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An Introduction To Binge Eating Disorder
|Binge Eating Disorder is a psychiatric disorder under the category of Eating Disorder NOS in which a subject:|
* recurrent episodes of excessive eating
* consumes unusually large amount of food at one time
* eats much more quickly during binge episodes than during normal eating episodes
* eats until physically uncomfortable
* does not regularly engage in compensatory behaviors to counteract calories eaten (i.e., excessive exercise, vomiting, use of laxatives)
* often have chaotic eating patterns, binges and overeats
* often eats alone during periods of normal eating, owing to feelings of embarrassment about food
* feels disgusted, depressed, or guilty after binge eating
Binge Eating Disorder (BED) is currently listed under Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-IV-TR. In binge eating disorder, the person does not regularly engage in compensatory behaviors, such as, vomiting, fasting or doing strenuous exercise after binge eating. Another eating disorder category under Eating Disorder NOS meets all the criteria for Bulimia except that binge eating and compensatory behaviors are less than two times per week or for less than three months. Often, people with Binge Eating Disorder are overweight or obese. Studies reveal that weight loss programs report 30% of their enrollees report binge eating behaviors. Binge eating is also an element of another eating disorder, bulimia nervosa. The formal diagnosis criteria are similar: at least two binges per week for an extended period of time  In binge eating disorder, by contrast, the person does not purge, fast or engage in strenuous exercise after binge eating. Additionally, people with bulimia are typically of normal weight or may be slightly overweight (the purging, etc., have little to no effect on the subject's body fat), whereas people with binge eating disorder are typically overweight or obese.
Binge eating disorder is similar to, but it is distinct from, compulsive eating. People with binge eating disorder do not have a compulsion to overeat and do not spend a great deal of time fantasizing about food. On the contrary, some people with binge eating disorder have very negative feelings about food. As with other eating disorders, binge eating is an expressive disorder - that is, the disorder is an expression of a deeper psychological problem.
It is actually hotly contested whether binge eating disorder has its own diagnosis. Some believe that it is a milder form, or subset of bulimia nervosa, but others argue that it is its own distinct disorder. Currently, the DSM-IV-TR categorizes it under EDNOS simply stating that more research is needed.
Most people with this problem are either overweight or obese (discussed below), but people of normal weight can also 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 is found in all ethno-cultural and racial populations.
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 more often.Causes
No one knows for sure what causes binge eating disorder. More than half of all people with binge eating disorder have a history of major depression. In 2002, the American Psychiatric Association was considering BED as it's own distinct psychiatric disorder. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known for sure.
Emotional cues such as; anger, sadness, boredom, anxiety, and as noted above, depression can trigger binge eating. Impulsive behavior (for example, compulsive shopping), post-traumatic stress disorder (PTSD), panic disorder or personality disorder can be more common in people with binge eating disorder. However, many people also claim that bingeing occurs regardless of their mood. Stress may also play an important role in understanding BED. Due to excessive stress, binge eating may act as a psychological and physiological release.
Individuals with BED are reported to come from families that put an undue emphasis on the importance of food and using food as a comfort to alleviate stress. Focus on cleaning one's plate and cultural attitudes towards thinness also play a role in those with BED.
Unclear as if dieting and binge eating are related, some studies have shown that about half of all people with BED had binge episodes before they started to diet.
Although the research is in the early stages, researchers are studying how brain chemicals and metabolism might affect binge eating disorder.Complications
People with binge eating disorder can become malnourished due to a lack of proper nutrition. Binging episodes usually include foods that are high in sugar and/or salt, but low in healthier nutrients.
People with binge eating disorder often report feelings of guilt and depression after binge eating.
People who are obese and also have binge eating disorder are at risk for type 2 diabetes, high blood pressure, high blood cholesterol levels, gallbladder disease, heart disease and 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.
Individuals, who are obese with binge eating disorder, often feel bad about themselves, and often 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 do not even know they binge eat.Dieting
People who are not overweight should avoid dieting because it can often worsen their binge eating behaviors. Dieting defined here is skipping meals, restricting daily food intake or avoiding certain food groups (i.e., carbohydrates or fats). Many people with binge eating disorder are obese and have health problems because of their weight. People with binge eating disorder who are obese may find it harder to stay on a weight-loss program. They also may lose less weight than other people, and may regain weight more quickly due to a slowing of the metabolism. Dieting can negatively impact individual with such psychological problems as depression, out of control behavior, and relationship problems. These people most likely will need psychological treatment as they address their weight issues.Treatment
People with binge eating disorder have often had long periods of dieting. Whether or not they want to lose weight, should get help from a health professional specialist such as a psychiatrist, psychologist, or clinical social worker for their underlying psychological issues and normalize eating patterns. Even those who are not overweight are usually upset by their binge eating, and treatment can help them. Treatments recommended are cognitive-behavioral therapy, interpersonal therapy and medication management. Cognitive-behavioral therapy educates individuals how to keep track of and change their unhealthy eating habits. The individual needs to eat regular meals and snacks to normalize their eating patterns. It also teaches them individuals how to change their thoughts so they can effectively deal with their emotions. Interpersonal psychotherapy also can help these individual to build effective relationships and make necessary changes in problem areas. Drug therapy, such as antidepressants, may also be helpful to decrease depression or anxiety to help give the individuals more of a chance to utilize their newfound coping skills.
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 individuals who are overweight, a weight-loss program utilizing exchanges 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 disorder.
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Officer of The Bella Vita established in
1985. She is a nationally renowned
expert in the treatment of anorexia.