Binge Eating Disorder – Overeating could be more than just an indulgence

By Anne Wilfong, R.D., L.D. – April 9, 2013

How familiar are you with binge eating disorder?  Binge eating disorder (BED) is the most common eating disorder in the United States. While everyone has overeaten at some point, those with BED have recurring episodes of uncontrolled eating followed by feelings of shame and guilt (it is important to note that those with BED do not follow an overeating episode with a form of purging).  Awareness for BED has been steadily increasing and it is widely expected to have its own specific category in the upcoming edition of the American Psychiatric Associations Diagnostic and Statistical Manual of Health and Mental Disorders (DSM V) to be released in May of this year.  According to the proposed DSM V entry, there is a sense of lack of control over eating during a binging episode.  Binges are characterized by three or more of the following:
 

  • Eating much more rapidly than normal,
  • Eating until feeling uncomfortably full,
  • Eating large amounts of food when not feeling physically hungry,
  • Eating alone because of embarrassment over how much one is eating, and
  • Feeling disgusted with oneself, depressed, or very guilty afterward.

These symptoms typically occur at least once a week for three months or more in patients diagnosed with BED.

Many of the side effects of BED, such as diabetes, heart disease, high blood pressure, and cholesterol are associated with obesity, but those with BED may be at a healthy body weight.

After reading the description for BED, you may wonder if your eating behaviors are indicative of BED because just last week you ate a party-sized bag of chocolate or polished off your plate (and then your spouse’s plate) at dinner.  The question is, did you feel in control of your eating while you were inhaling these large amounts of food?  Repeated overeating coupled with a feeling of lack of control and feelings of embarrassment or shame, or attempts to hide the evidence so no one will know what you ate may be signs of a struggle with BED.

Different things trigger binges in different people but, in general, binges can be caused by unsettling emotions, food restrictions, or particular foods (sugar, chocolate, baked goods, salty foods, fast foods, etc.).  For example: You feel extremely sad about a fight you had with your spouse.  Next, you find yourself eating large amounts of food very quickly and discreetly.  Binging like this temporarily provides distraction from the distress you were feeling and, therefore, gives you some relief.  Eventually, however, the binge will end and the unsettling feeling/emotions rush back, combined with additional guilt and shame as well as the physical feeling of over fullness.  Another example may look like the following: You have created a food rule such as “I will not eat any white flour foods.”  The minute you find yourself eating the forbidden food, you feel very guilty and have a “what the heck” response.  As a result, you try to eat as much as possible as quickly as possible because, as soon as you are done eating, the food rule will be reestablished with even more vigor.  With BED, these binge episodes occur at least once a week for three months.

One of the most common reactions to a binge is restricting food at the next meal or snack in order to make up for the extra calories consumed during a binge.  Not only does this not work, it also quite possibly sets you up for another binge because you allow yourself to get excessively hungry, which inevitably leads to overeating.

Just as awareness around BED has increased, treatment options and success stories are equally encouraging.  Learning to start and stop eating based on your hunger and fullness level and abolishing food rules and trusting yourself around food are first steps toward developing a healthy relationship with food. Figuring out how to work through the emotions you may be trying to bury with food is another vital step in recovery. There are many therapists in Austin who specialize in working with BED, and you can check out Austin Eating Disorders Specialists at austineds.com to contact someone who can help you toward the path to recovery.

 

 
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