Binge Eating Disorder
Food is always considered a right that all people are entitled to have alongside clean water. Some nations thrive in food producing lands and livestock while there are nations that have scarce means to produce food. For those who could access food, there are people who would eat only a few due to their physical weight and people who would keep eating despite the consequences of too much food in the body. While many note that people who eat too much would become obese, they do not realize that there are many reasons as to why a person becomes obese and it may be due to an eating disorder. Food is often noted to also be a form of a luxury and therapy for many to reduce their stress; however, too much eating fosters the beginning of eating disorders. In this extent, binge eating disorder is acquired by people who consume a large quantity of food due to bouts of emotional lows and as a result of a person’s physical condition.
Costin (2006) notes that binge eating and its subsequent disorder, the binge eating disorder has been around the globe for centuries. It is only in 1949 when a case was drafted, providing the public a description of this disorder. In 1950, Dr. Albert Stunkard from the University of Pennsylvania saw the relationship between binge eating and obesity in his study. Several studies had also been done throughout the years as to how all eating disorders are connected to binge eating, some noting that binge eating should have its own category given the nature of patients and their reasons for bingeing. People who were discovered to be binging were originally known as compulsive overeaters, emotional overeaters and even called as food addicts. However, Dr. Robert Spitzer from Columbia University noted that these “food addicts” have a disorder known as the “pathological overeating syndrome”. POS patients tend to binge eat without showcasing behavioral effects such as fasting and purging to lose their excess weight. The distinction of these binge eaters was noted to be crucial as there are individuals, mostly obese patients that do not binge. Finally, Spitzer introduced the term “binge eating disorder” in 1992 in the International Journal of Eating Disorders. The DSM-IV TR also included this new term to binge eating.
According to Baugh (2008), Binge eating normally occurs when a person consumes a large amount of food in a short period without a break. The problem itself is not uncommon as people or at least 4.5% of the population experience binge episodes once or twice in a given situation. While it may be a natural occurrence in one's lifetime, there are at least 2.8% of the population that are diagnosed to have a binge eating disorder. BED is considered a psychiatric disorder since patients with this disorder experiences a control lapse on their food habits and the amount of food they intake. Sometimes, food consumption for BED patients happens twice a week or within a six-month period. Within the binge eating period, patients experience several emotions that contribute to the problem. BED patients are seen to eat faster than usual, enabling them to eat a large amount of food despite the body's actual capacity. Some often eat until they are overly full of the food they have consumed. In some cases, BED patients also consume large quantities of food even if they do not feel hungry. Emotions are also visible in BED patients as some may find seclusion due to the amount of food eaten by the person; others feel depression or disgust in themselves for the food intake. There are also chances of stress playing a part with binge eating disorder that may come from work, personal relationships and even social issues.
The DSM-IV TR Research Criteria had also indicated the same signs on patients with BED. The first criteria details the duration of recurrent episodes of binge eating, normally characterized by the eating duration of the person, the amount of food acquired and the control lapse on overeating. The second criteria cover the additional signs of binge eating, namely how the person eats in any circumstances and how emotions play in the compulsion. The criteria also noted that patients exhibiting marked distress on overeating or binge eating is a notable sign of BED. The fourth criteria denote on how much time binge eaters have their episodes. Under the DSM-IV, determining frequencies for binge eating is different with patients for bulimia. Since the BED discovery is still a recent discovery, future research is noted to develop a method that would constitute frequencies in bingeing. Finally, the criteria also includes that binge eating is not connected with other compensatory behaviors like fasting and purging that could also be seen in Anorexia and Bulimia. In addition to these criteria on determining if a person has BED, professionals also indicate that there is a possibility that there are two categories of binge eating: deprivation-sensitive binge eating and addictive or dissociative binge eating. Deprivation-sensitive binge eating is acquired through weight-loss diets or restrictive eating. Both of these weight loss programs could trigger binge episodes. The addictive or dissociative category, on the other hand, is acquired through self-medication of an emotional turmoil or depression. Some patients with the second category report feelings of dissociation and calmness after bingeing.
Experts believe that there are a few causes as to why binge eating occurs and how it could morph into a psychological disorder. According to the US Department of Health and Human Services (2008), the lack of data on BED makes it difficult to determine the exact cause of the BED. Some people often see binge eating as a means to cure depression or stress and utilize it as a form of compensation for feeling these negative emotions. Stress is often considered one of the major contributors to binge eating as the person may feel stressed from the pressures others are placing on him and from the feelings he experiences. A few would note that binge eating is their means to seclude themselves from others and a time for them to run from their problems for a few hours. It is also noted that binge eating could be correlated to other mental and physical health complications. Mental health conditions such as depression, anxiety and psychological complications are just some of the examples wherein binge eating could occur. Physical health problems mostly reflect the risk of obesity and other eating disorders. It is notable that BED patients are mostly overweight and have additional complications such as heart problems and organ failures. However, experts and health professionals note that while BED patients exhibit similarities with other eating disorders, it is crucial to note the influence of binge eating in a person’s treatment of his psychological problems. Obesity, a normal cause for binge eating could also be caused by other forces such as eating high-calorie foods without the need to eat in long periods. Some other studies have suggested that people with BED tend to have problems controlling their emotions. Patients tend to also feel signs of anger and boredom when they binge eat, thereby causing questions as to how they relate to each other. Research is now being done to understand the brain’s impact in binge eating and how brain chemicals and metabolism fair in BED. Other research had also suggested the influence of genetic composition thus the increased signs of binge eating.
The risk BED has covers not just women, but also men despite the additional instances women would acquire this eating disorder. As noted above, binge eaters tend to be overweight or obese, with a history of having emotional or mental issues in the past. Obese or overweight binge eaters are noted by studies to have struggled with their weight and tried all kinds of dieting to reduce their weight. However, with the fact that dieting acts slowly, the frustration of seeing diet results adds to the person's depression and triggers binge-eating. Frequent dieters are also at risk with binge eating despite the fact that some patients with BED have not tried dieting. It is visible that patients with BED also have an issue with their health condition that had been triggered by their weight. Some BED patients are recorded to have instances of diabetes, high blood pressure, cancer, and cardiorespiratory complications. Additional complications due to BED included joint and digestive pains, including problems in sleeping or working. Age and ethnic origin is also not an issue with binge eating as it affects both young and adult groups, opening additional risks to any person. Since BED is a somewhat relatively new disorder, there is no clear evidence or research as to how age and ethnic origin are influenced by BED. According to Neinstein (2008) community-based surveys had indicated that binge eating disorders occur in 1% to 2% of the adolescents under ages 10 to 19. Surveys had also noted that patients with BED are obese; nonetheless, people with regular eating habits can also be affected. In some epidemiological tests done on children and adolescents, boys are seen to be more prone to having binges than girls. Results showcased that 19-33% of boys have BED as compared to the 6-7% of girls seen to have the disorder. However, if one bases the symptoms of binge eating control tendencies, it is visible that girls are more prone in having this problem with 25.6%. BED also influences not just a small number of people as it affects both male and female groups from all forms of ethnic groups .
Treating BED is similar to the procedures and treatment given to patients with bulimia due to their similarities. What varies from BED and bulimia is the lack of compensatory behaviors attached to bulimia, such as purging, laxative and diuretic use and over-exercise. Since BED is a psychological disorder, patients are also given anti-depressants to reduce depression that triggers binge episodes. In some extreme cases, patients with BED are given appetite suppressants to curb hunger and binge episodes. Therapy is also given to patients, such as cognitive behavioral therapy to resolve behavioral causes of binge eating. This type of therapy also teaches patients to control and keep track of their eating habits and divert them into more healthy diets. It also enables patients to change their outlook regarding their body shape and weight. Interpersonal psychotherapy is also considered an acceptable treatment method for BED as this would enable patients to reconnect with their families and friends, enabling the solution of issues contributing to binge eating. Group and family therapies are also given to ensure that families and individuals are given enough attention in remedying binge episodes . BED treatments also focus mostly on binge eating and food compulsion, eliminating all perceptions of utilizing food to overcome problems and cope up with emotional stress. Experts and doctors have indicated that inclusion of weight loss as part of BED treatment is controversial in essence as it may influence a patient’s psychological, emotional and relational capacity should it fail to show results. Therapists have noted that weight loss as a major goal in treating BED would present danger as it may sound as if they are prejudice with patients with BED . In addition to this, people with BED and are obese could benefit in weight-loss programs that also cover other eating disorders. For people who are not overweight, but have signs of BED, they should avoid trying to lose weight as it triggers the tendencies of binge eating.
Aside from cognitive behavioral therapy, drug therapy and intrapersonal therapy, scientists are also looking at the benefits of other therapies for BED. This includes dialectical behavioral therapy that controls and regulates emotions, enabling patients to channel their emotions into other mediums and forms. Drug therapy through anti-seizure medication topiramate is also considered reducing food compulsion and alleviate stress. Bariatric surgery is also given a consideration as it would help patients lose weight significantly. Some therapists would also give excellent reviews for self-exercise with additional concentrations on cognitive behavioral therapy. Self-help is often available for patients with BED given the direction and supervision of a loved one or a therapist. Self-help books, videos, and group sessions are available in the market for patients to work on their binge eating. However, many still consider professional help regarding the problem on BED considering that not all of these alternative methods work in a given situation.
The issue on treatment had constantly been studied by experts considering the complications of treatment and prognosis of BED. Researchers at this point are still trying to come up with newer methods to control BED by combining both drug and behavioral therapy. Nonetheless, it is noted that there are still characteristics in BED that has yet to be solved by the scientific community . According to DeAngelis (2002), some clinicians have noted that BED must be treated as an eating disorder that influences psychopathology that causes patients to feel the stress of overeating. Treatment in this extent could include cognitive behavioral therapy, enabling patients to feel right about themselves and address behaviors on how they treat eating and stress. Denise Wiftley of the San Diego State University cited that intrapersonal therapy is more successful in treating BED than others, giving a sample of a patient she helped in treatment through this method. The woman had lived in another country and upon returning to the US, lost every social support she had before moving. Binge eating became the patient’s coping mechanism to the additional stress she was feeling about her family. With the use of interpersonal treatment, the woman was able to address her relationship with her family, reducing binge eating tendencies. Wilfley also noted that this treatment is capable of reducing the patient’s weight as they abstain from binge eating throughout treatment. Some researchers commented that behavioral weight-loss treatments may indeed eliminate binge-eating; however, it is noted that it does not do much benefit in the long run. Some studies had noted that there are some cases of subgroups that are affected more by BED and must be given specialized treatment as noted by Terence Wilson, psychologists from Rutgers University. He stressed that while some patients may indeed respond to behavioral weight loss treatment, there are others who do not have the same mental structure and pathology, and it may hinder treatment .
As of today, BED is still being researched considering the nature of this illness and how to develop treatments for patients. The lack of specification and distinction from other eating disorders makes it hard to separate BED, increasing chances of misidentification. Patients with BED must be made aware that they are not alone in facing this ordeal as anyone could be inflicted with this eating disorder and also have issues on treating the problem. While there is still a gap as to how BED could be treated and understood, patients must not lose hope and seek professional help. It is noted by research that most people who seek treatment for BED had done well in treatment and overcome their binge eating tendencies. It is necessary for people to control and watch what, and how much they eat considering that binge eating may lead up to complications such as obesity and cardiorespiratory diseases, which could be fatal if not prevented.
References
Baugh, E. (2008, August). Binge-Eating Disorder. Retrieved November 24, 2012, from University of Florida Institute of Food and Agricultural Sciences Extension Publication: http://edis.ifas.ufl.edu/fy1058
Costin, C. (2006). The Eating Disorders Sourcebook: A Comprehensive Guide. New York: McGraw Hill Professional.
DeAngelis, T. (2002, March). Binge-eating disorder: What's the best treatment? Monitor on Psychology, 33(3), 30.
Neinstein, L. (2008). Adolescent Health Care: A Practical Guide. Philadelphia: Lippincott, Williams and Wilkins.
US Department of Health and Human Services. (2008, June). Binge Eating Disoder. Retrieved November 24, 2012, from Weight-control Information Network: DHHS and NIDDK Publication: http://win.niddk.nih.gov/publications/PDFs/bingedis10.04.pdf
