Binge Eating Disorders (2)

When the term eating disorder comes up, it likely brings to mind skeletally thin girls purposely starving themselves and returning each day to the ever-critical scale.

Anorexia and bulimia are the eating disorders that receive the most attention and they do have life-threatening consequences. However, there is a flip side to the eating disorder coin and these are the binge eating disorders.

In binge eating disorder and nocturnal binge eating disorder, individuals eat too much and gain excessive weight.

Disordered binge eating is more than simply regular over-indulgence. Many of us overeat from time to time and some do it often, but this alone does not constitute a binge eating disorder.

In order for binge eating to be diagnosed, binge 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.

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. I will cover this condition in more detail in a later column.

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. A recent study combining cognitive behaviour therapy and guided self help for binge eating showed positive results with almost two thirds of people free from binge eating after one year.

When treating the eating disorder, it is also important to treat underlying depression and anxiety disorders if they are present. As with bulimia, Selective Serotonin Re-uptake Inhibitor (SSRI) medication has been shown to be effective in controlled clinical trials.

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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