Binge eating disorder (BED) is a severe, life-threatening, yet a treatable, eating disorder characterised by recurrent episodes of eating large quantities of food. Other characteristics include a sense of loss of control during the episode; eating continuously without feeling hungry; experiencing embarrassment, feeling disgusted, depressed or guilty afterwards.
Compared to other eating disorders such as anorexia and bulimia nervosa that are usually present in the teenage or adolescent years, binge eating disorder can be present in people of all age groups.
Emerging as one of the latest eating disorders of the millennium, this problem can have a huge impact on overall health, longevity, quality of life etc. Many young children, adolescents and even adults in their twenties or thirties tend to binge eat due to the availability of huge variety of junk and colourful food .
Diagnosing the disorder
Almost everyone overeats on occasions, having second or third helpings of a holiday meal. There are no obvious physical signs or symptoms when you have binge-eating disorder. You may be overweight or obese, or you may have a normal weight. However, there are several behavioural and emotional signs and symptoms that can help in its diagnosis. These may include:
- Recurrent episodes of binge eating can occur averaging a minimum of twice per week for six months.
An episode of binge eating is characterised by:
- Eating too soon too much e.g. within any 2-hour period eating an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode.
The binge eating episodes are associated with three (or more) of the following:
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling hungry
- Eating alone because of feeling embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, ashamed or guilty afterwards
- Experiencing depression and anxiety
Prevention and treatment
Although it might not be possible to prevent all cases of binge eating disorder, it is helpful to begin treatment in people as soon as their symptoms are recognised. In addition, teaching and encouraging healthy eating habits in childhood and realistic attitude about food and body image also might be helpful in preventing the development or worsening of eating disorders. Nevertheless, the disorder can be managed in various ways.
Psychotherapy is suggested and is helpful to a large extent because it involves an effective blend of cognitive therapy (better understanding and interpretation of situations) and behavioural therapy (meaningful impact on improved behaviour). This can result in better outcome due to a personalised / tailor-made approach.
Medications can be given for treating depression / ADHD, since binge eating is the net result of these medical conditions.
Family counselling is usually required for the successful treatment of this disorder as all family members need to be supportive of the affected person should not feel not being wanted in the family.
Group therapy is another effective way to address the problem since sharing of common feelings and experiences among those with similar behavioural response can go a long way in helping the patient.
Lifestyle modifications such as regulated hours of sleeping, encouraging good sleeping habits, stocking the refrigerator with healthy, nutritious food rather than junk foods. The “bingeing” literally needs to be curtailed without compromising on the quality, variety, satiety of the food.
Motivating for mindful eating can help in treating BED to a great percentage. Intelligent amalgamation of “balanced eating and regular exercise under medical supervision is recommended.
What can cause the disorder
While the exact causes of binge eating are unknown, it can result from a combination of biological, psychological, environmental and social factors.
Biological: Hormonal irregularities or genetic mutations.
Psychological: There is strong connection between depression and binge eating. Negative body image, low self-esteem and difficulty in dealing with intense emotions can be a contributing factor.
Social and cultural: Traumatic circumstances, peer pressure, social or public ridicule or comments about body or weight, may negatively affect vulnerable persons.
Complications and risks
The aftermath of binge eating can signify corollaries ranging from risk for heart failure, reduced resting metabolism and slowed digestion, inadequate nutrition/malnutrition to threat to life. When you overeat, you wind up with a sore, stuffed belly. Everyone feels like this from time to time. But if you have binge eating disorder, your eating habits could lead to serious problems that might last a lifetime.
- Weight gain and obesity
- Arthritis
- Breathing that stops many times during the night (sleep apnea)
- Emotional and mental distress
- Heart disease
- High blood pressure
- Type 2 diabetes
— The writer is chief nutritionist, Cloudnine group of Hospitals, Bengaluru.
