Binge- Eating Disorder

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Binge- Eating Disorder

Binge- eating disorder is the most common eating disorder in the United States. It is an eating disorder that is distinguished by binging on food and purging it. It typically starts in the late teens to early twenties, although it can occur at any age. It is a chronic disease and can last for many years. Like other eating disorders, it is more common in women than men. However, it is the most common type of eating disorder among men. The disorder is more prevalent among individuals seeking weight-loss treatment than in the general population. Binge-eating can be difficult to detect because you can be of normal weight, but that does not mean an individual is not suffering from this disorder. There is effective treatment that can help you feel better about yourself, and adopt healthier eating patterns.

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Binge- Eating Disorder Defined

Binge- eating disorder is an eating disorder that is distinguished by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.

An essential feature of binge-eating disorder is recurrent episodes of binge- eating that must occur, on average at least once per week for 3 months. An “episode of binge eating” is defined as eating, in a discrete period of time, an amount of food that is definitely larger than most individuals would eat in a similar period of time under similar circumstances. An indicator of loss of control is the inability to refrain from eating, or to stop eating once started. Binge eating can also be planned. Some people describe dissociative quality during, or following, the binge-eating episodes. Binge-eating disorder occurs in normal- weight, overweight, and obese people. People with binge-eating disorder are typically ashamed of their eating habits and do whatever in their power to conceal their symptoms. Binge- eating is not about food, but related to an inability to handle emotional problems in a healthy manner.

Different Types of Binge- Eating Disorders:

There are not separate types of binge-eating disorder, but there are levels of severity. The minimum level of severity is based on the frequency of inappropriate compensatory behaviors. The level of severity may be increased to reflect the other symptoms and the degree of functional disability.

Mild: An average of 1-3 binge-eating episodes per week.

Moderate: An average of 4-7 binge-eating episodes per week.

Severe: An average of 8-13 binge-eating episodes per week.

Extreme: an average of 14 or binge-eating episodes per week.

Binge- Eating Disorder Causes:

Binge-eating disorder often begins in late teens, early 20's but can occur at any age. The onset of this disorder is often associated with feeling negatively about oneself holistically, not just in physical looks. Triggers like availability to binge food, stress and poor body self-image are aspects that can cause binge-eating disorders. If you have a history of dieting or restricting calories you are more susceptible to developing binge-eating disorder, especially if you have symptoms of depression. If your parents or siblings have or had an eating disorder, you are more at risk for developing a binge-eating disorder, implying it may be an inherited gene.

Binge- Eating Disorder Symptoms:

To be diagnosed with binge-eating disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the following criteria must be met:

A. Recurrent episodes of binge-eating. An episode of binge eating is characterized by both of the following:

    • Eating, in a discrete period of time (e.g., within nay 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating control what or how much one is eating)

B. The binge-eating episodes are associated with 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 feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least one a week for 3 months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

There are several symptoms and physical symptoms related to binge-eating disorder. They may include:

    • Eating unusually large amounts of food in a specific amount of time, such as over a two-hour period
    • Eating until you're uncomfortably full
    • Frequently dieting, possibly without weight loss
    • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
    • Frequently eating alone or in secret
    • Eating even when you're full or not hungry
    • Feeling that your eating behavior is out of control
    • Eating rapidly during binge episodes
    • Fluctuations in weight
    • Feelings of low self-esteem

The severity of binging is dependent on the number of times a week that you are binge-eating.

How to Approach a Loved One:

There is not a perfect way to approach a loved one that you assume or know is struggling with binge-eating disorder. It is very common for people to keep their binging a secret because of their shame and embarrassment. Since they may not physically look like they have an eating disorder (unlike anorexia) it can be more difficult to detect. If you notice that a family member or friend is has a lack of control when eating, an extreme low self-esteem, eating in secret consider talking to him or her about these issues. Urge them to talk to their doctor. You can not force someone to seek professional care, but you can always offer your support and encouragement. Even though you may not be able to prevent your loved one from developing binge-eating disorder, you can still talk about healthier behavior or treatment options. For more help on how to approach loved ones visit:

https://www.helpguide.org/articles/eating-disorders/helping-someone-with-an-eating-disorder.htm.

Types of Binge- Eating Disorder Treatment:

There are effective treatments for binge-eating disorder. The main goal if treatment is to reduce eating binges and achieve healthy eating habits. Other mental health issues may accompany binge-eating disorder, like depression, so it is necessary to address the emotional and mental components underlying the binge-eating.

Behavioral Weight- loss programs

It is important that if you are partaking in weight-loss programs, they are done under medical supervision so ensure that proper steps are being taken to lose weight in a healthy and safe manner. Weight- loss programs should include identifying triggers to binge-eating, which can also be achieved in psychotherapy. These program are also not recommended until after psychotherapy  treatment is completed because of the emphasis on learning healthy habits and triggers to binge-eating.

Psychotherapy

Psychotherapy, also known as talk therapy or psychological counseling, involves discussing your binge-eating and related issues with a mental health professional. Psychotherapy is the most common treatment for binge-eating and has the greatest research support. Evidence indicates that these types of psychotherapy help improve symptoms of binge-eating.

Individual therapy

One goal of psychotherapy is to normalize eating patterns and identity triggers to binge-eating. Cognitive behavioral therapy, specifically enhanced cognitive behavioral therapy, has been shown to help. Cognitive-behavioral therapy will often focus on identifying and altering dysfunctional thought patterns, attitudes and beliefs, which may trigger and perpetuate the person’s eating habits. Another goal is to help change distorted beliefs and thoughts that maintain unhealthy eating habits. Individual therapy can be very helpful in addressing not only your disordered eating, but also your overall emotional health and happiness. The purpose is to address the underlying cognitive and emotional issues that result in binge-eating disorder. Improving interpersonal skills, how you relate to others, may help reduce binge-eating that can be triggered by problematic relationships and unhealthy communication skills.

Dialectical behavior therapy

This form of therapy can teach you behavioral skills that are necessary in regulating emotions, tolerating stress, as well as improving relationships with others.

Medications

There are medications that can assist in controlling binge-eating habits, but do not assist in weight-loss. Several types of medication may help reduce symptoms which can include:

  • Lisdexamfetamine dimesylate (Vyvanse) is the first FDA-approved medication to treat moderate to severe binge-eating disorder in adults. This stimulant can be abused so it is important to monitor your reliance on this drug and talk to your doctor about if you are worried concerned. Common side effects are, but not limited to, dry mouth and insomnia. If you are experiencing or concerned about these side effects, consult with your doctor immediately.
  • Antidepressants- While it is not sure how antidepressants reduce binge-eating, researchers relate the impact of the medication to specifically affect the mood, which is associated with binge-eating episodes.
  • Topiramate (Topamax), an anticonvulsant that has been found to reduce binge-eating episodes. Side effects to this anticonvulsant include nervousness, dizziness, trouble concentrating, and sleepiness. If you are experiencing or concerned about these side effects, consult with your doctor immediately.

Differences Between Common Disorders:

There are other possible causes of either binge eating and regular inappropriate compensatory behaviors. These are common disorders but the differences between them and binge-eating disorder.

  • Bulimia nervosa- Binge-eating disorder has recurrent binge-eating in common with bulimia nervosa but differs in terms of recurrent inappropriate compensatory behaviors (e.g., purging,, driven exercise). Unlike bulimia nervosa, individuals with binge-eating disorder typically do not show marked or sustained dietary restriction designed to influence body weight and shape between binge-eating episodes. Rates of improvement are higher among people with binge-eating disorder then those with bulimia nervosa disorder.
  • Obesity- While binge-eating disorder can be associated with overweight and obesity but is very different then obesity. Over-evaluation of weight, shape, and body are higher in obese individuals with binge-eating disorder than those without binge-eating disorder. The long-term successful outcome of evidence-based psychological treatments for binge-eating disorder can be contrasted with the absence of effective long-term treatments for obesity. Finally, the rates of psychiatric comorbidity are significantly higher among obese individuals with binge-eating disorder, then those obese individuals without the disorder.
  • Bipolar and depressive disorders- Symptoms such as weight gain and increases in appetite are common for major depressive episodes and atypical feature specifiers for depressive and bipolar disorders. Increased eating in these context are not associated with loss of control. It is possible to meet criteria for both binge-eating as well as bipolar and other depressive disorders.
  • Borderline personality disorder-Binge- eating behavior is included in the impulsive behavior criterion that is part of the definition of borderline personality disorder. If the criteria for both personality disorder and bulimia nervosa are met, then you may have both diagnosis.

Resources:

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. (5th ed.) Arlington, VA: American Psychiatric Association.

Binge Eating Disorder. (2018). Retrieved from

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed

Binge-eating disorder. (2018). Retrieved from

https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/symptoms-causes/syc-20353627

Guerdjikova, A., Mori, N.,  Casuto, L., McDlroy, S. (2017). Binge Eating Disorder. Psychiatric Clinic North America, 40(2). http://DOI: 10.1016/j.psc.2017.01.003
Kessler, C., Berglund, A., Chiu, T., Veitz, C., Hudson, J., Shaly, V.. & Xavier, M. (2013). The prevalence and correlates of binge eating disorder in the WHO World Mental Health Surveys. Biological Psychiatry, 72(9), 904-914. http://doi.org/10/1016/j.biopsych.2012.11.020

WebMD Binge Eating Disorder (Binging) Center: Symptoms, Treatments, and Effects on the Body. (n.d.). Retrieved from
https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/default.htm

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