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Binge Eating Disorder: What it is, what it isn't and how to get help

Posted Feb 16 2011 12:11am

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 - 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.

Therefore, in writing this blog, I usually try to stick to topics that I have some experience in. But 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 but with an estimated 3-5% of the adult population of the US suffering from this disorder it is simultaneously the most prevalent and yet least talked about of all the eating disorders. And judging from the amount of e-mails and comments I get, it's an important topic to you guys too. Today we're talking Binge Eating Disorder .

What Binge Eating Disorder Is

Deb from Fat to Fit for the Finish recently wrote a very brave post about her unhealthy relationship with food. She recalls,
I think I was about 12 years old. It was just after Christmas. I love the Christmas buffet we have every year. I think my mom told me to stop eating the spinach dip, or asked if I had enough, or something innocuous like that. I'm not sure though. All I remember is sneaking downstairs to the basement with a big bowl of spinach dip and bread to eat it with. Then eating and eating and eating it. I ate it until I made myself sick and was in the basement bathroom puking just swallowed spinach dip and bread.
It was one of the first times I remember sneaking off to eat food, but it hasn't been the last. Even as an adult, I'd had snacks, meals, etc. I'd be afraid going out with friends that I didn't want them to see how much I ate, or that I wouldn't get full. So I'd eat secretly before going out, then eat a full meal an hour later. Just in case. Just in case I didn't get enough food on my plate. We all know how impossible that would be, given restaurant portions.
In addition to Deb's story this powerful article about BED in the NY Times goes a long way in describing what it feels like from the inside. This fear of food and it's ability to manipulate and control us at our most basic level is a feeling a lot of us can relate to. So what separates a clinical binge eater from the college student who eats a whole pizza during a particularly Bacchanalian evening?

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. Anorectics 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. Intuitive Eating as described by Geneen Roth (you know how I love her!) is very healing for many. And yet still others respond positively to medication. Or a combination of any of the above.

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. You are not alone. You can be helped.

Do you have any experience with Binge Eating Disorder, personal or otherwise? Do you have any advice, words of encouragement or questions for people suffering from this? Anyone else

Written with love by Charlotte Hilton Andersen for The Great Fitness Experiment (c) 2011. If you enjoyed this, please check out my new book The Great Fitness Experiment: One Year of Trying Everything for more of my crazy antics and uncomfortable over-shares!
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