Now regarded as a psychiatric problem unto itself, binge-eating disorder is, essentially, bulimia without the purging. Binge-eaters do not force themselves to vomit, take laxatives, or otherwise rid themselves of their food, and hence, are almost always extremely overweight. They are also referred to as compulsive overeaters.
Some degree of binge-eating takes place in a substantial percentage of people in weight-control programsanywhere from 15 to 50 percent, according to various studies. General surveys have found that as many as four percent of Americans may engage in binge-eating, often after completing a weight-control program or attaining weight goals. Dieting itself does not seem to cause binge eating in someone who is not already predisposed to the problem. However, with nearly one-quarter of Americans now meeting criteria for obesity (body mass index greater than 30), the chance of developing the disorder is clearly on the increase. Forty percent of binge-eaters are male.
When Does Binge-Eating Become a Disorder?
Because binge-eating disorder has only recently been recognized as a true illness, it has not been studied to the same extent as anorexia and bulimia. The official diagnostic criteria are still viewed as general guidelines, and shouldn't be considered definitive.
Binge-eaters eat large amounts of food, sometimes when they are not even hungry. They usually eat alone, feeling embarrassed about the amount they consume. After a binge, they often have feelings of self-disgust, guilt, or depression.
For those with a true disorder, the episodes occur, on average, at least twice a week for at least six months. Like bulimics, people with binge-eating disorder are likely to eat very quickly, continuing even after they feel uncomfortably full. While bingeing, compulsive overeaters feel they are unable to stop.
What Happens to Your Mind and Body
Studies have found that people with binge-eating disorder are more prone to major depression, anxiety disorder, and other psychiatric conditions. They are also more likely to have a family history of substance abuse. However, doctors are not sure whether binge-eating causes the psychiatric problems or vice versaor even if there is any relation at all.
Binge-eaters often suffer from frustration and low self-esteem, and may connect other difficulties, for example, problems with relationships or employment, to their eating habits. The secretive nature of their disorder may cause social isolation, as it does for bulimics.
The most common physical consequence of binge-eating is weight gain, and often obesity. Along with this comes increased risk of a number of diseases associated with being overweight: high blood pressure, clogged blood vessels, heart attack, stroke, diabetes, and sometimes bone and joint problems.
For a binge-eater, food is an addictionin some ways harder to treat than an addiction to drugs or alcohol. If you have a substance abuse problem you can learn to completely avoid drugs or alcohol. But it's impossible to totally give up food. Moreover, certain foods that are likely to cause eating problemssuch as sweets or high-fat foods like potato chipsare often part of everyday social activities. If you are a binge-eater, it can be very difficult indeed to successfully negotiate these potential pitfalls. Learning what triggers a binge and substituting a healthier reaction when you encounter a trigger can be a major help.
Like other eating disorders, binge-eating can be treated with behavioral therapy and psychotherapy. A number of medications have also been found to help, including fluvoxamine (Luvox), desipramine (Norpramin), sertraline (Zoloft), and topiramate (Topamax). In addition, a prescribed exercise regimen can be a valuable part of treatment. However, support and self-help groups are especially important. Overeaters Anonymous, for instance, is a 12-step program that is often helpful for those with binge-eating disorder. Remember, though, that the habits that mark this disorder have often developed over a long period of time, and quick fixes are unlikely.
The most extreme treatment for intractable obesity is surgery, either stomach stapling or some variation that makes it virtually impossible to ingest large amounts of food. The latest innovation is an adjustable band that can be implanted around the stomach through a very small incision. Surgery, however, is recommended for only the most highly motivated patients.
Therapy is often a long-term process, punctuated with relapses. Still, just as with alcohol or drugs, it is possible to control this most insidious of all addictions.
