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Understanding
Binge Eating Disorders |
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Binge
eating disorder is a newly recognized condition that probably
affects millions of Americans. People with binge eating disorder
frequently eat large amounts of food while feeling a loss
of control over their eating. This disorder is different from
binge-purge syndrome (bulimia nervosa) because people with
binge eating disorder usually do not purge afterward by vomiting
or using laxatives.
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Most
of us overeat from time to time, and many people feel they frequently
eat more than they should. Eating large amounts of food, however,
does not mean that a person has binge eating disorder. Doctors
are still debating the best ways to determine if someone has
binge eating disorder. But most people with serious binge eating
problems have:
- Frequent
episodes of eating what others would consider an abnormally
large amount of food.
- Frequent
feelings of being unable to control what or how much is
being eaten.
- Several
of these behaviors or feelings:
- Eating
much more rapidly than usual.
- Eating
until uncomfortably full.
- Eating
large amounts of food, even when not physically hungry.
- Eating
alone out of embarrassment at the quantity of food being
eaten.
- Feelings
of disgust, depression, or guilt after overeating.
Episodes
of binge eating also occur in the eating disorder bulimia
nervosa. Persons with bulimia, however, regularly purge, fast,
or engage in strenuous exercise after an episode of binge
eating. Purging means vomiting or using diuretics (water pills)
or laxatives in greater-than-recommended doses to avoid gaining
weight. Fasting is not eating for at least 24 hours. Strenuous
exercise, in this case, is defined as exercising for more
than an hour solely to avoid gaining weight after binge eating.
Purging, fasting, and strenuous exercise are dangerous ways
to attempt weight control.
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Although
it has only recently been recognized as a distinct condition,
binge eating disorder is probably the most common eating disorder.
Most people with binge eating disorder are obese (more than
20 percent above a healthy body weight), but normal-weight people
also can be affected. Binge eating disorder probably affects
2 percent of all adults, or about 1 million to 2 million Americans.
Among mildly obese people in self-help or commercial weight
loss programs, 10 to 15 percent have binge eating disorder.
The disorder is even more common in those with severe obesity.
Binge
eating disorder is slightly more common in women, with three
women affected for every two men. The disorder affects blacks
as often as whites; its frequency in other ethnic groups is
not yet known. Obese people with binge eating disorder often
became overweight at a younger age than those without the
disorder. They also may have more frequent episodes of losing
and regaining weight (yo-yo dieting).
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The
causes of binge eating disorder are still unknown. Up to half
of all people with binge eating disorder have a history of depression.
Whether depression is a cause or effect of binge eating disorder
is unclear. It may be unrelated. Many people report that anger,
sadness, boredom, anxiety or other negative emotions can trigger
a binge episode. Impulsive behavior and certain other psychological
problems may be more common in people with binge eating disorder.
Dieting's
effect on binge eating disorder is also unclear. While findings
vary, early research suggests that about half of all people
with binge eating disorder had binge episodes before they
started to diet. Still, strict dieting may worsen binge eating
in some people.
Researchers
also are looking into how brain chemicals and metabolism (the
way the body burns calories) affect binge eating disorder.
These areas of research are still in the early stages.
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The
major complications of binge eating disorder are the diseases
that accompany obesity. These include diabetes, high blood pressure,
high cholesterol levels, gallbladder disease, heart disease,
and certain types of cancer.
People
with binge eating disorder are extremely distressed by their
binge eating. Most have tried to control it on their own but
have not succeeded for very long. Some people miss work, school,
or social activities to binge eat. Obese people with binge
eating disorder often feel bad about themselves, are preoccupied
with their appearance, and may avoid social gatherings. Most
feel ashamed and try to hide their problem. Often they are
so successful that close family members and friends don't
know they binge eat.
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People
who are not overweight or only mildly obese should probably
avoid dieting, since strict dieting may worsen binge eating.
However, many people with binge eating disorder are severely
obese and have medical problems related to their weight. For
these people, losing weight and keeping it off are important
treatment goals. Most people with binge eating disorder, whether
or not they want to lose weight, may benefit from treatment
that addresses their eating behavior.
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Several
studies have found that people with binge eating disorder may
find it harder than other people to stay in weight loss treatment.
Binge eaters also may be more likely to regain weight quickly.
For these reasons, people with the disorder may require treatment
that focuses on their binge eating before they try to lose weight.
Even those who are not overweight are frequently distressed
by their binge eating and may benefit from treatment.
Several
methods are being used to treat binge eating disorder. 1.Cognitive-behavioral
therapy teaches patients techniques to monitor and change
their eating habits as well as to change the way they respond
to difficult situations. 2. Interpersonal psychotherapy helps
people examine their relationships with friends and family
and to make changes in problem areas. 3. Treatment with medications
such as antidepressants may be helpful for some individuals.
4. Self-help groups also may be a source of support. Researchers
are still trying to determine which method or combination
of methods is the most effective in controlling binge eating
disorder. The type of treatment that is best for an individual
is a matter for discussion between the patient and his or
her health care provider.
If
you believe you have binge eating disorder, it's important
you realize that you are not alone. Most people who have the
disorder have tried unsuccessfully to control it on their
own. You may want to seek professional treatment.
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Behavioral
Medicine
Stanford University School of Medicine
Department of Psychiatry TD209
Stanford, CA 94305
Tel: (415) 723-5868
Binge
Eating Program
Western Psychiatric Institute and Clinic
3811 O'Hara Street
Pittsburgh, PA 15213
Tel: (412) 624-2823
Eating
Disorders Clinic
New York State Psychiatric Institute
Columbia Presbyterian Medical Center
722 W. 168th Street
Unit #98
New York, NY 10032
Tel: (212) 960-5739/5746
Eating
Disorder Research Program
University of Minnesota
2701 University Avenue, S.E.
Suite 102
Minneapolis, MN 55414
Tel: (612) 627-4494
Nutrition
Research Clinic
Baylor College of Medicine
6535 Fannin Street
MS F700
Houston, TX 77030
Tel: (713) 798-5757
Rutgers
Eating Disorders Clinic
GSAPP, Rutgers University
Box 819
Piscataway, NJ 08854
Tel: (908) 932-2292
Women's
Recovery Center
110 N. Essex Avenue
Narberth, PA 19072
Tel: (215) 664-5858
Yale
Center For Eating and Weight Disorders
P.O. Box 11A, Yale Station
New Haven, CT 06520
Tel: (203) 432-4610
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References:
1.)National Institutes of Health
2.)de Zwaan MD, Mitchell JE. "Binge Eating in the Obese."
Annals of Medicine. Vol. 24, pp. 303-308, 1992.
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