Binge eating disorder

Definition

Binge eating disorder (BED) is characterized by loss of control over eating behaviors. The binge eater consumes unnaturally large amounts of food in a short time period, but unlike a bulimic, does not regularly engage in any inappropriate weight-reducing behaviors such as excessive exercise , induced vomiting , or taking laxatives following the binge episodes.

Description

BED typically strikes individuals sometime between adolescence and the early twenties. Because of the nature of the disorder, most BED patients are overweight or obese. Studies of weight loss programs have shown that an average of 30 percent of individuals enrolling in these programs report binge eating behavior.

Demographics

Binge eating affects an equal numbers of females and males. Although there are no good statistics on how many children suffer from the condition, an estimated 1 to 2 million Americans of all ages are binge eaters. Many of them report that their condition started in childhood.

Causes and symptoms

Binge eating episodes may act as a psychological release for excessive emotional stress. Other circumstances that may make a child or adolescent more likely to engage in binge eating include heredity and certain psychological affective disorders such as major depression. BED patients are also more likely to have a comorbid (co-existing) diagnosis of impulsive behaviors such as compulsive buying, post-traumatic stress disorder (PTSD), panic disorder, or personality disorders .

Individuals who develop BED often come from families who put an extreme emphasis on the importance of food as a source of comfort in times of emotional distress. Children with BED may have been taught to clean their plates regardless of their satiety or that their finishing a meal makes them a "good" girl or boy. Cultural attitudes towards beauty and thinness may also be a factor in whether a person binges.

During binge episodes, BED patients experience a definite loss of control over their eating. They eat quickly and to the point of discomfort even if they are not hungry. They typically binge alone two or more times a week and often feel depressed and guilty when the episode concludes.

Diagnosis

Binge eating disorder is usually diagnosed and treated by a psychiatrist and/or a psychologist. In addition to an interview with the child, personality and behavioral inventories, such as the Minnesota Multiphasic Personality Inventory (MMPI), may be administered as part of the assessment process. One of several clinical inventories, or scales, may also be used to assess depressive symptoms, including the Hamilton Depression Scale (HAM-D) or Beck Depression Inventory (BDI). These tests may be administered in an outpatient or hospital setting.

Treatment

Many BED individuals binge after long intervals of excessive dietary restraint; therapy helps normalize this pattern. The initial goal of BED treatment is to teach the patient to gain control over the eating behavior by focusing on eating regular meals and avoiding snacking. Cognitive-behavioral therapy (learning new behavior), group therapy, or interpersonal psychotherapy may be employed to uncover the emotional motives, distorted thinking, and behavioral patterns behind the binge eating.

Because the prevalence of depression in BED patients is high, treatment with antidepressants may also be prescribed. Once the binge eating behavior is curbed and depressive symptoms are controlled, the physical symptoms of BED can be addressed. The overweight BED patient may be placed on a moderate exercise program and a nutritionist may be consulted to educate the patient on healthy food choices and strategies for weight loss.

Prognosis

If left unchecked, the poor dietary habits and obesity that are symptomatic of BED can lead to serious health problems, such as high blood pressure, heart attacks, and type 2 diabetes. BED is a chronic condition that requires ongoing medical and psychological management. Some of these conditions such as diabetes can occur in young people. To bring long-term relief to the BED patient, it is critical to address the underlying psychological causes for binge eating behaviors. It appears that up to 50 percent of BED patients stop bingeing with cognitive behavioral therapy.

Parental concerns

Binge eating can lead to excessive weight, a risk for serious current and future diseases including heart disease, type 2 diabetes, and cancer . Overweight children also suffer from psychological distress, particularly when teased or shunned by peers. Parents should be aware that antidepressant drugs used to treat BED as of 2004 contain a warning that recommends close observation of pediatric patients treated with the drugs. In some cases, worsening depression or emergence of suicidal tendencies may occur.

See also Bulimia nervosa .

Resources

BOOKS

Gay, Kathlyn. Eating Disorders: Anorexia, Bulimia, and Binge Eating. Berkeley, NJ: Enslow Publishers, 2003.

Matthews, Dawn D. Eating Disorders Sourcebook: Basic Consumer Health Information about Eating Disorders . . . Detroit, MI: Omnigraphics, 2001.

Parker, James N., et al. The 2002 Official Parent's Sourcebook on Binge Eating Disorders. Boulder, CO: netLibrary, 2002.

ORGANIZATIONS

American Psychiatric Association. 1400 K Street NW, Washington DC 20005. Web site: http://www.psych.org .

American Psychological Association (APA). 750 First St. NE, Washington, DC 20002–4242. Web site: http://www.apa.org.

Eating Disorders Awareness and Prevention. 603 Stewart St., Suite 803, Seattle, WA 98101. Web site: http://www.edap.org.

National Eating Disorders Association (NEDA). 603 Stewart St., Suite 803, Seattle, WA 98101. Web site: http://www.nationaleatingdisorders.org.

Overeaters Anonymous World Service Office. 6075 Zenith Ct. NE, Rio Rancho, NM 87124. Web site: http://www.overeatersanonymous.org.

Christine Kuehn Kelly