Binge Eating Disorder

Introduction

Through time, the definition of the word 'binge' has evolved to mean different things altogether. In the 70s, people binge when they go on a "drunken spree." (The American Heritage Dictionary) Today, people binge when they overindulge, not in alcoholic beverages, but in food. Many like to use this word trivially, to describe an episode of slight overeating. There are some, however, who cannot afford to see binging as an insignificant rise in food intake. When they binge, these people gorge and find themselves losing control over the amount of food they consume. They are the people who suffer from the binge-eating disorder. (Fairburn, 1995)

What is Binge-Eating Disorder?

Binge-eating disorder is a common illness that faced by many today, particularly those in western countries such as the United States (U.S) and United Kingdom (Fairburn, 1995). In U.S alone, four million out of the general population suffers from this eating disorder. This number is far greater than the number of people suffering from either anorexia nervosa or bulimia nervosa (Wardlaw & Smith, 2006).

With the trivial usage of the word 'binge', it has become difficult for us to distinguish to what extent overeating constitutes a serious problem. Dr. Christopher Fairburn identified "the feature... (that) distinguishes binge eating from everyday overeating and mere indulgence... (as) the sense of loss of control." (Fairburn, 1995) True bingers not only eat an abnormally large amount of food each time they eat, they feel an irrepressible desire to eat. It is this seemingly uncontrollable desire that differentiates a binger from a mild overeater.

What Causes Binge-Eating Disorder?

Binge eating is usually triggered by "negative moods." (Agras & Telch, 1998) According to Wardlaw and Smith, "stressful events and feelings of depression or anxiety" (Wardlaw & Smith, 2006) can trigger binge eating. They also stated loneliness, anxiety, self-pity, depression, anger, rage, alienation, and frustration as triggers of binge eating. Typically, bingers engage in binge eating "to induce a sense of well-being and perhaps even numbness, usually in an attempt to avoid feeling and dealing with emotional pain and anxiety." (Wardlaw & Smith, 2006) They seek pleasure, as well as distraction from their worries and anxieties, from food. Eating, for them, is a form of escapism.

The Characteristics of Binge-Eating Disorder

People with binge-eating disorder go through recurrent episodes of overeating. In each episode, the patient eats "an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances." (American Psychiatric Association, 2000) The patient also has "a sense of lack of control (over) what or how much (he/she) is eating." (American Psychiatric Association, 2000) During these binge episodes, the patient tends to eat much more rapidly than usual. The patient usually eats until he/she feels uncomfortably full. Such binge episodes can happen even when the patient is not feeling "physically hungry." (American Psychiatric Association, 2000) Patients of the binge-eating disorder also tend to eat alone, for they feel a sense of embarrassment by the large amount of food that they eat. Patients typically feel "disgusted with (themselves), depressed, or very guilty" after these binging episodes. (American Psychiatric Association, 2000)

Nutritional Effects of Binge-Eating Disorder

Obesity is a common problem among patients with binge-eating disorder. Though it is not known how prevalent binge eating is among obese individuals, "clinically significant binge problems are common among those seeking treatment for obesity." (Fairburn & Wilson, 1993) In fact, it was reported that 28.6% of obese patients who sought obesity treatment binge eat at least twice per week (Fairburn & Wilson, 1993).

Patients suffering from binge-eating disorder are vulnerable to being obese because they have a higher caloric intake than others (Yanovski et al, 1992). The food that bingers would typically choose is what that is easy to eat in large amounts, such as noodles, rice, and bread, (Wardlaw & Smith, 2006) foods which are high in carbohydrates and energy content. They also tend to consume a lot of what we call 'fattening' foods, foods that "carry the social stigma of 'junk' or 'bad' foods", such as ice cream, cookies, sweets, potato chips, and other snacks (Wardlaw & Smith, 2006). Studies have shown too, that people with binge-eating disorder "consume significantly more meat than (those) without binge-eating disorder." (Cooke et al, 1996) As can be gathered from these food choices, and was scientifically tested, people with binge-eating disorder consume a greater percentage of energy as fat, and a lesser percentage of as protein than those without this eating disorder (Yanovski et al, 1992). Each of these factors can lead to unhealthy weight gain, which explains the commonness of obesity among bingers.

Apart from obesity, patients with binge-eating disorder are also generally poor in health. They are reported to have "poorer functioning and lower scores on all six scales of the General Health Survey." (Bulik & Kjennerud, 2003) Findings go on to show that there is an "increased prevalence of joint pain, headaches, gastrointestinal problems, menstrual problems, shortness of breath, chest pain, and Type II diabetes" among them. (Bulik & Kjennerud, 2003) Bingers also suffer from sleeping problems; Statistics show that they are seven times more likely to experience sleeping difficulties than those without binge-eating disorder. (Bulik & Kjennerud, 2003) Such are the detrimental effects that binge-eating disorder can have on human health. These effects prove binge-eating disorder to be a clinically significant illness which cannot be ignored; Binge-eating disorder requires treatment.

Treatment for Binge-Eating Disorder

As binge eating sessions are mostly triggered by negative emotions and thoughts, psychological treatments are used on patients to reduce their frequency of binge eating. One example of such psychological treatments will be the cognitive behavioral therapy (CBT), a treatment which "emphasize(s) (the) establishing healthy eating patterns, self-monitoring food intake, developing problem solving skills, and preventing recurrence." (Wonderlich et al, 2003) Short-term CBT has been shown to be effective in