How
Does Someone Know if He or She Has Binge Eating Disorder?
Most
of us overeat from time to time, and many people often feel
they've eaten more than they should have. Eating a lot of
food does not always mean that a person has binge eating
disorder. Doctors generally agree that most people with
serious binge eating problems often
•
feel their eating is out of control
• eat what most people would think is an unusually
large amount of food
• eat much more quickly than usual during binge episodes
• eat until so full they are uncomfortable
• eat large amounts of food, even when they are not
really hungry
• eat alone because they are embarrassed about the
amount of food they eat
• feel disgusted, depressed, or guilty after overeating
Binge
eating also takes place in another eating disorder called
bulimia nervosa. Persons with bulimia nervosa, however,
usually purge, fast, or do strenuous exercise after they
binge eat. Purging means vomiting or using a lot
of diuretics (water pills) or laxatives to keep from gaining
weight. Fasting is not eating for at least 24 hours.
Strenuous exercise, in this case, means exercising
for more than an hour just to keep from gaining weight after
binge eating. Purging, fasting, and overexercising are dangerous
ways to try to control your weight.
How Common Is Binge Eating Disorder,
and Who Is at Risk?
Binge
eating disorder is probably the most common eating disorder.
Most people with this problem are either overweight or obese,*
but normal-weight people also can have the disorder.
About 2 percent of all adults in the United States (as many
as 4 million Americans) have binge eating disorder. About
10 to 15 percent of people who are mildly obese and who
try to lose weight on their own or through commercial weight-loss
programs have binge eating disorder. The disorder is even
more common in people who are severely obese.
Binge eating disorder is a little more common in women than
in men; three women for every two men have it. The disorder
affects blacks as often as whites. No one knows how often
it affects people in other ethnic groups.
People who are obese and have binge eating disorder often
became overweight at a younger age than those without the
disorder. They might also lose and gain back weight (yo-yo
diet) more often.
* The 1998 NIH Clinical Guidelines on the Identification,
Evaluation, and Treatment of Overweight and Obesity in Adults
define overweight as a body mass index (BMI) of 25 to 29.9
and obesity as a BMI of 30 or more. BMI is calculated by
dividing weight (in kilograms) by height (in meters) squared.
What Causes Binge Eating Disorder?
No
one knows for sure what causes binge eating disorder. As
many as half of all people with binge eating disorder have
been depressed in the past. Whether depression causes binge
eating disorder or whether binge eating disorder causes
depression is not known.
Many people who are binge eaters say that being angry, sad,
bored, or worried can cause them to binge eat. Impulsive
behavior (acting quickly without thinking) and certain other
emotional problems can be more common in people with binge
eating disorder.
It is also unclear if dieting and binge eating are related.
Some studies show that about half of all people with binge
eating disorder had binge episodes before they started to
diet.
Researchers also are looking into how brain chemicals and
metabolism (the way the body uses calories) affect binge
eating disorder. This research is still in the early stages.
What Are the Complications of Binge Eating Disorder?
People
with binge eating disorder can get sick because they may
not be getting the right nutrients. They usually eat large
amounts of fats and sugars, which don't have a lot of vitamins
or minerals.
People with binge eating disorder are usually very upset
by their binge eating and may become very depressed.
People who are obese and also have binge eating disorder
are at risk for
•
diabetes
• high blood pressure
• high blood cholesterol levels
• gallbladder disease
• heart disease
• certain types of cancer
Most
people with binge eating disorder have tried to control
it on their own, but have not been able to control it for
very long. Some people miss work, school, or social activities
to binge eat. Persons who are obese with binge eating disorder
often feel bad about themselves and may avoid social gatherings.
Most people who binge eat, whether they are obese or not,
feel ashamed and try to hide their problem. Often they become
so good at hiding it that even close friends and family
members don't know they binge eat.
Should People With Binge Eating Disorder
Try To Diet?
People who are not overweight should avoid dieting because
it sometimes makes their binge eating worse. Dieting here
means skipping meals, not eating enough food each day, or
avoiding certain kinds of food (such as carbohydrates).
These are unhealthy ways to try to change your body shape
and weight. Many people with binge eating disorder are obese
and have health problems because of their weight. These
people should try to lose weight and keep it off. People
with binge eating disorder who are obese may find it harder
to stay in a weight-loss program. They also may lose less
weight than other people, and may regain weight more quickly.
(This can be worse when they also have problems like depression,
trouble controlling their behavior, and problems dealing
with other people.) These people may need treatment for
binge eating disorder before they try to lose weight.
How Can People With Binge Eating Disorder Be Helped?
People
with binge eating disorder, whether or not they want to
lose weight, should get help from a health professional
such as a psychiatrist, psychologist, or clinical social
worker for their eating behavior. Even those who are not
overweight are usually upset by their binge eating, and
treatment can help them. There are several different ways
to treat binge eating disorder. Cognitive-behavioral
therapy teaches people how to keep track of their eating
and change their unhealthy eating habits. It also teaches
them how to change the way they act in tough situations.
Interpersonal psychotherapy helps people look at
their relationships with friends and family and make changes
in problem areas. Drug therapy, such as antidepressants,
may be helpful for some people.
Researchers are still trying to find the treatment that
is the most helpful in controlling binge eating disorder.
The methods mentioned here seem to be equally helpful. For
people who are overweight, a weight-loss program that also
offers treatment for eating disorders might be the best
choice.
If you think you might have binge eating disorder, it's
important to know that you are not alone. Most people who
have the disorder have tried but failed to control it on
their own. You may want to get professional help. Talk to
your health care provider about the type of help that may
be best. The good news is that most people do well in treatment
and can overcome binge eating.
For More Information
For
more information, contact one of the centers listed below.*
National
Eating Disorder Association
Information and Referral Program
603 Stewart Street, Suite 803
Seattle, WA 98101
1-800-931-2237
(206) 382-3587
(206) 829-8501 (fax)
Web: www.nationaleatingdisorders.org
Email: info@nationaleatingdisorders.org
Academy for Eating Disorders
6728 Old McLean Village Drive
McLean, VA 22101-3906
(703) 556-9222
(703) 556-8729 (fax)
Web: www.aedweb.org
The following programs are for patients with binge eating
disorder or compulsive overeating.
