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Binge Eating Disorder

April 15 , 2016

By Gurkirat Kaur and Amarjeet Kaur

Food Science & Technology, India

Signs, Causes, Effects & Tips to Control Binge eating disorder

Eating disorders are a group of conditions characterized by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and emotional health, resulting in binge eating disorder, bulimia nervosa, anorexia nervosa some of the most common eating disorders in the United States. Though primarily thought of as affecting females (an estimated 5–10 million being affected in the U.S.), eating disorders affect males as well (an estimated 1 million U.S. males being affected). While proper treatment can be highly effective for many of the specific types of eating disorders, the consequences of eating disorders can be severe, including death (whether from direct medical effects of disturbed eating habits or from co-morbid conditions such as suicidal thinking). It is not known with certainty what causes eating disorders. It can be due to a combination of biological, psychological or environmental causes. Most people with eating disorders also suffer from body dysmorphic disorders, altering the way a person sees themselves. The main types of eating disorders are: anorexia nervosa, bulimia nervosa and binge eating disorder.

Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight, and an obsessive fear of gaining weight due to a distorted self image which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. It is a serious mental illness with a high incidence of co-morbidity and the highest mortality rate of any psychiatric disorder.

Anorexia affects the body in following ways:

  • Malnutrition and vitamin deficiencies.
  • Nails and hair become brittle, and skin may become dry and yellow.
  • Body breaks down muscles to provide energy.
  • Individuals may have constipation or edema, which is bloating due to water retention in tissues.
  • Severe dehydration can lead to kidney failure.

Brain and nervous tissue

  1. Vitamin deficiencies cause cognitive problems like poor judgment or memory loss and other psychiatric conditions
  2. Seizures
  3. Damage to nerves, causing loss of feeling
  4. Changes in chemical signals which impact appetite, mood and reward systems.

Hormonal changes

  1. Brain senses the decrease in weight and sends signals to ovaries to decrease the amount of estrogen made.
  2. Decrease in estrogen causes decrease in bone density.
  3. Both males and females with anorexia have loss of bone density.

Bulimia nervosa is an eating disorder characterized by the restraining of food intake for a period of time followed by an over intake or binging period that results in feelings of guilt and low self-esteem. Sufferers attempt to overcome these feeling through a number of ways. The most common form is defensive vomiting, sometimes called purging; fasting, the use of laxatives, enemas, diuretics, and over exercising are also common. Bulimia nervosa is nine times more likely to occur in women than men.

Bulimia affects the body in following ways:

  1. Callused or bruised fingers: From using the fingers to vomit.
  2. Salivary gland enlargement: may have puffy face.
  3. Dental problems: erosion enamel, gum recession, teeth loss.
  4. Damage to the oesophagus from acid due to purging: internal bleeding which may lead to death.
  5. Upset of the body's fluid/mineral balance, possibly causing rapid or irregular heartbeats or even a heart attack.

Binge eating disorder(BED) is the most common eating disorder in the United States affecting 3.5% of females and 2% of males and is prevalent in up to 30% of those seeking weight loss treatment. Although it is not yet classified as a separate eating disorder, it was first described in 1959 by psychiatrist and researcher Albert Stunkard as "Night Eating Syndrome" (NES), and the term "Binge Eating Disorder" was coined to describe the same binging-type eating behaviour without the exclusive nocturnal component. BED usually leads to obesity although it can occur in normal weight individuals as well. There may be a genetic inheritance factor involved in BED independent of other obesity risks and there is also a higher incidence of psychiatric co-morbidity.

The key features of binge eating disorder are:

  • Frequent episodes of uncontrollable binge eating
  • Feeling extremely distressed or upset during or after binging
  • No regular attempts to “make up” for the binges through vomiting, fasting, or over-exercising.

Emotional Eating and food addiction

People with binge eating disorder suffer from this psychological food addiction. Like the alcoholic that can’t say no to a drink, they can’t say no to food. Often, their binge eating is triggered by a depressed or anxious mood, but they may also overeat when they’re tense, lonely, or bored. They eat to feed their feelings, rather than their bodies. The problem is that emotional eating doesn’t solve anything. It may be comforting for a brief moment, but then reality sets back in, along with regret and self-loathing. Emotional eating also leads to problems of its own—including weight gain and obesity. Unfortunately, weight gain only reinforces compulsive eating. It’s not that people with binge eating disorder don’t care about their bodies; they agonize over their ballooning weight. But the worse they feel about themselves and their appearance, the more they use food to cope. It becomes a vicious cycle: eating to feel better, feeling even worse, and then turning back to food for relief.

Signs and Symptoms of Binge Eating Disorder

People with binge eating disorder are embarrassed and ashamed of their eating habits, so they often try to hide their symptoms and eat in secret. Many binge eaters are overweight or obese, but some are of normal weight.

Behavioural symptoms of binge eating and compulsive overeating

  • Inability to stop eating or control what you’re eating.
  • Rapidly eating large amounts of food.
  • Eating even when you’re full.
  • Hiding or stockpiling food to eat later in secret.
  • Eating normally around others, but gorging when you’re alone.
  • Eating continuously throughout the day, with no planned mealtimes.

Emotional symptoms of binge eating and compulsive overeating

  • Feeling tension that is only relieved by eating.
  • Embarrassment over how much you’re eating
  • Feeling numb while binging—like you’re not really there or you’re on auto-pilot.
  • Never feeling satisfied, no matter how much you eat
  • Feeling guilty, disgusted, or depressed after overeating
  • Desperation to control weight and eating habits

Causes of Binge Eating

Most experts believe that it takes a combination of things to develop an eating disorder — including a person's genes, emotions, and experience.

Biological causes of binge eating disorder

Studies show that biological abnormalities contribute to binge eating. For example, the hypothalamus (the part of the brain that controls appetite) may not be sending correct messages about hunger and fullness. Researchers have also found a genetic mutation that appears to cause food addiction. Finally, there is evidence that low levels of the brain chemical serotonin play a role in compulsive eating.

Psychological causes of binge eating disorder

Depression and binge eating are strongly linked. According to the U.S. Department of Health and Human Services, up to half of all binge eaters are either depressed or have been before. There is further evidence that low self-esteem, loneliness, and body dissatisfaction are involved in compulsive overeating. People with binge eating disorder may also have trouble with impulse control and managing and expressing their feelings.

Social and cultural causes of binge eating disorder

Social pressure to be thin can add to the shame binge eaters feel and fuel their emotional eating. The way one is raised can also increase the risk for binge eating disorder. Some parents unwittingly set the stage for binging by using food to comfort, dismiss, or reward their children. Children who are exposed to frequent critical comments about their bodies and weight are also vulnerable. Another factor which has been linked to binge eating is sexual abuse in childhood.

Effects of Binge eating disorder

Binge eating leads to a wide variety of physical, emotional, and social problems. People with binge eating disorder report more health issues, stress, insomnia, and suicidal thoughts than people without an eating disorder. Depression, anxiety, and substance abuse are common side effects as well. Binge eating also interferes with a person’s relationships and career. For example, you may skip work, school, or social activities in order to binge eat. But the most prominent effect of binge eating disorder is weight gain.

Obesity and binge eating

Over time, compulsive overeating usually leads to obesity. Obesity, in turn, causes numerous medical complications. Common physical effects of binge eating disorder include:

  1. Type 2 diabetes
  2. Gallbladder disease
  3. High cholesterol
  4. High blood pressure
  5. Heart disease
  6. Certain types of cancer
  7. Osteoarthritis
  8. Joint and muscle pain
  9. Gastrointestinal problems
  10. Sleep apnea

Tips for Overcoming Binge Eating

Eat breakfast. Skipping breakfast often leads to overeating later in the day, so start your day right with a healthy meal. Eating breakfast also jump starts your metabolism in the morning. Studies show that people who eat breakfast are thinner than those who don’t.

  • Avoid temptation. You’re much more likely to overeat if you have junk food, desserts, and unhealthy snacks in the house. Remove the temptation by clearing your fridge and cupboards of your favourite binge foods.
  • Stop dieting. The deprivation and hunger of strict dieting can trigger food cravings and the urge to overeat. Instead of dieting, focus on eating in moderation. Find nutritious foods that you enjoy and avoid labelling foods as “good” or “bad.”
  • Exercise. Not only will exercise help you lose weight in a healthy way, but it also lifts depression, improves overall health, and reduces stress. The natural mood-boosting effects of exercise can help put a stop to emotional eating.
  • Distress. Learn how to cope with stress in healthy ways that don’t involve food.

Treatment for Binge Eating Disorder

Binge eating disorder can be successfully treated in therapy. Therapy can teach you how to fight the compulsion to binge, exchange unhealthy habits for healthy ones, monitor your eating and moods, and develop effective stress-busting skills.

Three types of therapy are particularly helpful in the treatment of binge eating disorder and compulsive overeating:

  • Cognitive-behavioural therapy – Cognitive-behavioural therapy focuses on the dysfunctional thoughts and behaviours involved in binge eating. One of the main goals is for you to become more self-aware of how you use food to deal with emotions. Your therapist may ask you to keep a food diary or a journal of your thoughts about eating, weight, and food. The therapist will also help you recognize your binge eating triggers and learn how to avoid or combat them. Cognitive-behavioural therapy for binge eating disorder also involves education about nutrition, healthy weight loss, and relaxation techniques.

  • Interpersonal psychotherapy - Interpersonal psychotherapy for binge eating disorder focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. Your therapist will also help you improve your communication skills and develop healthier relationships with family members and friends. As you learn how to relate better to others and get the emotional support you need, the compulsion to binge becomes more infrequent and easier to resist.Dialectical behaviour therapy – Dialectical behaviour therapy combines cognitive-behavioural techniques with mindfulness meditation. The emphasis of therapy is on teaching binge eaters how to accept themselves, tolerate stress better, and regulate their emotions. Your therapist will also address unhealthy attitudes you may have about eating, shape, and weight. Dialectical behaviour therapy typically includes both individual treatment sessions and weekly group therapy sessions.

Support for Binge Eating

Breaking the old pattern of binge eating is hard, and you may slip from time to time. This is where the support of others can really come in handy. Family, friends, and therapists can all be part of your support team. You may also find that joining a group for binge eaters is helpful. Sharing your experience with other compulsive eaters can go a long way towards reducing the stigma and loneliness you may feel.

There are many group options, including self-help support groups and more formal therapy groups.

  • Group therapy Group therapy sessions are led by a trained psychotherapist, and may cover everything from healthy eating to coping with the urge to binge.

  • Support groups – Support groups for binge eating are led by trained volunteers or health professionals. Group members give and receive advice and support each other.

Medications for Binge Eating Disorder

A number of medications may be helpful in binge eating disorder treatment. Some studies have shown that medication can reduce the frequency of binge eating episodes, improve body mass index, and speed weight loss. Drug research for binge eating is still in its early stages, however, and more studies are needed.

The medications that show promise for binge eating disorder include:

  • Antidepressants – Research shows that antidepressants decrease binge eating in people with bulimia. Antidepressants may also help people with binge eating disorder, but studies also show that relapse rates are high when the drug is discontinued.

  • Appetite suppressants – Studies on the appetite-suppressing drug sibutramine, known by the brand name Meridia, indicate that it reduces the number of binge eating episodes and promotes weight loss.

  • Topamax– The seizure drug topiramate, or Topamax, may decrease binge eating and increase weight loss. However, Topamax can cause serious side effects, including fatigue, dizziness, and burning or tingling sensations.

Conclusions: As a food technologist when we are concerned about the techniques and science involved with respect to food, we should also be aware of proper eating patterns. BED is a compulsive behaviour, mainly in teens in which people feel out of control and powerless to stop consuming huge amounts of food. It is more prevalent in females than in males. It leads to many physical, emotional and social problems. Use a team approach in treating eating disorders.

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