Overcoming Binge Eating and Compulsive Overeating
Binge Eating Disorder: Symptoms, Causes and Treatment
Treatment for binge eating may involve a combination of psychological therapies and counselling, cognitive-behavioural interventions, nutritional coaching and support groups, all tailored to address the challenges associated with eating disorders.
Did you know that eating disorders are potentially life-threatening conditions affecting millions of individuals worldwide?
The good news is that instant intensive treatment can substantially improve the chance of people recovering from these conditions. For this reason, it is necessary to be aware of the warning signs and symptoms of eating disorders and the treatment options available to help people in need.
Core Psychopathology at the Core of an Eating Disorder
An eating disorder is a mental health condition characterised by unhealthy disordered patterns of behaviour, including
- binge eating,
- starving,
- obsessive calorie counting,
- self-induced vomiting,
- misusing diuretics and laxatives
- excessive exercising.
These unhealthy behaviours can dramatically affect people’s social, physical and psychological functioning.
Evidence from clinical research indicates that at the core of most eating disorders is the individual core psychopathology. Most other characteristics of eating disorders appear to be peripheral to this psychopathology and its outcomes, such as under-eating or binge eating.
The core psychopathology typically comprises various emotional issues leading to binge eating or your specific relationship with food. This psychopathology occupies a focal place in most patients’ presentations and is a primary aim of treatment. Clinical practice reveals that unless the core psychopathology is effectively addressed, patients are at considerable risk of relapse into bingeing.
Eating Disorder Diagnoses Versus Disordered Eating
There is a difference between disordered eating and eating disorder diagnoses. Disordered eating is sadly very normalised and, in some cases, reinforced in our society, particularly in certain communities. For instance, in a lot of athletic communities, disordered eating is not only normalised but possibly praised. In this instance, non-normative eating patterns do not necessarily cause consistent psychological or physical distress or are below the diagnostic threshold for frequency, intensity, and duration of eating disorder symptoms.
What is a Binge Eating Disorder (BED)?
According to the DSM-5, the manual that clinicians use to diagnose psychiatric conditions, you may have a binge eating disorder if you binge eat recurrently at least once a week for three months, large amounts of food in a short period of time. Furthermore, you are unable to control how much and what you are eating. You may be very distressed by your binge eating and feel ashamed trying to hide this issue.
Binge eating disorder episodes are characterised by three or more of the following symptoms:
- Eating large amounts of food, even when not hungry;
- Eating until uncomfortably full;
- Eating isolated because of feeling embarrassed about
- binge eating;
- Eating much faster than usual;
- Feeling disgusted with oneself, very guilty or depressed afterwards.
Causes
Many factors can contribute to the development of binge eating disorder:
- Past trauma;
- Physical, emotional or family issues;
- Bullying;
- History of yo-yo dieting and other dieting behaviours;
- Genetics.
Thus, the precise causes of a binge eating disorder are not identified. However, among the most frequently recognised causes are the following:
- Rigid and extreme dietary restraint due to excessive worries about being fit or slim, especially if it is societal or job pressure;
- Anxiety;
- Low self-esteem;
- Being a perfectionist or having an obsessive personality;
- History of a traumatic experience, for example, sexual abuse;
- Being criticised for your body shape, eating traditions or weight;
- Familial history of eating disorders, dependencies or depression.
Triggers
Some common triggers for binge eating include the following:
- Feeling anxious, unfortunate, unhappy or other negative emotions;
- Feeling bored;
- HALT triggers: feeling Hungry, Angry, Lonely or Tired;
- Interpersonal relationship problems;
- Interpersonal conflict resulting in anger, frustration or self-blame;
- Advertisements on TV, in magazines, etc.;
- Certain memories or mental images.
Delay Discounting at the Core of Impulsive Behaviour
It is critically important to analyse the negative consequences of binge eating episodes. This cognitive tool aims to minimise so-called delay discounting, which features impulsive behaviour. The essence of delay discounting is that binge eating is maintained because positive consequences resulting from binge eating behaviours are more immediate than negative consequences.
Health Risks
Binge eating disorder is the most commonly occurring eating disorder. People may frustratingly spend decades trying to stop bingeing.
Unfortunately, the health risks related to binge eating disorder are severe. They include
- Type two diabetes mellitus,
- High blood pressure,
- Heart disease,
- High cholesterol,
- Weight gain or obesity.
Thankfully, binge eating disorder is treatable and most of its physical consequences are reversible. However, if you do not seek help for the emotional issues leading to binge eating or your relationship with food, the outcomes of binge eating disorder can be debilitating and life-threatening.
BED vs Similar Conditions
Binge Eating Disorder vs. Bulimia Nervosa
The main distinction between binge eating disorder and bulimia nervosa is that people with bulimia nervosa try to avoid weight gain after binge eating episodes by purging (employing compensatory behaviours, including vomiting, excessive exercising, using diuretics or laxatives or starving). People with binge eating disorder may sometimes try these tactics to prevent weight gain, but it does not happen consistently.
Binge Eating Disorder vs. Obesity
Many people suffering from binge eating disorders are overweight. However, people with normal weight can also have a binge eating disorder. On the other hand, many people who are overweight or have obesity do not have a binge eating disorder. Therefore, it is critical not to confuse binge eating disorder with obesity, which is a physical condition featuring the excessive accumulation of body fat. Even though BED and obesity often overlap, the treatment for them differs.
Binge Eating Disorder vs. Compulsive Overeating
Binge eating disorder has many similarities with compulsive overeating. Yet, no distinct diagnostic criteria for compulsive overeating exists, and it belongs to the diagnosis of Other Specified Feeding or Eating Disorders (OSFED). OSFED comprises disordered eating conditions that induce substantial distress but do not match the full criteria for any other eating disorder. For example, people may have a compulsive overeating episode for a briefer period or less regularly than individuals with the diagnosis of BED.
Compulsive overeating features regular and chronic overeating. People who compulsively overeat will ingest a large amount of food very fast and may not necessarily be hungry. One description of compulsive overeating is that it occurs at least twice a week for more than one month. The treatment approach is similar to the treatment of BED and includes psychological therapies and counselling and, sometimes, medications.
Challenges of Dealing with Binge Eating
Both an eating disorder therapist and a person suffering from BED, might find binge eating a big problem to deal with for several reasons. First of all, the regular binge-eating cycle resembles dependence, but unlike chemical dependency, one cannot cease eating. Secondly, binge eating may alleviate unpleasant feelings. Many people find it stress-reducing soothing, calming, comforting or even reinforcing. So, it can be seen as a coping strategy, although dysfunctional in the long term. Finally, the feelings and behaviours associated with binge eating are often maintained by dysfunctional thoughts and misunderstandings about our bodies, weight and food.
In addition, someone who binge eats usually has had previous unsuccessful attempts to stop the behaviour. When stopped bingeing, people often experience emotional fluctuations and other unpleasant withdrawal symptoms, including physical.
However, there are reasons to be positive. Many people can effectively discontinue binge eating.
Treatment for Binge Eating Disorder
BED is often treated by means of non-pharmacological interventions, such as cognitive-behavioural therapy, counselling, coping skills training and nutritional coaching. Sometimes, psychological interventions for binge eating are combined with pharmacological treatment for comorbid conditions, such as anxiety or depression.
Treatment options need to be discussed with a general practitioner, psychiatrist or eating disorder counsellor to find the right course. Counsellors deliver explorative counselling and coping skills training, which are crucial for enhancing coping mechanisms and preventing symptom return in the long term.
Psychological interventions, effective at treating binge-eating disorder include cognitive behavioural therapy and counselling, interpersonal therapy and dialectical behavioural therapy. They are provided as individual interventions and are also very effective in group treatment. Furthermore, an eating disorder counsellor or therapist may suggest a guided self-help programme as a treatment intervention for a binge eating disorder.
Psychological therapy for binge eating disorders primarily aims to break the cycle of binge eating. This is often achieved through a collaborative effort between a therapist and the client.
The goal of this collaboration is to
- identify and challenge dysfunctional thoughts and feelings that contribute to binge eating episodes,
- analyse triggers and consequences of the episodes,
- and establish more effective coping strategies and healthy eating routines.
Bibliography:
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- https://doi.org/10.1002/(sici)1098-108x(199809)24:2<125::aid-eat2>3.0.co;2-g
- https://doi.org/10.1093/med/9780198795551.003.0009
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