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Binge Eating Disorder, Coming To A Table Near You

Posted Feb 10 2009 11:29am

Anyone curious as to what happens to the male anatomy when running in sub-zero temps? Sorry, can't help you. How about what to do if an adorably squishy-wishy koala bear wanders into your back yard? Again, I have no idea. Even things that you'd think I'd know something about, like CPR - I am actually certified in both pediatric and adult and reup my certification every year - often fail me as evidenced by the time I was faced with a student having a stroke in my adult computer literacy class and my first instinct was to Heimlich the poor woman. What can I say? I'm not good in a crisis.

Therefore, in writing this blog, I usually try to stick to topics that I have some experience in. Me being me, this means a lot (okay, A LOT) of posts on fitness, a side order of food and nutrition, a smattering of sexual assault, a lot of whining about the State of Society and... eating disorders. Heck, I even went on TV (twice!), much to my parents' chagrin, to talk about my crazy food issues.

So today I'm going to break with tradition and write about something I know absolutely nothing about. I'm really nervous since this topic is very sensitive and the last thing I want to do is proverbially Heimlich the stroke victim again. I wouldn't normally touch something so far out of my purview except that I've been getting a lot of e-mails from you guys on this subject. And everytime I write about eating disorders, someone brings it up in the comments. (I've even e-mailed some of you asking you to share your personal experience but to no avail.) Misguided as I may be, I want to help. Today we're talking Binge Eating Disorder.

What Binge Eating Disorder Is
One of the perks of having an internationally reknown professor for a father (besides advance copies of all the textbooks a geek girl could want, nevermind the fact that no matter how fast they come out they're still 2 years obsolete thanks to the magic of the Internet) was all of the cool foreign food we got to eat. I remember being about 9 years old when I was first introduced to real Chinese won-tons. Words do not exist to describe their awesomeness. I snuck out of the grown-up chat room (known as the front room in those ancient days) and hid under the table. I ate the whole plate - probably 30 or so won-tons - by myself. And then I puked for the rest of the night.

That is what I think of when I think "binge." That is not what we are talking about when we are speaking of binge eating disorder. Everyone has, at some point in their life, eaten past the point of fullness. Perhaps, like me, you've even eaten to the point of regurgitation. But for people with BED - approximately 3-5% of the adult population, making it by far the most prevalent of all the eating disorders - this does not even approximate their reality.

Simply put, BED is eating an unusually large amount of food (some websites estimate about 8,000 - 10,000 calories in one sitting) while feeling out of control eating, as if unable to stop and not taking any steps to purge afterwards. These occurrences happen at least twice a week for at least six months. Binge eating episodes can also be characterized by:

- Eating very quickly
- Eating alone to hide the behavior and/or the food
- Eating when not physically hungry
- Eating to the point of physical discomfort
- Feelings of extreme shame, embarrassment, depression and/or disgust after eating

I know that I've done all of these things - especially the last one! - and yet while I might off-handedly call an overeating episode a binge, it is not a disorder until it significantly affects your quality of life. All eating disorders ruin your physical and mental health.

What Binge Eating Disorder Is Not
1. Obesity. People with BED are often overweight or obese but they don't have to be. Also, not everyone who is overweight or obese suffers from BED.

2. Gluttony. The term gluttony implies pleasure in the behavior. Some people overeat and love it - think the ancient Romans - but people with BED do not enjoy their food nor the process.

3. Depression. While people with BED are often depressed - as are sufferers of all eating disorders - it is not known whether the depression helps cause the BED or is an effect of it.

4. Weakness. It's a disorder. And people in the throes of a binging episode are every bit as frightened and overwhelmed by their problem as anorexics or bulimics are of theirs. It's not just a matter of willpower. Just like telling an anorexic to "just eat a sandwich already" doesn't cure them, telling a person with BED to "just stop eating" is not helpful either.

5. Bulimia or Anorexia. It is true that part of bulimia is bingeing but a bulimic also purges. People with BED do not induce vomiting, take laxatives, over exercise or ortherwise purge after the binge episodes. Anorexics are also known to binge after prolonged periods of starvation but these bingeing episodes stop on their own once the anorectic's weight reaches a healthy level.

6. A Female Problem. While women do account for slightly more of reported cases of BED, the numbers are pretty close. Men have this problem almost as frequently as women.

7. Cured by Dieting. In fact, chronic dieting can actually reinforce the binge eating pattern. Sufferers of BED often do need to lose weight but the emphasis should be on helping them overcome their eating disorder before putting them on a calorie-restricted plan.

What To Do if You Have Binge Eating Disorder
Sadly, BED is just not as "sexy" of an eating disorder as some of the others and so gets far less press, research money and public support. There are very few well done research studies available on treatment approaches to BED. The summary of the many (many) articles I read on the subject is basically to try it all and see what works for you. Some people have found a lot of relief with groups like Overeater's Anonymous. Others have done well in traditional eating disorder therapies. And yet still other respond positively to medication.

Back when I was in treatment for my eating disorder(s), my therapist said something that I have found helpful ever since: that all eating disorders are a form of Obsessive Compulsive Disorder (OCD). Jack Nicholson and Howard Hughes notwithstanding, OCD is not just about hand washing and lock checking, rather it is about mitigating one's anxiety (the obsessive thoughts) by performing a ritualized behavior (the compulsions). Where anorexics respond to their anxiety by strictly controlling their food, people with BED respond by overeating. It's two sides of the same coin. I have spoke in the past about how I have had a lot of success managing my eating disorder and depression with CBT (cognitive behavioral therapy) and while I freely admit I am no expert in BED, I think it may be of use here as well.

But whatever you do, do something. If you recognize yourself or a loved one in these symptoms, please seek out aid. You are not alone. You can be helped.

Your Stories
To see what BED really looks like you can start here, with this powerful story about BED in the NY Times. But I'm hoping you all will help me put a face (even if it's an anonymous one!) on this. You've proven in the past how much smarter and stronger and wiser and wittier you are than I am - a fact for which I am eternally grateful! - so please reach out here and share your experiences with BED. I know that there are some of you out there who are fighting this right now and despairing that you will never be able to overcome it. I also know that there are some of you out there who have overcome it. And I know that many of you have loved ones who are struggling with this as well. Or perhaps you would just like to offer encouragement and support. I'd love to hear from all of you.

Update: Reader Marste has generously offered to share her experience with bingeing with us. She has put it up on her blog and I highly recommend it! Her perspective and generosity of spirit are beautifully conveyed. I think many of you will find comfort in her story! Thank you Marste!
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