Binge eating, or binge-eating disorder (BED), involves episodes of binging (or ingesting excessive amounts of food) which the patient finds difficult to control. This differs from other eating disorders such as bulimia because it has no compensatory action (purging, excessive exercising, or fasting).

Behaviors associated with binge eating

• Rapid eating
• Eating excessively even when not hungry
• Eating alone because of shame
• Eating until there is a feeling of uncomfortable fullness
• Feeling guilty, depressed, or disgusted at self after binging

A binge eater generally has eating episodes that last for about an hour and averages 4,000 calories. This is usually done two times a day.

Prevalence

Binge eating in the U.S. is more common than bulimia or anorexia, according to the National Institutes of Health. In the U.S., binge eating disorder affects about 2% of the population, but is a problem for as much as 8% of obese people; furthermore, it affects about 30% of obese people seeking treatment for obesity. BED occurs in both men and women with a ratio of 2:3, and affects both whites and non-whites. There is also a significant correlation between the degree of obesity and the severity of BED.

Causes

Many factors may lead to binge-eating disorder. Some can be considered complicated, such as those related to distorted views of the ideal body size or physiological factors (e.g., chemical makeup of the brain), while some are simple, taking advantage of the opportunity to eat as much as one wants prior to starting a new diet regimen.

Binge eating is often used as a method of distracting oneself from problems or stressors. We often turn to ‘comfort food’ when we feel depressed or tense, but binge eaters take this concept to a whole new level. Sometimes the disorder may be due to an incident in the past which has not been resolved – a death of a loved one, physical and/or emotional abuse, a divorce – and may start innocently, gradually worsening to uncontrollable eating.

In teens, binge eating may be their response to having a bad day in school or frustration in their personal and social relationships. Some eat so little and even miss meals, that when they do get the opportunity to eat, they do so in excess.

We all go through these episodes at one time or another in our lives, but when it becomes a regular occurrence, or when excessive eating is followed by feelings of disgust, shame, and guilt, then that is when the situation becomes problematic. 

Self-check

Since patients of BED do not necessarily have to be obese to have the disorder, some individuals may already have it but are not aware of it. Below are a few questions a patient may ask himself or herself to help determine its presence:

• Do you eat hidden from others’ view?
• Do you lose self-control while eating?
• Do you often think about food?
• Do you gorge yourself until you are so stuffed that you feel sick?
• Do you feel shame or disgust after overeating?
• Do you resort to eating to overcome feelings of depression?

Effects

Aside from obesity, binge eating can lead to deficiencies in nutrition. This is because in most cases, food taken in large amounts during a binge are those that are bad for one’s health, such as high-sugar and high-fat foods. Contrary to popular belief, not all patients of BED are obese or overweight. Some may have the ideal body weight and size, but more often than not, they carry several nutritional deficiencies.

Obesity could further lead to the following ailments: problems of the bones and joints; secondary diabetes; heart disease (caused by raised triglyceride levels) and hypertension; gall bladder disease; and various cancers.

Treatment

1. Cognitive Behavior Therapy (CBT)
Used as the first line of treatment, CBT combines the management of depression with weigh-t and eating-management education.

a. First treatment phase (8 weekly sessions): The objectives of this stage are to inform the patient about obesity and binge eating; to put an end to the aberrant eating pattern and to regain control over eating habits; and to start an exercise regimen.
b. Second treatment phase (8 weekly sessions): This stage’s goals are to pinpoint wrong thoughts and beliefs; and to know about and put into practice skills in problem solving.
c. Third treatment phase (6 sessions over a period of 2 months): The aims are to advance the acceptance of one’s own body and to develop an effective maintenance plan.

2. Weight-Loss Programs

3. Interpersonal Therapy
Also known as IPT, this is an alternative to CBT and involves the treatment of depression. The principle behind this method is that interpersonal issues tend to have an effect on self-esteem, which in turn brings about the eating disorder.

4. Medication

a. Antidepressants
b. Opioid antagonists, for the suppression of the intake of foods high in fat and sugar
c. Anorectic agents (appetite suppressants)

5. Self-help
If you are bent on conquering an eating disorder, you can manage your own binge eating habits with a few tips.

a. Eat a balanced diet. There is a wealth of resources on how to put together meals that are satisfying but are equally nutritious. Try to avoid diets that call for skipped meals or those that require you to eat in minuscule portions, as this may only aggravate binging to compensate for the lack.
b. Eat regularly. Establish an eating routine which would provide you with enough nutrients to sustain you throughout the day. Small and frequent meals are recommended. In addition, studies have shown that ‘snacking’ rather than having three big meals a day is more effective for weight loss.
c. Take up a distracting activity. Instead of resorting to binging when you have nothing else to do, engage yourself in useful activities such as taking up a hobby or craft, art, reading, getting involved in a civic organization or cause, or listening to your favorite music.
d. Exercise. Although it can stimulate the appetite, especially after heavy workouts, exercising puts you in a frame of mind where you will again appreciate your body and realize that binge eating can cause harm to it. When you start feeling and looking good, chances are you’ll keep away from doing things that will destroy your physical health.

6. Alternative Treatments
Meditation is an example of an alternative treatment for BED. In a study conducted by Kristeller and Hallett in Utah, they found that a 6-week meditation-based program for BED patients resulted in a decrease in the frequency as well as in the severity of binges among 18 obese women.