Binge Eating Disorder (Esssucht)

Binge Eating Disorder is an eating disorder characterized by binge eating. Large amounts  of food are  eaten during an attack. Those affected often experience a loss of control (the feeling of not being able to stop eating or not having control over the quantities eaten). The binge eating typically takes place in the absence of witnesses.

Binge Eating Disorder

It is usually eaten quickly, without feeling hungry and indiscriminately, consuming a far larger amount of food in a short time than healthy people would eat under similar conditions. This is often followed by feelings of guilt and shame as well as depressed moods. Binge eating differs from  bulimia  in the absence of the compensatory behavior typical of the latter (e.g. self-induced vomiting, abuse of laxatives and/or diuretics) after the binge eating.

About two percent of the population is affected by binge eating. Most people with this eating disorder are overweight. Binge eating can also occur in people of normal weight. About twenty to forty percent of moderately to severely obese people who see a therapist about  being overweight  have binge eating disorder.

Binge eating is slightly more common among women than men (ratio about 3:2). Overweight people with a binge eating disorder are often overweight earlier (even as children) than “normal” obese people. They also usually go through more phases of weight gain and loss ( yo-yo effect ).

Binge Eating: Causes

The causes of binge eating are still unclear. About half of those affected have suffered from  depression at some point in their lives  . However, it is unclear whether depression is the cause or consequence of the eating disorder. There does not necessarily have to be a connection. Many sufferers report that feelings of  anxiety , sadness, anger, boredom, or other negative feelings trigger binge eating.

The effect of dieting on the development of binge eating disorder is also still unclear. Various studies suggest that repeated strict  dieting  (rigid control) can trigger binge eating. However, about half of those affected already suffer from binge eating before they start dieting.

Binge Eating: Symptoms and Signs

Many people sometimes overeat, and many feel they have eaten more than they should. However, just eating large amounts of food does not mean that someone also suffers from a binge eating disorder. The following signs belong to the binge eating disorder:

• Regular episodes of binge eating, in which a far larger amount of food is eaten in a short period of time than other people would eat under similar conditions.
• Feeling out of control (unable to control what or how much is eaten) during binge eating.
• Several of the following behaviors or feelings: Eating much faster than usual. Eating until an uncomfortable feeling of fullness. Eating large amounts of food without physiological hunger. Eating alone, ashamed of the amounts consumed. Self-disgust, depression, and/or guilt after overeating.

Binge eating also occurs in bulimia. In contrast to people who suffer from binge eating, bulimics exhibit purging behavior,  fast  or exercise excessively. These behaviors are “countermeasures” to increased calorie intake and are intended to counteract weight gain. Such countermeasures are missing in binge eating.

Binge Eating: Consequences and Complications

The main physical complications are complications of  obesity :   type II  diabetes mellitus, hypertension , cardiovascular diseases and dyslipidemia. Binge eating can also create psychological complications. Affected people are very stressed by the disease. Many have already tried independently to reduce binge eating, which often only worked for a short time.

The stress and suffering caused by the eating disorder can mean that those affected can no longer fulfill their work or social obligations. Overweight people with binge eating disorder often feel bad about their eating habits, are overly concerned with their weight and shape, and avoid social contact. This withdrawal can lead to isolation. Most feel ashamed and try to hide their disorder from other people.

Binge Eating: Therapy and Treatment

Individuals with binge eating disorder who are not or only moderately overweight should avoid weight loss diets, as strict dieting can exacerbate the eating disorder. However, many are clearly overweight and suffer from physical complications. For these people, losing weight and maintaining weight are important treatment goals. For most people, whether they want to lose weight or not, treatment specific to their eating disorder is recommended. Any weight loss can be carried out after the eating disorder has been treated.

Various studies have shown that people with binge eating have a harder time staying on a weight loss program than overweight people without the eating disorder. They also tend to regain weight more quickly if binge eating is not addressed first. Therefore, the eating disorder should be specifically treated before attempting weight loss.

Different approaches to treatment

There are different approaches to treatment. Previous research results show that cognitive  behavioral therapy  and interpersonal therapy can lead to a reduction in binge eating. In a cognitive-behavioural therapy treatment, those affected learn techniques and strategies for observing and changing their eating behavior and they learn how to react to difficult situations (as an alternative to a binge eating).

In interpersonal therapy, the current interpersonal (interpersonal) relationships are in the foreground, without specifically addressing eating habits. Drug treatment with  antidepressants  can also help and reduce binge eating. However, drugs  are less effective when used alone than psychotherapeutic approaches. They should only be used in combination.

Preventive Measures

Avoid rigid diets:  The range of diets is constantly increasing. Many seem quite logical; it is understandable that overweight people are willing to go on appropriate diets. However, many of the starvation diets do not work in the long term. Their weakness is that they do not take into account the set point, emotional responses to dieting, individual differences in normal weight, and the unreasonableness of the thin ideal.

Rigid diets that result in relatively high weight loss in a short period of time based on an unbalanced diet pose a health risk. Binge eating can be a direct result of hunger. The more attempts are made to restrict food intake, the greater the tendency to binge eating. Often the mistake will begin by skipping a meal (as a way of making amends) after an binge eating. This automatically pre-programs the next loss of control. Compare flexible control of eating behavior.

Individuals with binge eating disorder who are not or only moderately obese should avoid dieting, as strict dieting can exacerbate the eating disorder. However, many people with binge eating disorder are also significantly overweight and suffer from its physical consequences. For them, weight loss and subsequent stabilization is sometimes an important treatment goal. Weight reduction can follow the specific treatment of the eating disorder.

Acknowledgment of being overweight:  The set point theory states that all people are of normal weight. This is determined by a combination of genetic and dietary factors. Set point weight is maintained through the interaction of a variety of biological factors. These factors mean that each individual is only able to feel comfortable and function within a limited weight range.

There are many indications in the literature that obesity is not the result of a lack of willpower, but is genetically determined for some. This does not mean that obesity as such is unchangeable: weight reduction is possible due to changes in eating and nutritional behavior and lifestyle. The scope within which this is possible appears limited.