What is Binge Eating Disorder?

What is Binge Eating Disorder?

By The Fix staff 07/30/14
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Recently recognized by the American Psychiatric Association as one of the three major eating disorders, binge eating is characterized by quick bursts of uncontrolled eating followed by extreme distress due to a lack of control, and generally occurs at least once a week over a period of three months. 

According to the National Eating Disorders Association, binge eating disorder affects approximately 4% of the population and includes by far the highest percentage of men to women ratio of all eating disorders, with 60% of all binge eaters being women and 40% men.  By contrast, anorexia and bulimia predominantly affect women.

What Behaviors/Factors Define BED?

People afflicted with binge eating disorder consume excessive amounts of food in one sitting – often 3,000-5,000 calories and sometimes in excess of 10,000 calories – in order to self-medicate the psychological anxiety disorder that motivates their behaviors. 

Binge eaters don’t feel shame or have the same anxiety about weight gain and body shape that bulimics experience, nor do they avoid nutrition completely as do anorexics. Binge eaters have a hot-and-cold relationship with food. They aren’t afraid of eating until they realize how much they’ve consumed, when it’s too late to do anything about it. Because of this inability to control their urges to binge, they often experience extreme anxiety and become depressed after a binge-eating episode because they can’t figure out how to stop it. 

Restricting food or denying specific food cravings can bring on a binge eating episode, which usually occurs over a minimum two-hour period and ends due to stomach cramping, interruption by a friend or family member, running out of food or falling asleep. Certain routines, social situations or specific restaurants can also trigger an incident, as can simply being bored at home alone. 

What transpires following a binge eating episode, however, determines whether a person suffers from BED or from bulimia. Those who seek to purge the excess calories from their system are considered to be bulimic by doctors and therapists. Those who do nothing and feel no compulsion to purge suffer from binge eating disorder.

How Does BED Affect the Body?

Binge eaters can be average weight, overweight, or even obese and are usually apathetic toward their appearance and weight. They don’t experience the same need to purge excess calories as those who suffer from anorexia and bulimia. Because of this, Jennifer Gaudiani, associate professor of medicine and assistant medical director for the Acute Center for Eating Disorders at Denver Health, said binge eating doesn’t always reveal itself through a person’s weight. 

“There’s a whole wide spectrum of normal. You can be sick and be underweight, and you can be sick and be overweight,” she states. 

Warning Signs 

People with disordered eating habits tend to vehemently deny the existence of their condition and go to great lengths to conceal it, often isolating themselves when they eat. They also exhibit emotional symptoms such as depression or anxiety because of the stress they experience over their loss of control.

BED frequently goes undetected because doctors miss the symptoms exclusive to eating disorders and incorrectly diagnose a different condition. It’s fairly common for less experienced doctors to examine patients for unexplained stomach pain or sore throats without realizing their patient is suffering from BED or bulimia. 

BED warning signs include: 

    • Hidden stashes of junk food.
    • Eating in secret.
    • Going alone on unexpected food runs. 
    • Disappearance of food.
    • Excess food wrappers or containers in the trash.


Tests

Since the majority of binge eaters are obese – which means more than 40% of their total body weight is made up of fat – most physicians first conduct a Body Mass Index to determine obesity. Although obesity is not a requirement for binge eating disorder, it is one of the warning signs that could indicate binge eating behaviors exist. 

The tests that identify binge eating disorder in patients are many of the same that diagnose bulimia, minus those that indicate purging. Complete blood counts, B12 and folic acid tests, cholesterol checks and thyroid tests all help diagnose someone with this disease.

Long-Term Effects

Since binge eaters don’t purge, they’re more likely to develop obesity as a long-term complication because their bodies are left with excess calories that convert to fat. Health consequences of the condition include fatigue, high blood pressure, heart disease, high cholesterol, diabetes and gallbladder disease, most of which are the same long-term complications from obesity. 

Coexisting Psychological Conditions

Struggling with their inability to stop a binge eating episode from occurring, or end an episode once it’s begun, causes many binge eaters to develop depression. Others turn to alcohol or substance abuse to alleviate anxiety over their loss of control. 

Treatment

Of the three major eating disorders, BED and bulimia are most misdiagnosed because the outward signs of a serious disease are minimal or are misinterpreted as normal-to-them or even excess body weight. Although the number of people diagnosed with eating disorders has significantly increased over the past 20 years, experts estimate that close to 50% of all cases are never diagnosed.

As with other eating disorders, cognitive behavior therapy is the most popular method of treating BED because it allows patients to express their thoughts and feelings with a therapist while helping them learn to change the habits and behaviors that trigger binge eating episodes. Working with a nutritionist often helps patients manage their harmful eating habits, as well.

Many doctors treating BED prescribe mood-stabilizing medications that relieve anxiety by increasing levels of serotonin to the brain. These selective serotonin reuptake inhibitors (or SSRIs) are found in medications like Prozac, Zoloft and Sarafem, which can help alleviate depression, panic attacks and compulsive behaviors exhibited by binge eaters. 

Anti-seizure medications containing the drug topiramate have also shown positive results, though enough patients have experienced a range of side effects that include fatigue, dizziness and tingling sensations that it is not as widely prescribed. 

When treating binge eating behaviors – particularly when the patient is overweight – it’s important that treatments exclude any type of dieting. Since dieting and restricting are two behaviors that often precipitate the development of this type of disordered eating, health experts frequently target alternate methods of improving the person’s health and body image that don’t involve dieting. Failure to recognize this aspect of treatment in patients can exacerbate the eating disorder and be detrimental to the recovery process.

Stress management techniques have also been helpful in reducing anxiety and decreasing the frequencies of binge eating. Engaging in crafts or hobbies and relaxing the body through yoga and massage have shown positive results in keeping binge eaters’ minds off thoughts that trigger episodes. 

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