Binge Eating Disorder
Binge eating disorder is the most common eating disorder in the U.S. affecting nearly 4% of women and 2% of men. It affects people of all ages and races. Binge eating is formally defined based on three distinctive features:
- The individual feels a “loss of control” over eating during the episode, that is, the individual does not feel able to stop
- The eating episode occurs over a short, discrete period of time
- The amount of food consumed is considered greater than what most people would eat in a similar period of time
These criteria would qualify for the definition of an “objective binge episode.” However, from a clinical perspective, the overall amount of food consumed may be less important than the subjective experience of the individual during the episode.
Eating disorder specialists recognize the importance of a “subjective binge episode” in which the individual feels out of control, eats more food than he or she wants to eat, and feels extremely guilty and upset following the episode. The amount of food eaten is less relevant than the subjective/emotional experience of the individual before, during, and after the episode.
Binge eating typically occurs as a way of coping with painful emotions, such as feeling lonely, sad, stressed, anxious, or depressed. It provides temporary relief and escape—a way of numbing or distracting from painful emotional states. Eating particular foods also releases hormones and neurotransmitters that provide immediate relief and satisfaction. Binge eating can also occur as a result of overly restrictive dietary practices, restricting amounts or types of foods. Individuals who are very restrictive in their attempts to lose weight, and who are concerned and preoccupied with body image, are at risk for binge eating when they break their overly stringent dietary restraint and transgress their rigid dietary rules. They end up bingeing on the very foods they typically avoid; the thought process is something like: “I blew it so I may as well go all the way and binge.” This is known as “all-or-nothing,” or dichotomous thinking. Whatever its cause and whether the binge is an “objective” or “subjective” binge experience, these episodes are always followed by extreme feelings of guilt, remorse, and shame.
Treatment for binge eating disorder is necessary in order to avoid other health problems that are occur as a result of the disorder. Binge eating is typically treated on an outpatient basis and includes:
- Individual psychotherapy
- Support or therapy groups
- Family/couples therapy
- Family member support/education
- Specialized nutrition counseling
- Medical/psychiatric support and medication management as needed
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