Binge Eating Disorder

Binge Eating Disorder

Kimberly Vavrosky, RD Rosewood Intensive Adolescent Program  Jessie remembers being in 6th grade and sneaking into her family's kitchen for leftovers late at night, cleaning up behind herself so there would be little evidence of her being there. She can also remember digging through trash cans for food that others had thrown away unfinished, and turning to her favorite foods for comfort after a bad day at school. Now that she is older, she catches herself ordering cheeseburgers, fries, shakes, onion rings, and buckets of fried chicken and mashed potatoes. Then she'll hit the store for cakes, cookies, ice cream and chips. Once home alone, she eats and doesn't stop until the food is gone and is so stuffed that she feels sick. But even then, the bad feelings still remain and the guilt, shame and disgust come in. She berates herself for being so disgusting, having no self control and hating her overweight body wondering what clothes will fit her in the morning, while thoughts of her joint pain and high cholesterol run through her mind. Jessie has Binge Eating Disorder (BED), which is the most prevalent eating disorder in the United States. It is one example of eating disorder not otherwise specified (EDNOS) in American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed,,(DSM-IV) and defined as "Recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa." BED is also in Appedix B of DSM-IV, which is reserved for possible new diagnostic categories.             Diagnostic criteria for BED is characterized by eating an amount of food, within a 2 hour period, that is larger than most people would eat in a similar amount of time under similar circumstances while having a sense of lack of control over eating during that episode. Binge eating is not associated with inappropriate compensatory behaviors that are seen in Bulimia Nervosa such as purging, fasting or excessive exercise. Episodes of binging are associated with three or more of the following: eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of being embarrassed by how much one is eating, or feeling disgusted with oneself, depressed or very guilty after overeating. To be considered BED, binge eating must occur on average at least 2 days a week for 6 months.             Binge eating can be comforting for a moment, but then reality sets in, and brings regret and self-loathing. The worse a binge eater feels about themselves and their appearance, the more they use food to cope. BED becomes a vicious cycle: eating to feel better, feeling even worse, and then turning back to food for relief. Risk factors are not as well defined as they are with other eating disorders, but are thought to include family history and genetic factors and psychological and sociological factors. Medical complications accompanying BED are extensive and include obesity, depression, high blood pressure, diabetes, high cholesterol, sleep apnea, joint and muscle pain, osteoarthritis and anxiety.             Breaking this cycle by seeking treatment allows a person to work through the obsessive and degrading thoughts, determining underlying reasons for turning to food, learning other coping skills and getting medical complications under control. For some, medications may be appropriate to help with treatment. If you suspect a loved one or yourself has binge eating disorder, discuss your concerns and inquire about help from a medical professional. Binge eating disorder is a complex illness that requires significant therapeutic intervention.  For more information on Binge Eating Disorder visit our website www.rosewoodranch.com.