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Binge-eating disorder and compulsive over-eating

Right now, Binge Eating Disorder is an official eating disorder in the DSM-IV as part of the "not otherwise specified" category, but research is being done as far as making B.E.D. it's own category. (click here to jump to the proposed DSM-IV criteria). Binge eating disorder is very similar to bulimia nervosa, except that there is no "compensation" for the binge. Because of the pressure to stay thin in this sport, this disorder is not very common in figure skaters. It is, however, probably the most common eating disorder in America today.

Many people may binge eat from time to time, but it becomes an eating disorder when it is recurrent and out of control. People with BED are often overweight or even obese, but the disorder may affect people of "normal" weight as well. People who binge eat who were sexually abused may actually be doing this in an attempt to make themselves overweight, and therefore (in this society anyway) sexually unattractive.

As in bulimia, binges may be triggered by intense emotions such as anxiety, depression, or fear. Research also suggests that there is a chemical aspect of so-called "food addiction." Blood sugar rises abruptly when there is a sudden, extreme intake of carbohydrates, then crashes just as abruptly very shortly therafter. This is not unlike a "high" achieved by recreational drugs. Food is used as self-medication to soothe or distract from negative feelings. This is why many people with B.E.D. also suffer from anxiety, depression, or other mood disorders.

Complications of binge eating and/or being significantly overweight may include high blood pressure, diabetes, heart disease, high cholesterol, and gallbladder disease. There may also be significant psychological effects such as depression or anxiety...which are, ironically enough, emotions which often can trigger more binges. Thus the disorder can be quite a vicious cycle.

Recovery from binge-eating disorder may involve weight loss, most often under doctor's supervision and often with help of a nutritionist or registered dietician. This is especially important in B.E.D. patients with Type II diabetes. Alternatives to the binge eating behaviors must be learned as well as the foundations of good nutritional knowledge.

Many people dismiss binge eating as a sheer lack of self-control, and not a legitimate eating disorder. What makes this a psychological disorder rather than just a medical phenomena is that the disorder is more about the thought process than observable behaviors. There are psychological needs and issues which need to be dealt with in treatment, and it is not just a matter of taking a few appetite suppressants. Yes, maybe that could stop a person from binging--- that's a pretty big MAYBE, by the way-- but if the underlying issues are not addressed, they will most likely manifest themselves in some other maladaptive behavior or disorder. Which brings me to my next point...

Binge Eating Disorder, like other eating disorders in the "N.O.S." category, can be a gateway to or from other eating disorders. I have heard many stories of people who used to binge eat who then turn to anorexic or bulimictype behaviors when they panic at the weight gain caused by their excessive eating. Weight loss is sometimes a part of recovery from binge eating disorder and compulsive overeating, but turning to other eating disorders is NOT the answer!

Diagnostic criteria for BINGE EATING DISORDER (sometimes referred to as "compulsive overeating")

A. Recurrent episodes of binge eating. An episode of binge eating is characterizedby both of the following:
     (1) eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely
larger than most people would eat in a similar period of time under similar circumstances.
     (2) a sense of lack of control over eating during the episode (i.e., feeling that one cannot stop eating or 
control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) ofthe following:
     (1) eating much more rapidly than normal
     (2) eating until feeling uncomfortably full
     (3) eating large amounts of food when not feeling physically hungry
     (4) eating alone because of being embarrassed by how much one is eating
     (5) feeling disgusted with oneself, depressed, or very guilty after overeating

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least 2 days a week for 6 months.

E. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e.g., purging,
fasting, excessive exercise) anddoes not occur exclusively during the course of Anorexia Nervosa or Bulimia Nervosa. 

Author: Evan Keraminas

Links specific to binge eating disorder and compulsive overeating

Binge eating disorder from Mental Health Source
Self Help Magazine Overcoming Overeating
Alternatives to Bingeing from EDSA Canada
Binge eating disorder from National Institute of Health
Overeaters Anonymous
Caring Online: binge eating article on BED
BED overview, signs and symptoms
Affirmations for binge eaters

Navigate the Eating Disorders Section
Anorexia Nervosa Bulimia Nervosa ED "Not Otherwise Specified"Binge Eating Disorder
Causes of eating disorders Physical and emotional effectsSigns and symptoms Getting help/Recovery
Why figure skaters? ED questionnaireBooks on eating disorders Eating disorder links
Issues of diagnosisSubmission formHealthy coping skillsBody image links
Healthy eating/Nutrition Self-injury

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