Understanding binge eating disorder (BED)
People struggling with BED engage in frequent binges which feel out of control. They feel tremendous distress over this behavior and eat alone due to their embarrassment. Unlike bulimics, they do not purge after binge eating episodes. Binges are often followed by intense feelings of guilt and shame. Because of the high ingestion of calories, individuals with BED are often overweight. Part of the reason for this all too common problem is cultural. We live in a “food toxic” environment, with continuous easy access to delicious, sweet, high-fat foods (as well as deceptive “No Fat” foods which are full of sugar and calories). Many studies have documented that when individuals from other cultures come to the United States, they give up their healthful native food, adopt the American diet, and suffer from the same obesity-related health problems as Americans. While some of us do not have to struggle to resist these temptations, there are those for whom temptation becomes obsession. For compulsive overeaters, any emotion can be experienced as a reason to eat. Feelings of anger, sadness, guilt, shame, fear, and even joy are experienced as a vaguely anxious feeling. Eating serves as a way to quiet this internal storm. There is a strong family connection for those with BED. Individuals with BED may have grown up watching their parents use food and other substances (drugs, alcohol) to self-medicate depression. By watching their parents, they learned that food was the most effective or appropriate way to comfort themselves.
Recent research is showing that compulsive overeating also has a genetic component. Some people may have a deﬁciency in the system that sends signals from the belly to the brain about hunger and fullness. Sufferers may also be struggling with a biologically-based depression. When this condition is treated with anti-depressants, individuals may ﬁnd that their urges to binge diminish to manageable levels.
But does this mean that a person with BED is destined to suffer with food obsession and misery for a lifetime? No! Unfortunately, however, people too often look to “the diet” as the answer. The rationale is, “I need more CONTROL.” Caught up in the promises of the multi-billion-dollar diet industry, individuals with BED try every diet conceivable, only to ﬁnd that the lost weight always returns, and usually even brings a few more pounds with it. Dieting fails because deprivation and hunger set the sufferer up for food obsessions, cravings, and binges. This is a normal, healthy, biologically adaptive human response to calorie restriction—not a sign of weakness or lack of willpower!
However, each failed diet chips away at their self-worth as the individual is bombarded with messages in society and in their relationships that they are weak, lazy, stupid and morally inferior to thin people. This further reinforces their feelings of depression and hopelessness that they will ever attain their goal weight. They isolate themselves socially and romantically, feeling that no one would have them as they are, or they remain in abusive or detached relationships, believing that this is as good as they deserve. The individual may avoid looking in mirrors and buy clothes that hide their body so that they do not have to know their true size. A shopping trip for new clothes or a photograph of themselves may bring about the stark realization that they are larger than they thought.
There are many approaches to addressing this problem, for most sufferers of BED, long-term success requires some combination of cognitive-behavioral therapy and anti-depressant medication. Medical, spiritual, emotional, and interpersonal issues must all be addressed. It is especially important to challenge the self-loathing and internalized weightism that fuel the problem.
- High cholesterol
- Heart disease
- Certain types of cancer
- Type 2 diabetes
- Gall bladder disease