the symptoms. These tests may also help detect medical consequences of an eating disorder, such as changes in digestive enzyme levels, liver functioning, or electrolytes (the normal salt concentrations in the blood). The person may also be referred to a psychiatrist or psychologist, health care professionals specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an eating disorder.

TREATMENT

Getting Started

Deciding to seek treatment for binge eating disorder is the first step toward getting better. Therapy can make you feel better about yourself and help you learn ways to stop overeating. Research shows that 70% of people who are treated for the disorder stop bingeing. That’s a higher success rate than for other eating disorders.

Here’s how to get started.

Step One: Talk to your doctor.

If you have a good relationship with your doctor, ask for a referral to a health care professional who specialises in eating disorders. You might feel embarrassed, but you shouldn’t. Chances are your doctor sees other patients who have it, too. Binge eating is the most common eating disorder. Your doctor can also test you for other problems that may be related to your bingeing, like depression or anxiety, and weight-related issues like high blood pressure. Catching these things early can help prevent complications. If you don’t want to discuss your bingeing with your primary care doctor, contact a psychologist or psychiatrist who specialises in eating disorders. Major medical centres, hospitals, and eating disorder treatment centres are good places to find binge eating experts. The National Eating Disorders Association and the Binge Eating Disorder Association offer search tools that can help you find a specialist near you. 

Step Two: Begin treatment.

Talk to your doctors and therapists about the type of treatment that would be best for you. There are several treatment options.

  • Outpatient treatment involves regular therapy sessions for a few months. You do not need to stay overnight at a hospital or medical centre. Experts usually recommend starting with this type of care. Most people with binge eating disorder do well with this therapy alone.
  • Medications are sometimes prescribed along with therapy. They may include stimulants, antidepressants, or anti-seizure The ADHD stimulant medication lisdexamfetamine dimesylate (Vyvanse) has proven effective in decreasing the desire to binge.
  • Inpatient treatment is round-the-clock care at a hospital or medical centre. This might be needed if you have other serious health problems that are related to your binge eating disorder, like severe depression or suicidal

Step Three: Don’t worry about your weight.

Though your therapist or doctor will probably tell you this, it’s worth repeating: Don’t focus on your weight or go on a diet. Doing so raises the chances that you’ll binge. That’s because cutting back on calories or avoiding certain foods makes you feel deprived. Those feelings might make you want to overeat.

Step Four: Get support.

Connecting with other people who also have binge eating disorder can be helpful. You can do this by attending group therapy, finding an online support group, or even just chatting regularly with someone else who’s going through treatment. Having a “partner” to call when you have the urge to binge can help you stay strong. Hearing from other people who stopped bingeing can motivate you, too.

Step Five: Stick with it.

You may not see improvement in your first weeks of treatment. Know that most people reduce their bingeing within six weeks or so and continue to improve over time. If you stick with treatment and still don’t have the results you’re hoping for, don’t give up. There are many treatment options you can try. Sometimes, just switching therapists or going from individual therapy to group therapy can make the difference.

Credit: WebMD.