Binge Eating Disorder - An outline of the struggle
Tuesday, April 21, 2009 at 8:52PM Although not everyone who is obese is affected by Binge Eating Disorder, it is a growing phenomenon, with about 2% of the population affected. BED also affects those individuals who are at a healthy weight. While BED is not the only road to obesity, I myself have experience with the disorder, so I feel it my duty to share this information with you all. I have never been treated for BED, although I am considering it now. I love feedback, and would love to know if this info is helpful!
Binge Eating Disorder
o May also be referred to as “Compulsive Overeating”
o 1992: Binge eating disorder first recognized as a diagnosis by the DSM-IV
Ø BED is listed in the DSM as “Eating Disorder ‘not otherwise specified’”, and the criteria are provisional
Ø Some Facts and FAQ’s about BED & other ED’s:
o www.eatingdisorderfoundation.org
o Here is a YouTube video with some explanation and discussion of BED and portion control: “binge eating”
Frequency of Occurrence & Risk Groups
- About 2-5% of US population has BED (Some experts now label BED as the most common of all ED’s)
- African-American girls: may be more vulnerable to develop BED vs. AN or BN
- Increased occurrences: varied socioeconomic and ethnic groups
- BED occurrence similar with men and women vs. higher occurrence with women of ED’s in general
- A growing number of people with an Intellectual Disorder (either institutionalized or living in the community) are stated to be either suffering from an ED or are obese.
Risk Factors
- 80% of US women unhappy with weight/physical appearance
- 95-98% of “dieters” fail and regain their weight back; sometimes gain even more weight after
- History of depression, substance abuse or difficult coping with issues like anger, stress and worry
- History of sexual abuse
- Extreme pressure from media glamorization of super thin celebrities and supermodels
Ø Click here for some “Pro-ana” YouTube videos
· *As an aside, I wanted to mention how frustrating it was to discover that most of the shocking photos I used in the presentation were actually used in these videos (and others on YouTube) to depict the rail thin woman with AN as a desirable body image.
- Research is ongoing as to whether there are genetic factors involved with the causes of BED.
- A link between overeating and stress is a topic of new research.
Ø Hormones including cortisol and leptin may be involved.
Unrealistic Expectations...
Characteristics of BED
o As a “recovering binge eater”, I can comfortably state that a number of characteristics of binge eating are:
o Eating a large amount of food in a short period of time
§ Most times when you are not even physically hungry)
§ Binging is NOT followed by purging
§ The behavior is exhibited for at least twice a week for a period of at least six months.
o Eating past the point of satiety, most times to the point of feeling ill or uncomfortable
o Having feelings of guilt, regret, depression & disgust after binging
o Binging alone to avoid embarrassment by loved ones, co-workers, etc...
o Likely to be overweight or obese
o Obsessing over food: this includes daydreaming about a next meal or the feelings of regret over a recent binge
Ø Check out http://www.nursinglink.com for a more complete list of BED characteristics and the criteria for BED in the DSM-IV-TR.
o Physical features:
o Those with BED may be overweight, obese, or of normal weight and have no other physical signs of the disorder.
o Physical health issues/complications:
o Joint pain
o Type II Diabetes
o Sleep Apnea
o Panic attacks/Anxiety
o Heart Disease
o Emotional/Mental health issues:
o Depression
o Anxiety
o Panic Attacks
o Substance/Alcohol abuse
Ø For a more complete list of all health issues check here: http://www.mayoclinic.com
People with BED may also suffer from:
o Sleep eating or Nocturnal eating syndrome
o Body dysmorphic disorder
Diagnostic screenings and tests include:
- Physical exam (may include checking for heart problems, sleep apnea and gallbladder disease – all risks for people with BED)
- Lab tests including a “CBC” (complete blood count)
- Psychological exam
Treatment Options
o Medical needs: Although urgent medical need may be more associated with AN and BN, people suffering from BED may eventually need medical care for the above mentioned health issues/complications that result from years of binge eating and/or being overweight/obese.
o Therapies:
o Psychotherapies (Cognitive behavior therapy, Interpersonal therapy, dialectical behavior therapy, family therapy)
o Nutrition Intervention: A combination of nutritional therapy by a registered dietician and psychotherapy
o Medications: These medications may not be designated by the FDA for the treatment of BED.
§ Topamax (generic=Topiramate) – An anticonvulsant drug for control of seizures that may help people with BED. Serious side effects can occur though.
§ Atomoxetine – A prescription medication for the treatment of ADHD.
§ SSRI’s (Selective serotonin reuptake inhibitor) – A class of anti-depressants.
o If a person with BED is also overweight or obese, a weight management program is helpful. Some common weight loss programs include:
- www.jennycraig.com
- www.nutrisystem.com
- www.weightwatchers.com
- Ø From November 2004 until mid 2006, I was a member of Weight Watchers online. I lost almost 100lb in that period. I did not attend weekly meetings, and did not exercise much.-Jessica
- §www.sparkpeople.com & www.sparkrecipes.com
- I now use this website daily to track my food intake and exercise. The site is not a weight loss program per se, but an online health and fitness community with some great resources (weight tracker, meal plans, exercise demos and some great healthy recipes!) -Jessica
o Bariatric Surgery is an extreme option for those suffering from BED who unsuccessfully attempted weight loss. Patients have gone through initial counseling before making the decision to choose surgery as their option. Some variants of bariatric surgery include Gastric Bypass and Gastric Banding. This option is seen as controversial since it involves an elective surgery that could result in serious medical complications.
Prognosis
- Comparisons suggest that those suffering from BED have a higher “remission” rate than their counterparts suffering from BN.
- Using a combination of psychological (primarily cognitive behavior therapy), emotional and nutritional counseling, those suffering from BED can work towards changing their approach to food and nutrition. Self-esteem and body image are also important components to focus on.
Controversies with treatments
- *See medication Topiramate mentioned above
- The linked article “Binge-eating disorder: What's the best treatment?” takes a look at the two courses to first take when starting treatment for a BED. The debate stems over which issues to tackle first: psychological issues or weight issues?