Bingeing can occur with any particular food group and crosses the range between sweet, sour and salty foods. It is designated an official eating disorder, much like anorexia nervosa and bulimia nervosa, major public health problems for which there are no definitive answers yet.
It is estimated that one in 35 adults in the United States has binge eating disorder, according to the National Eating Disorders Institute. It is more common among women, but 40 percent of men also have the affliction. It is found in every ethnicity in roughly equal proportions. The bingeing tendency usually manifests in the late teens or early 20s.
Although most binge eaters are overweight or suffer from obesity, there are those who are of normal weight who partake in the practice. It is important to note that binge eaters are not bulimic. They do not purge to rid themselves after consuming food, leading to the weight gain associated with many who have the problem.
Signs of Binge Eating
Several symptoms define binge eating disorder. These include:
1) Eating large amounts of food in a relatively short period, accompanied by a feeling that the consumption is out of control;
2) Eating when not hungry, and not stopping when full, producing an uncomfortable feeling;
3) Eating very rapidly;
4) Eating frequently alone or in secret, followed by depression, shame, guilt or other upset feelings;
5) Frequently dieting, sometimes to no effect on weight loss.
The number of times per month that these episodes of binging occur is a key to diagnosing the disorder. While some people occasionally may binge, particularly during holidays where food is the centerpiece, the binge eater continuously engages in the behavior.
An official diagnosis is based on confirmation that binge eating happened at least once a week for three months or more and was accompanied by distress over the episode and a feeling that the eating behavior was out of control.
Doctors will examine whether the patient admits to eating rapidly, gets uncomfortably full, eats alone out of embarrassment or eats when not particularly hungry. All of these practices, combined with post-eating depression and guilt, lead to the formal diagnosis.
Unfortunately, it's difficult to detect this eating disorder, given the secretive nature of the practice. Family and friends can notice weight gain but may attribute it to things other than bingeing, like lack of exercise or poor diet choices. Researchers are still trying to determine a particular cause for the disorder. Some believe it may be related to genes, while others believe particular family dynamics can trigger the issue. Others feel it relates to depression, which is found in nearly every patient diagnosed with binge eating disorder.
Doctors will attack the disorder in several ways, all with the goal of decreasing or ending the behaviors. Ultimately, psychological counseling is at the core of treatment, as eliminating triggers and directing the patient towards health. Wellness is the prize in treatment, not necessarily weight reduction, although that is typically part of the treatment. Not everyone who is overweight is a secret binger.
Help Is Available
Binge eating disorder is treatable, so those who have the illness are advised to seek a doctor’s counseling. While this may be difficult for some, it is necessary. A trusted friend, loved one, counselor or other person may be the bridge to breaking the binge cycle.
Family members should gently confront suspected binge eaters about their behavior in a non-judgmental way. Offers to help find treatment options and making an appointment could be life-savers.
In addition to a complete physical exam, doctors will inquire about the patient’s family history, social life, work situation, and any other habits or interactions. A medical professional usually will include a psychological examination referral. Blood and urine tests, as well as a sleep disorder evaluation, may be a part of the diagnosis.
After Binge Eating Disorder Is Diagnosed
Once diagnosed, binge eaters typically will engage in talk therapy with a psychological counselor in individual or group sessions. These sessions will focus on reasons for bingeing and offer potential ways to change. The patient may engage in cognitive behavioral therapy (CBT), which allows patients to discuss negative feelings that may lead to bingeing; interpersonal therapy, which focuses on relationships with others that may cause bingeing because of poor relationships and bad communication; and dialectical behavior, which focuses on reducing stress, controlling emotions and creating better relationships with others.
Lisdexamfetamine dimesylate (Vyvanse) is a drug that has been approved for use in treating binge eating disorders. The drug, which is used to treat attention-deficit disorder, is the first that has won Food and Drug Administration approval for binge eating disorders. It’s a stimulant and can be habit-forming, so it must be administered and supervised by a medical professional.
Other drugs that have uses in treating binge eating include the anticonvulsant topiramate (commercially, Topamax), which is used to control seizures but also can reduce binge eating. Antidepressants in the selective serotonin reuptake inhibitor class (SSRI) may also be used to help fight bingeing.
All of the medications have side effects, ranging from dry mouth to kidney stones, so they must be regulated and monitored.
Doctors may recommend a group weight-loss program after treatment has commenced, but this approach typically is not recommended until the binge treatments are well underway.
During therapy, family members can cooperate by not bringing home foods that can trigger bingeing or at least keeping them in a controlled location. Moderate exercise programs, maintaining social connections and monitoring nutrition are considered as part of the plan to control binge eating.