Binge Eating Disorders

For the past two weeks I have been focusing on the eating disorders anorexia nervosa and bulimia. Today I want to talk about a couple of conditions that represent the flip side of the eating disorder coin.

These are the disorders where a person eats too much and gains excessive weight, binge eating disorder and nocturnal binge eating disorder.

Binge eating disorder is a condition where individuals binge frequently and feel a lack of control over it. This disorder is different from bulimia because it is not followed by purging behaviour.

Obviously, many of us overeat from time to time and some of us do so regularly, but simply eating too much does not constitute a binge eating disorder.

In order to be diagnosed, the binge eating must be accompanied by frequent feelings of being unable to control what or how much is eaten as well as several of the following: eating more rapidly than usual; eating until uncomfortably full; eating large amounts of food when not physically hungry; eating alone out of embarrassment; and feelings of disgust, depression or shame after overeating.

Binge eating disorder is probably the most common eating disorder affecting roughly two per cent of the population. Most individuals with this condition are obese and among the obese population, the condition affects at least 10 to 15 per cent of people.

As with other eating disorders, binge eating disorder affects more women than men, but the ratio is less extreme, it affects approximately three women for every two men.

Depression very often accompanies binge eating disorder and it is not clear whether it is the cause or effect of the condition, but negative emotions can trigger binge episodes.

Health problems caused by binge eating are the same as those that accompany any kind of obesity and include diabetes, heart disease, high cholesterol, stroke and others.

Treatment of binge eating disorder is not as simple as going on a diet. Because the binging is emotionally linked, it is important to focus on the binge eating behaviour before attempting weight loss.

Cognitive Behaviour Therapy can be helpful in teaching self monitoring and behaviour modification. It is also important to treat underlying depression and anxiety disorders when they are present. As with bulimia, Selective Serotonin Re-uptake Inhibitor (SSRI) medication has been shown to be effective in controlled clinical trials.

Nocturnal binge eating disorder is a sleep related condition where individuals binge eat in the night while they are sleeping. Food wrappers and used dishes are found in the morning but the individual usually has no memory of getting up or eating during the night as with sleep walking.

Usually, food consumed is high fat, high calorie comfort food that may be restricted during the day. Once individuals realize what they have done, they are often embarrassed and ashamed of their nocturnal behaviour.

Often, individuals with nocturnal binge eating disorder diet during the day, which may result in them feeling hunger during the night. Unfortunately, the uncontrollable nocturnal eating can lead to depression and weight gain. This is a vastly under-recognized condition.

Treatment may involve spending a night at a sleep disorder unit to be monitored and positively diagnosed. Once a diagnosis is made, SSRI antidepressant medication can be helpful and lifestyle modifications to reduce stress and anxiety may be appropriate.

Taking sleep medication is not helpful and can lead to further confusion and disorientation. I have seen this condition emerge in those who are on very sedating medication for other conditions and subside when that medication is reduced or discontinued.

If you believe you have a binge eating disorder, speak to your health care provider. You are not alone and help is available.


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