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Medical Encyclopedia:

Binge-Eating Disorder

Definition

Binge eating disorder (BED) is characterized by a loss of control over eating behaviors. The binge eater consumes unnaturally large amounts of food in a short time period, but unlike a bulimic, does not regularly engage in any inappropriate weight-reducing behaviors (for example, excessive exercise, vomiting, taking laxatives) following the binge episodes.

Description

BED typically strikes individuals sometime between adolescence and the early twenties. Because of the nature of the disorder, most BED patients are overweight or obese. Studies of weight loss programs have shown that an average of 30% of individuals enrolling in these programs report binge eating behavior.

— Paula Anne Ford-Martin


 
 
Sci-Tech Dictionary: binge eating disorder
(¦binj ′ēd·iŋ dis′örd·ər)

(psychology) A condition that is characterized by recurrent episodes of excessive eating but, unlike bulimia nervosa, no extreme weight control behaviors (purging, laxatives, fasting) are present; persons with the disorder have chaotic eating patterns and frequently overeat as well as binge.

 
Alternative Medicine Encyclopedia: Binge Eating Disorder

Definition

Binge eating disorder (BED) is characterized by a loss of control over eating behaviors. The binge eater consumes unnaturally large amounts of food in a short time period, but unlike a bulimic, doesn't regularly engage in any inappropriate weight-reducing behaviors (like excessive exercise, vomiting, taking laxatives) after the binge episodes.

Description

About three percent of women and one-tenth as many men have duffered from either bulimia or binge eating disorder at some time in their lives. BED typically strikes individuals between their adolescent years and their early 20s. Because of the nature of the disorder, most BED patients are overweight or obese. Studies of weight loss programs have shown that an average of 30% of individuals enrolling in these programs report binge eating behavior. Binge eating in milder forms is even more common, as are attempts to compensate for the binges.

Causes & Symptoms

Binge eating episodes may act as a psychological release for excessive emotional stress. Other circumstances that may predispose an individual to BED include heredity and mood disorders, such as major depression. BED patients are also more likely to have an additional diagnosis of impulsive behaviors (for example, compulsive shopping), post-traumatic stress disorder (PTSD), panic disorder, or personality disorders. More than half also have a history of major depression. In 2002, the American Psychiatric Association was considering including BED as a psychiatric diagnosis.

Individuals who develop BED often come from families who put an unnatural emphasis on the importance of food. For example, these families may use food as a source of comfort in times of emotional distress. As children, BED patients may have been taught to clean their plates regardless of their appetite, or to be a good girl or boy and finish all of the meal. Cultural attitudes towards beauty and thinness may also be a factor in BED.

During binge episodes, BED patients experience a definite sense of lost control over their eating. They eat quickly and to the point of discomfort, even if they aren't hungry. They typically binge alone two or more times a week, and often feel depressed and guilty when the episode is over.

Diagnosis

BED is usually diagnosed and treated by a psychiatrist and/or a psychologist. In addition to an interview with the patient, personality and behavioral inventories, such as the Minnesota Multiphasic Personality Inventory (MMPI), may be administered as part of the assessment process. One of several clinical inventories, or scales, may also be used to assess depressive symptoms, including the Hamilton Depression Scale (HAM-D) or Beck Depression Inventory (BDI). These tests may be administered in an outpatient or hospital setting.

Treatment

Many BED individuals binge after long periods of excessive dieting; therapy helps normalize this pattern. The initial goal of BED treatment is to teach the patient to gain control over his or her eating behavior by focusing on eating regular meals and avoiding snacking. Cognitive behavioral therapy, group therapy, or interpersonal psychotherapy may be used to uncover the emotional motives, distorted thinking, and behavioral patterns behind the binge eating. The overweight BED patient may be placed on a moderate exercise program and a nutritionist may be consulted to educate the patient on healthy food choices and strategies for weight loss.

Initial treatment may focus on curbing the depression that is a characteristic feature of BED. Recommended herbal remedies to ease the symptoms of depression may include damiana (Turnera diffusa), ginseng (Panax ginseng), kola (Cola nitida), lady's slipper (Cypripedium calceolus), lavender (Lavandula angustifolia), lime blossom (Tilia x vulgaris), oats (Avena sativa), rosemary (Rosmarinus officinalis), skullcap (Scutellaria laterifolia), St. John's wort (Hypericum perforatum), valerian (Valeriana officinalis), and vervain (Verbena officinalis).

Binge-eating episodes that appear to be triggered by stress may be curbed by educating the patient in relaxation exercises and techniques, including aromatherapy, breathing exercises, biofeedback, music therapy, yoga, and massage. Herbs known as adaptogens may also be prescribed by an herbalist or holistic healthcare professional. These herbs are thought to promote adaptability to stress, and include Siberian ginseng (Eleutherococcus senticosus), ginseng (Panax ginseng), wild yam (Dioscorea villosa), borage (Borago officinalis), licorice (Glycyrrhiza glabra), chamomile (Chamaemelum nobile), and nettles (Urtica dioica). Tonics of skullcap (Scutellaria lateriafolia), and oats (Avena sativa), may also be recommended to ease anxiety.

Allopathic Treatment

Treatment with antidepressants may be prescribed for BED patients. Selective serotonin reuptake inhibitors (such as Prozac) are usually preferred because they offer fewer side effects. However, clinical studies don't show much effectiveness for use of antidepressants in treating BED. Psychotherapy shows better results. Once the binge eating behavior is curbed and depressive symptoms are controlled, the physical symptoms of the disorder can be addressed.

Expected Results

The poor dietary habits and obesity that are symptomatic of BED can lead to serious health problems, such as high blood pressure, heart attacks, and diabetes, if left unchecked. BED is a chronic condition that requires ongoing medical and psychological management. To bring long-term relief to the BED patient, it is critical to address the underlying psychological causes behind binge eating behaviors. It appears that up to 50% of BED patients will stop bingeing with cognitive behavioral therapy.

Resources

Books

Abraham, Suzanne and Derek Llewellyn-Jones. Eating Disorders: The Facts. 4th ed. Oxford: Oxford University Press, 1997.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Press, Inc., 1994.

Siegel, Michele, Judith Brisman, and Margot Weinshel. Surviving an Eating Disorder: Strategies for Family and Friends, 2nd ed. New York: Harper Perennial, 1997.

Periodicals

Brewerton, Timothy D. "Binge Eating Disorder: Recognition, Diagnosis, and Treatment." Medscape Mental Health 2, no. 5 (1997). http://www.medscape.com.

"Treatment of Bulimia and Binge Eating." Harvard Mental Health Letter (July 2002).

Tufts University. "Binge Eating Disorder Comes Out of the Closet: Experts Say Leading Obesity Factor Has Long Been Overlooked." Tufts University Diet & Nutrition Letter 14, no. 11 (January 1997): 4-5.

Organizations

American Psychiatric Association (APA). Office of Public Affairs. 1400 K Street NW, Washington, DC 20005. (202) 682-6119. http://www.psych.org/.

American Psychological Association (APA). Office of Public Affairs. 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. http://www.apa.org/.

Eating Disorders Awareness and Prevention. 603 Stewart St., Suite 803, Seattle, WA 98101. (800) 931-2237. http://www.edap.org

National Eating Disorders Organization (NEDO). 6655 South Yale Ave., Tulsa, OK 74136. (918) 481-4044.

Overeaters Anonymous World Service Office. 6075 Zenith Ct. NE, Rio Rancho, NM 87124. (505) 891-2664. http://www.overeatersanonymous.org/.

[Article by: Paula Ford-Martin; Teresa G. Odle]

 
Children's Health Encyclopedia: Binge Eating Disorder

Definition

Binge eating disorder (BED) is characterized by loss of control over eating behaviors. The binge eater consumes unnaturally large amounts of food in a short time period, but unlike a bulimic, does not regularly engage in any inappropriate weight-reducing behaviors such as excessive exercise, induced vomiting, or taking laxatives following the binge episodes.

Description

BED typically strikes individuals sometime between adolescence and the early twenties. Because of the nature of the disorder, most BED patients are overweight or obese. Studies of weight loss programs have shown that an average of 30 percent of individuals enrolling in these programs report binge eating behavior.

Demographics

Binge eating affects an equal numbers of females and males. Although there are no good statistics on how many children suffer from the condition, an estimated 1 to 2 million Americans of all ages are binge eaters. Many of them report that their condition started in childhood.

Causes and Symptoms

Binge eating episodes may act as a psychological release for excessive emotional stress. Other circumstances that may make a child or adolescent more likely to engage in binge eating include heredity and certain psychological affective disorders such as major depression. BED patients are also more likely to have a comorbid (co-existing) diagnosis of impulsive behaviors such as compulsive buying, post-traumatic stress disorder (PTSD), panic disorder, or personality disorders.

Individuals who develop BED often come from families who put an extreme emphasis on the importance of food as a source of comfort in times of emotional distress. Children with BED may have been taught to clean their plates regardless of their satiety or that their finishing a meal makes them a "good" girl or boy. Cultural attitudes towards beauty and thinness may also be a factor in whether a person binges.

During binge episodes, BED patients experience a definite loss of control over their eating. They eat quickly and to the point of discomfort even if they are not hungry. They typically binge alone two or more times a week and often feel depressed and guilty when the episode concludes.

Diagnosis

Binge eating disorder is usually diagnosed and treated by a psychiatrist and/or a psychologist. In addition to an interview with the child, personality and behavioral inventories, such as the Minnesota Multiphasic Personality Inventory (MMPI), may be administered as part of the assessment process. One of several clinical inventories, or scales, may also be used to assess depressive symptoms, including the Hamilton Depression Scale (HAM-D) or Beck Depression Inventory (BDI). These tests may be administered in an outpatient or hospital setting.

Treatment

Many BED individuals binge after long intervals of excessive dietary restraint; therapy helps normalize this pattern. The initial goal of BED treatment is to teach the patient to gain control over the eating behavior by focusing on eating regular meals and avoiding snacking. Cognitive-behavioral therapy (learning new behavior), group therapy, or interpersonal psychotherapy may be employed to uncover the emotional motives, distorted thinking, and behavioral patterns behind the binge eating.

Because the prevalence of depression in BED patients is high, treatment with antidepressants may also be prescribed. Once the binge eating behavior is curbed and depressive symptoms are controlled, the physical symptoms of BED can be addressed. The overweight BED patient may be placed on a moderate exercise program and a nutritionist may be consulted to educate the patient on healthy food choices and strategies for weight loss.

Prognosis

If left unchecked, the poor dietary habits and obesity that are symptomatic of BED can lead to serious health problems, such as high blood pressure, heart attacks, and type 2 diabetes. BED is a chronic condition that requires ongoing medical and psychological management. Some of these conditions such as diabetes can occur in young people. To bring long-term relief to the BED patient, it is critical to address the underlying psychological causes for binge eating behaviors. It appears that up to 50 percent of BED patients stop bingeing with cognitive behavioral therapy.

Parental Concerns

Binge eating can lead to excessive weight, a risk for serious current and future diseases including heart disease, type 2 diabetes, and cancer. Overweight children also suffer from psychological distress, particularly when teased or shunned by peers. Parents should be aware that antidepressant drugs used to treat BED as of 2004 contain a warning that recommends close observation of pediatric patients treated with the drugs. In some cases, worsening depression or emergence of suicidal tendencies may occur.

See also Bulimia nervosa.

Resources

Books

Gay, Kathlyn. Eating Disorders: Anorexia, Bulimia, and Binge Eating. Berkeley, NJ: Enslow Publishers, 2003.

Matthews, Dawn D. Eating Disorders Sourcebook: Basic Consumer Health Information about Eating Disorders . . . Detroit, MI: Omnigraphics, 2001.

Parker, James N., et al. The 2002 Official Parent's Sourcebook on Binge Eating Disorders. Boulder, CO: netLibrary, 2002.

Organizations

American Psychiatric Association. 1400 K Street NW, Washington DC 20005. Web site: www.psych.org.

American Psychological Association (APA). 750 First St. NE, Washington, DC 20002–4242. Web site: www.apa.org.

Eating Disorders Awareness and Prevention. 603 Stewart St., Suite 803, Seattle, WA 98101. Web site: www.edap.org.

National Eating Disorders Association (NEDA). 603 Stewart St., Suite 803, Seattle, WA 98101. Web site: www.nationaleatingdisorders.org.

Overeaters Anonymous World Service Office. 6075 Zenith Ct. NE, Rio Rancho, NM 87124. Web site: www.overeatersanonymous.org.

[Article by: Christine Kuehn Kelly]


 
Wikipedia: binge eating disorder
The references in this article would be clearer with a different or consistent style of citation, footnoting, or external linking.

Binge eating disorder (BED), is a psychiatric disorder in which a subject shows the following symptoms.

  • Periodically does not exercise control over consumption of food
  • Eats an unusually large amount of food at one time -- more than a normal person would eat in the same amount of time.
  • Eats much more quickly during binge episodes than during normal eating episodes
  • Eats until physically uncomfortable
  • Eats large amounts of food even when they are not really hungry
  • Usually eats alone during binge eating episodes, in order to avoid discovery of the disorder
  • Often eats alone during periods of normal eating, owing to feelings of embarrassment about food
  • Feels disgusted, depressed, or guilty after binge eating

Relationship to other eating disorders

Binge eating symptoms are also present in bulimia nervosa. The formal diagnosis criteria are similar in that subjects must binge at least twice per week for a minimum period of three months.[1] Unlike in bulimia, those with BED do not purge, fast or engage in strenuous exercise after binge eating. Additionally, bulimics are typically of normal weight or slightly overweight, whereas those with binge eating disorder are typically overweight or obese.

Binge eating disorder is similar to, but it is distinct from, compulsive overeating. Those with BED do not have a compulsion to overeat and do not spend a great deal of time fantasizing about food. On the contrary, some people with binge eating disorder have very negative feelings about food. As with other eating disorders, binge eating is an "expressive disorder" — a disorder that is an expression of deeper psychological problems. Some researchers believe BED is a milder form, or subset of bulimia nervosa, while others argue that it is its own distinct disorder. Currently, the DSM-IV categorizes it under Eating disorder not otherwise specified (EDNOS), an indication that more research is needed.

Occurrence and risk factors

Most people with this problem are either overweight or obese (discussed below), but people of normal weight can also have the disorder.

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. About 10 to 15 percent of people who are mildly obese and who try to lose weight on their own or through commercial weight-loss programs have binge eating disorder. The disorder is even more common in people who are severely obese.

Binge eating disorder is a little more common in women than in men; three women for every two men have it. The disorder is found in all ethno-cultural and racial populations.

People who are obese and have binge eating disorder often became overweight at a younger age than those without the disorder. They might also lose and gain back weight more often.

Causes

No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder have been depressed in the past. Whether depression causes binge eating disorder or whether binge eating disorder causes depression is not known for sure.

Emotional cues such as anger, sadness, boredom, and anxiety can trigger binge eating. Impulsive behavior and certain other emotional problems can be more common in people with binge eating disorder. However, many people also claim that binging occurs regardless of their mood.

It is also unclear if dieting and binge eating are related. Some studies show that about half of all people with binge eating disorder had binge episodes before they started to diet.

Researchers also are looking into how brain chemicals and metabolism affect binge eating disorder, although this study is in its early stages.

Complications

People with binge eating disorder can get sick due to a lack of proper nutrition. Binging episodes usually include foods that are high in sugar and/or salt, but low in healthier nutrients.

People with binge eating disorder are usually very upset by their binge eating and may become very depressed.

People who are obese and also have binge eating disorder are at risk for type 2 diabetes, high blood pressure, high blood cholesterol, levels, gallbladder disease, heart disease, certain types of cancer.

Most people with binge eating disorder have tried to control it on their own, but have not been able to control it for very long. Some people miss work, school, or social activities to binge eat. Persons who are obese with binge eating disorder often feel bad about themselves and may avoid social gatherings.

Most people who binge eat, whether they are obese or not, feel ashamed and try to hide their problem. Often they become so good at hiding it that even close friends and family members don't know they binge eat.

Dieting

People who are not overweight should avoid dieting because it sometimes makes their binge eating worse. Dieting here means skipping meals, not eating enough food each day, or avoiding certain kinds of food (such as carbohydrates or fats). Many people with binge eating disorder are obese and have health problems because of their weight. People with binge eating disorder who are obese may find it harder to stay in a weight-loss program. They also may lose less weight than other people, and may regain weight more quickly due to a slowing of the metabolism. (This can be worse when they also have problems like depression, trouble controlling their behavior, and problems dealing with other people.) These people may need treatment for binge eating disorder before they try to lose weight. Dieting is usually not successful for those with BED, as they will usually gain back all of the weight lost, and sometimes more. Those with BED have more difficulty adhering to traditional weight-loss treatment.[2]

Treatment

People with binge eating disorder, whether or not they want to lose weight, should get help from a health professional including physicians, nutritionists, psychiatrist, psychologists, or clinical social workers for their eating behavior. Even those who are not overweight are usually upset by their binge eating, and treatment can help them. There are several different ways to treat binge eating disorder. Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in tough situations. Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas. Drug therapy, such as antidepressants, may be helpful for some people.

Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. The methods mentioned here seem to be equally helpful. For people who are overweight, a weight-loss program that also offers treatment for eating disorders might be the best choice.

Experimental Treatments

A small (40 people) 10 week double-blind clinical trial was reported in the Journal of Clinical Psychiatry on the effectiveness of Atomoxetine (a prescription ADHD medicine) for treating Binge-Eating Disorder. The results of the trial was that Atomoxetine was "associated with a significantly greater rate of reduction in binge-eating episode frequency, weight, [and] body mass index." The average daily dose given was 106 mg/day. The authors conclude that Atomoxetine is effective for short term treatment of Binge-Eating Disorder [3].

External links

References

  1. ^ United States Department of Health and Human Services - Substance Abuse and Mental Health Services Administration (2007-07-10). Eating Disorders. Retrieved on 2007-07-10.
  2. ^ Kriz, Kerri-Lynn Murphy (May 2002). The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge-Easting Disorder and Bulimia Nervosa. Virginia Polytechnic Institute and State University. 
  3. ^ Elroy, Susan (2007). "Atomoxetine in the Treatment of Binge-Eating Disorder: A Randomized Placebo-Controlled Trial" (PDF). Journal of Clinical Psychiatry 68: 390-398. 

Unattributed references

  • Fairburn, C.G. (1995). Overcoming Binge Eating. New York: Guilford Press, ISBN 0-89862-961-6. This book discusses who binges and why, how bingeing differs from overeating, and how a binge eater can gain control. It presents a step-by-step program for overcoming binge eating.
  • Grilo, C.M. (1998). "The Assessment and Treatment of Binge Eating Disorder." Journal of Practical Psychiatry and Behavioral Health 4 pp. 191–201. This article, written for health professionals, reviews the literature on binge eating disorder with a particular focus on its assessment and treatment. Implications for practice and future research are discussed.
  • Siegel, M.; Brisman, J.; & Weinshel, M. (1988). Surviving an Eating Disorder: New Perspectives and Strategies for Family and Friends. New York: Harper & Row, ISBN 0-06-015859-X. This book discusses family therapy, psychopharmacology, hospitalization policies, insurance coverage, and support services for binge eating disorder patients and their families.
  • Stunkard, A.J. (1959). "Eating Patterns and Obesity." Psychiatric Quarterly 33 pp. 284–295. This classic paper provides one of the first descriptions of binge eating in obese individuals.
  • Yanovski, S.Z. (1993). "Binge Eating Disorder: Current Knowledge and Future Directions." Obesity Research 1 (4) pp. 306–323. This review of existing research on binge eating disorder, geared to health professionals, describes treatment methods, discusses their effectiveness, and recommends that doctors treating obese patients be aware of the disorder.
Portions of this article are taken from the public domain NIH Publication No. 99-3589, updated February 2001.

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

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