Binge Eating Disorder

What is Binge-Eating Disorder?
Binge-Eating Disorder is characterized by recurrent episodes of binge eating, but without related behaviors such as purging, fasting, or excessive exercise. Body weight may vary from normal to mild, moderate, or severe obesity. Individuals with this eating pattern may report eating or weight interfering with relationships with other people, work, and the ability to feel good about themselves. The onset of binge eating typically is in late adolescence or in the early 20's, often coming soon after significant weight loss from dieting.

What Causes Binge-Eating Disorder?
Some individuals report binge eating is triggered by "dysphoric" moods, such as depression and anxiety. Others are unable to identify specific causes but may report a nonspecific feeling of tension that is relieved by the binge eating. Some individuals describe feeling "numb" or "spaced out." Many individuals eat throughout the day with no planned meal times. Most have a long history of repeated efforts to diet and feel desperate about their difficulty in controlling food intake. Some continue to make attempts to restrict calorie intake, whereas others have given up all efforts to diet because of repeated failures.

Eating disorders arise from a combination of long-standing psychological, interpersonal, genetic, and social conditions. Feelings of inadequacy, depression, anxiety, and loneliness, as well as troubled family and personal relationships, may contribute to the development of an eating disorder. The relentless idealization of thinness and the "perfect body" in our culture is often a contributing factor.

Once started, eating disorders may become self-perpetuating. Dieting, bingeing, and purging are destructive attempts for some people to cope with painful emotions and to feel as if they are in control of their lives. Actually, these behaviors undermine physical health, self-esteem, competence, and control.

Signs and Symptoms

. Recurrent episodes of binge eating
. A sense of lack of control over eating
. 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 being embarrassed by how
  much one is eating
. Feeling disgusted with oneself, depressed, or very
  guilty after overeating
. Marked distress regarding binge eating

Treatment Options
Clinical eating disorders, and some borderline conditions, require the care of a trained professional, preferably with expertise in the treatment of eating disorders. The most effective and long-lasting treatment is some combination of psychotherapy, careful attention to nutritional needs, and medical care--which may include medication. Ideally, this treatment should be tailored to the individual and will vary according to both the severity of the disorder and the client's particular problems, needs, and strengths.

Treatment must address both the eating disordered symptoms and underlying psychological, interpersonal, and cultural concerns. Exclusive attention to either symptoms or underlying causes may impede the recovery process. Treatment is typically on an outpatient basis and often includes individual, family, and/or group therapy. Psychiatric medication, support groups, or nutritional counseling are useful adjuncts for some individuals.

Hospitalization is recommended when an eating disorder has led to physical problems that may be life-threatening, or when the eating disorder is associated with severe psychological or behavioral dysfunction. A specialized eating disorders inpatient unit or day hospital may be the best choice when hospitalization is needed. Treatment can be a long and costly struggle. Sometimes, in spite of the best efforts, treatment is not successful. In such cases, individuals remain chronically symptomatic, or more tragically, death occurs as a result of the physical or psychological damage incurred. Therefore, the very best treatment for eating disorders involves preventing them before they develop.

Information provided by Lisa Walsh, PhD, Psychologist at Pine Rest's Northeast Clinic. Information Sources: American Psychiatric Association; National Eating Disorders Association