Do you ever feel out of control around food? Dietitian Caitlin Reid explores the eating disorder that’s more common than you think.
Think you’re the only one who overeats? Hardly! Everyone overindulges every now and then – but what if you find yourself bingeing regularly? If that sounds more like you, you’re not alone. This behaviour has only recently been recognised as a type of eating disorder, known as binge eating disorder, and experts suspect it’s on the rise. In fact, it’s now thought that up to 30 per cent of people who are currently dieting or trying to control their weight are sufferers.
What is binge eating disorder?
Binge eating disorder (BED) is characterised by the consumption of large amounts of food in a relatively short period of time, together with feeling a ‘loss of control’ and severe distress about these eating episodes. Like bulimia nervosa, it involves consuming large amounts of food in a short time, however BED sufferers do not try to purge or exercise off all the kilojoules consumed.
Binge eaters usually experience intense feelings of secrecy and shame surrounding these episodes, a total inability to control their behavior, but also real concern about the damage these binges may be doing to their bodies. BED can affect anyone, although it’s most common in obese individuals. Experts estimate between 2 and 5 per cent of all Australians are affected, making it the most common of all eating disorders.
Is your binge eating out of control?
Do you feel out of control when you eat?
Do you eat in secret, or hide food to eat later in private?
Do you eat continuously throughout the day, with no planned mealtimes?
Do you think about food all the time?
Do you feel ashamed, guilty or embarrassed after you eat?
Do you feel powerless to stop eating?
Do you eat when you are stressed or to comfort yourself?
Do you feel numb while eating?
Do you eat until you are uncomfortably full?
Do you eat large amounts of food when you are not physically hungry?
Do you feel that you’re never satisfied after eating, no matter how much you eat?
Do you binge eat at least two days a week and has this been going on for more than six months?
The more ‘yes’ answers you have, themore likely it is that you could have binge eating disorder.
Why are you bingeing?
There is no single cause of binge eating disorder, but health professionals believe a combination of factors can contribute to the condition.
Genetics: Recent research shows that gene abnormalities may contribute to binge eating. Abnormalities in peptides, involved in regulating appetite, may play a role in binge eating behaviour. Other studies have found that low levels of serotonin may also play a role.
Psychological: A recent review of the research has found a strong link between depression and BED. Low self-esteem, loneliness, perfectionism and body dissatisfaction are associated with BED. Sufferers may also have difficulties with impulse control and expressing their feelings.
Dieting: Research shows that dieting behaviours increase the likelihood of bingeing, and may lead to weight gain as a result of long-term, unhealthy eating patterns. Psychological distress arising from the social stigmatisation obese people can experience can also lead to binge eating.
Culture: Social pressures and media images, which regard thinness as the ideal body shape, can add further shame and guilt to BED sufferers and fuel their emotional-eating response. Childhood experiences, such as negative comments about their weight during childhood and teen years, can increase the likelihood of developing BED. Parents can unknowingly set the stage for binge eating by using food as a comfort or reward.
Emotional: Using food as the main coping strategy to deal with stress and emotions can develop into an unhealthy addiction to food. In this situation, people eat to feed their feelings, rather than their bodies. Eating doesn’t solve the problem and after a binge, regret and self-loathing is common. Weight gain is likely, and the worse people feel about themselves, the more they use food to cope, creating a vicious circle.
Health effects of binge eating disorder
There are a number of physical, social and emotional effects associated with binge eating disorder. Research shows that people suffering from the condition report more health problems, stress, insomnia and suicidal thoughts than people without an eating disorder. People with binge eating disorder often have low self-efficacy – the confidence about their capabilities to produce effects – and have a disjointed life because they miss work, school or social activities to binge eat.
Despite large amounts of food being consumed, people with binge eating disorder are at risk of nutritional deficiencies. This is because the foods they consume tend to be high in kilojoules and low in nutrients, which can cause weight gain and ultimately lead to obesity. Obesity increases the risk of developing a number of other diseases, including diabetes, gall bladder disease, heart disease, various forms of cancer, and bone and joint problems. Depression may also occur since bingeing increases feelings of guilt, anger and sadness. If you think you, or someone you know, has BED, it’s important you contact your doctor.
How to beat your binges
As with any other eating disorder, recovering from BED requires a multi-faceted approach. Your treatment needs to be customised to address your individual situation, and it is extremely important that you seek the assistance of a qualified specialist. But treatment will generally focus on a combination of the following:
Stopping the ‘diet’ cycle
The dieting cycle, which involves deprivation of certain foods, is a major factor in setting off a binge, causing the sufferer to again diet and deny themselves food – perpetuating and reinforcing the cycle. It’s important to form a healthy relationship with food, by focusing on providing your body with nutritious foods you enjoy, and ditching the ‘good’ and ‘bad’ labels dieters typically associate with food.
Boosting emotional well-being
It’s well documented that BED sufferers experience feelings of shame and have a poor sense of self-image. There is also a link between BED and depression. Successful treatment must therefore address these, and any other, psychological issues. Two forms of psychotherapy, cognitive behavioural therapy (CBT) and interpersonal therapy (IPT), have been proven to help sufferers, by identifying binge eating triggers and developing coping strategies.
Establising ‘ordered’ eating patterns
For some, but not all, binge eaters having the day’s meals planned out in advance can be beneficial. A pre-planned menu can establish a level of stability in eating patterns, which can help sufferers avoid potential triggers associated with unplanned eating. It’s also important that bingers eat breakfast, as research shows that skipping this meal can lead to overeating or poor food choices later on in the day; both of which can be triggers for binge eaters.
Addressing environmental triggers
Triggers vary for individuals, so addressing them may involve keeping certain foods out of the house, or avoiding a favourite take-away shop.
Scheduling in exercise
Regular exercise can help build self-confidence, ease depression and reduce stress. As a result, it can help arrest emotional eating, which can be a trigger for binges.
Losing weight (if necessary)
Weightloss treatments may help to improve a sufferer’s emotional well-being. However, disordered eating and emotional wellbeing are generally higher priority. Sufferers may also find that weight loss occurs naturally, without specific treatment, once the other factors are addressed. Anyone with BED should see a doctor and discuss available treatment options before choosing a course of action.
For Laura Economos, 30, a teenage obsession with dieting, food and weight fed an ongoing battle. Today, she is a nutritionist and personal trainer, helping others develop healthy relationships with food.
During my teenage years, I started constructing my own diets and depriving myself of the foods I really wanted in an attempt to lose weight. I’d always used food as a coping mechanism. It was always a forbidden thing in my head, but when I did eat something ‘bad’ I would gorge on it, eating so much I would be sick and bloated for ages.
Food was never fuel, just an ongoing psychological battle. My obsession with my weight affected my whole life – family, relationships, school and career. I never really put 100 per cent into anything, as I was too worried about exercising, or busy planning my next diet.
After school, I became a nutritionist and personal trainer, and started working in a gym. Initially, this fueled my obsession, and made my problem worse. I quit the job at the gym and started my own business. It was then that I started to see a psychologist and life coach to get to the root of my problem – low self-esteem and an inability to accept myself as I was. Binge eating, for me, was an escape from my problems. But I have now realised that recovery from binge eating disorder involves constantly choosing to feel good and cope with issues and events in a healthier way.
Even today there are times when I overeat and don’t listen to my body, but I don’t binge eat any more. One of the biggest changes I’ve made is changing my mindset from being ‘in control’, to making better choices. Now I choose to nourish my body; listen to it as best as I can; eat when I am hungry; stop when I am satisfied; stay aware when I am eating and enjoy what I eat.
The advice I can offer other sufferers is to seek professional help to determine the emotional triggers that are causing you to overeat. So any people hide in shame or try to deal with it on their own. Our health, both emotional and physical, is one of the most valuable assets we have; look after it and get the help you need to empower yourself and make positive changes in your life.
Today, food is no longer an enemy and thanks to therapy, the support from my family and my husband’s wonderful cooking, I now enjoy food.
What to do if you suspect a friend has binge eating disorder?
If you suspect a friend or family member has binge eating disorder, it’s important that you emphasise that there may be a problem, but beware of jumping to conclusions based on an isolated incident. BED does not develop overnight, so it’s important to look for a pattern of behaviour before you confront them. Remember, they will more than likely feel ashamed and fearful about their eating behaviours, and react angrily or withdraw, when you raise the issue. Approach them with care and focus on your concern for them, instead of labelling them a ‘binger’. Support them through the recovery process by encouraging them to seek help and let them know that you care about their health and well-being.