Glutton for punishment: binge eaters are impulsive and often unable to control their emotions and behavior - includes related information

American Fitness, Nov-Dec, 1997 by Christine F. Ridout

Binge eating has been called the "forgotten eating disorder" because it has not received the same attention as anorexia and bulimia. But for those who live with it, the disorder cannot be forgotten. Fortunately, medical experts report significant progress in treating binge eating.

What Is Binge Eating?

For a binge eater, daily life revolves around food. Affecting approximately 4% of the adult population, binge eating has recently been defined as a medical and psychiatric disorder associated with obesity, bulimia and depression. However, according to Howard Rankin, Ph.D., director of the Wellness Retreat in Hilton Head Island, South Carolina and a specialist in eating disorders, bingeing can be difficult to define because it differs from overeating. For example, what constitutes a binge for one person may not be for another. There are, however, some hallmarks of bingeing which set it apart from simple overeating.

Rankin says that binge eating is characterized by consuming more food than is appropriate for the person's body type. During bingeing, food is quickly eaten without regard to hunger. Binge eaters often feel unable to control how much and what type of food they eat, and they frequently do not remember gorging themselves.

Rankin also says that binge eaters tend to consume meals alone out of shame at the amount of food being consumed, and they typically feel depressed, disgusted, gully and isolated afterward. In order to be classified as a binge eater, Rankin says a person must binge at least twice a week for a minimum of six months. While binge eaters occasionally purge, this behavior is not intrinsic to the disorder.

Common Characteristics of Binge Eaters

Although there is significant variation in the underlying personalities of binge eaters, most professionals agree sufferers share some common characteristics. For example, Rankin says that binge eaters are often perfectionists who set high standards for themselves. They tend to depend on others for approval, have low self-esteem, and frequently exhibit "all or nothing" thinking. The latter manifests itself when a binge eater "slips" off a diet. Thinking one mistake equals total failure, they will go on a binge.

Binge eaters often have a history of depression, anxiety or other psychiatric problems, according to Sharon Alger, M.D., associate professor of medicine at Albany Medical College in Albany, New York and a specialist in eating disorders. One study found that as many as 80% of binge eaters are depressed. Binge eaters are also impulsive and often feel out of control of their emotions and behavior.

Experts agree that is considered emotional eating. Rankin and Emil Rick, director of the Sparrow Hospital Weight Management Center in Lansing, Michigan, emphasize binge eating has little to do with food or hunger. Rick says that during bingeing, food is used for comfort and managing unpleasant emotions. Binge eaters often report that an episode of gorging is set off by negative emotions such as anger, guilt or anxiety, and that food is a "drug" to alleviate unpleasant feelings. For many bingers, food has a numbing or sedative effect which promotes temporary feelings of well-being. Rick says that this encourages the binger to overeat again.

"No One Should Have to Live Like This."

Binge eating takes an enormous toll on a person's life. Sarah, who has struggled with food most of her life, says that eating is an addiction that "has taken over my whole life." Each day she vows not to binge, but "eats all day anyhow." The result is a sense of failure which increases her underlying depression.

Sarah also says that she often feels out of control of her life, eats alone and frequently sneaks food after her family has gone to bed. She feels guilty, ashamed and isolated, but is unable to stop. She believes eating disorders can only be overcome with professional help.

Sarah adds binge eating has tied her to a lifestyle which excludes other activities. She spends so much time eating and preparing food, she doesn't have time for more pleasurable activities. She also says the obesity which has resulted from her binge eating precludes activities such as sports. Even simple things, like sitting in an airplane seat, become an ordeal.

Sarah is a typical binge eater. She says that her weight was painful during adolescence when her self-esteem considerably suffered. She has a history of obesity in her family and a record of yo-yo dieting. After a "successful" diet, she would regain weight because her compulsions about food "always came back."

Sarah has also had problems with depression and alcohol abuse, and been a heavy smoker. She says these addictions are similar to food addictions because they involve the use of substances to handle stress and painful emotions.

Reflecting on her life, she says she feels sad and believes that "no one should have to live like this." She is taking appropriate steps to deal with her difficulties and has made considerable progress.

Causes

Eating Disorders Awareness and Prevention, Inc., in Seattle, Washington states eating disorders arise "from a combination of psychological, interpersonal and social conditions. Feelings of inadequacy, depression, anxiety and loneliness, as well as troubled family and personal relationships, may contribute to the development of an eating disorder. Our culture, with its unrelenting idealization of thinness and the `perfect body,' is often a contributing factor." Thus, eating disorders, including bingeing, have multiple causes. Professionals who work with binge eaters say each case must be individually treated.