Binge Eating

Binge-eating: description

People with food addiction (binge eating disorder or English: “binge eating disorder”) are regularly hit by “eating bugs”. As if they were addicted to food, they indiscriminately devour food in enormous quantities. The binge sometimes takes hours. Enjoyment, hunger or satiety play no role here. Characteristic of binge eating disorder is that those affected can not control the binge. They often only stop when they feel sick and the stomach hurts. The binge attacks usually take place when those affected are alone. After the seizure-like eating, the addicts feel shame, guilt, and disgust.

Unlike bulimia sufferers (Ess-Brech-addicts), eating people do not try to balance the ingested calories through vomiting, medication or excessive exercise. That’s why most addicts are overweight. However, even normal-weight people can have regular bingeing.

Characteristic of the binge eating disorder is also that the affected people eat very irregularly between binges and keep dieting for a longer period of time, until they come over the next binge. Esssüchtige deal a lot with their figure and their weight, but not as extreme as anorexic or bulimic.

Who is affected by binge eating?

Binge eating disorder typically occurs later than anorexia or bulimia. It mainly affects young adults or people in the middle of life. However, even children can have binge eating. However, the full-frame “binge eating” is very rare in childhood.

In 1994, binge eating disorder was described for the first time as a separate disease in the American psychiatric disorder classification system (DSM-IV). It is much less explored than bulimia or anorexia. That’s why you do not know exactly how many addicts there are. However, experts estimate that around one to four percent of the population is affected. This makes binge eating disorder much more common than other eating disorders.

Three sick women have about two men suffering from food addiction. In contrast to bulimia and anorexia, the difference between the sexes is significantly lower.

Binge eating: symptoms

For the diagnosis of binge eating, the seizure must occur at least once a week for a period of three months.

Diagnostic criteria of binge eating disorder

According to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the following criteria apply to the diagnosis of binge eating:

A) Repeated episodes of binge eating

B) Episodes of binge eating along with at least three of the following symptoms:

1. Eat much faster than normal
2. Eating up to an unpleasant feeling of fullness
3. Eating large amounts of food when you do not feel physically hungry
4. Eating alone out of embarrassment about the amount you eat
5. Disgust with yourself, depression or great guilt after overeating

C) There is a significant suffering from binging.

D) The binging occurs on average at least one day a week for three months.

E) Binge eating is not associated with the regular use of inappropriate compensatory behaviors (eg intentional vomiting, fasting or excessive physical activity) and does not occur exclusively during anorexia nervosa or bulimia nervosa.

Repeated episodes of binge eating

The main symptom of binge eating is the recurring binge eating. Similar to bulimics, people who suffer from food addiction can not stop eating in a seizure. An episode of binging is characterized by the following two criteria:

1. Consuming a quantity of food in a definable period of time (eg two hours), which is definitely greater than most people would eat in similar circumstances in a similar period of time.
2. A feeling of loss of control over the food consumed during the episode (for example, a feeling that you can not stop eating or not control what you eat).

The food addiction is something other than overeating. In countries with abundant food supply, most have eaten far beyond hunger. A delicious buffet from which you want to try everything, even if the stomach hurts, can lead to overeating. On the other hand, people who suffer from binge eating do not enjoy eating the food. Rather, the binge eating is accompanied by negative emotions such as disgust, guilt, depression and shame. Therefore, those affected keep the scares secret.

Delineation of binge eating to bulimia and obesity (obesity)

In contrast to bulimia, eating addicts usually do not take countermeasures to make up for the calories they have taken. The food is therefore not regularly vomited and there are no laxatives or excessive exercise for weight loss. The body mass index (BMI) is therefore often higher than in people with bulimia.

Binge eating is almost always associated with obesity (obesity) – because frequent binging can naturally derail the weight and thus be a cause of severe overweight. However, not all obese are by far the most addictive. While the diagnosis of obesity alone refers to the body mass index and thus too high a weight, binge eating is a mental disorder. Eating addicts are also more dissatisfied with their bodies and have lower self-esteem than people who are just overweight. Further differences are the recurring binge eating binge eating and a more irregular and chaotic eating behavior than pure obesity. People with food cravings are more mentally impaired and at the same time often suffer from other mental disorders, such as anxiety disorders.

Physical consequences of binge eating

The most common concomitant disease (comorbidity) of binge eating is attributed to concomitant obesity. 40 percent of binge eating patients are severely overweight. People with a body mass index of more than 30 are considered obese. The BMI is calculated as the body weight divided by the height squared. A woman with a height of 1.68 m and a weight of 85 kg would therefore have a BMI of 30.

Being overweight has a big impact on your physical health. It primarily affects the cardiovascular system. Possible disorders include hypertension, elevated blood lipid levels and atherosclerosis (arteriosclerosis). This increases the risk of a heart attack and a stroke. Another possible result of being overweight is heart failure. Patients lose their capacity and become short of breath. In addition, water retention can form in the tissue. Diabetes is another and common result of obesity.

The increased weight also damages the joints and spine. Especially the knee and hip joints as well as the discs suffer from the strain. In severe obesity, respiratory and sleep disorders occur.

Mental comorbidity and consequences of binge eating

Many people have low self esteem. They are ashamed of their weight and their eating habits. They therefore withdraw more and more and avoid social contacts. Concerned ones deal a lot with their weight and their body. Most of the time they have a negative body concept and try to reduce their weight by dieting again and again. The success usually lasts only briefly, because starving increases the urge to eat. The loss of control during binge eating triggers a sense of powerlessness and may result in self-hatred.

The most common psychiatric comorbidities of binge eating are mood disorders (20 to 30 percent) that affect mood and drive. These include depression, mania and bipolar disorder. In addition, around 20 percent of people with binge eating disorders suffer from an anxiety disorder. This includes phobias and panic disorders. Ten percent of the addicts are substance dependent, especially alcoholics.

Binge eating: causes and risk factors

Why some people become addicted is unclear. Presumably, several biological, social and psychological aspects play a role in the development of food addiction.

Genesis theories about binge eating disorder

Studies indicate that there are two main factors that contribute to the development of a binge eating disorder:

1. A general susceptibility to the emergence of a mental disorder, for example, caused by the occurrence of mental illness in the family, abuse experiences, negative self-image and critical life events.
2. Overweight and obesity in childhood.

In many cases, binge eating triggers an interaction of obesity in childhood and insults on the part of the family in terms of appearance and attractiveness. In addition, it has been found that severe parental nutritional practices can negatively impact children’s eating habits. If the amount that the child eats is not determined by their needs, but is always determined by the parent, the child does not learn when it is full and how it can regulate feelings of hunger.

Also endangered are people who make many diets because they are dissatisfied with their body. The slender beauty ideal of our society leads to a devaluation of one’s own body in many girls and women. They try convincingly to come closer to the ideals through restrained food. However, abstinence from food, especially to certain foods, increases the craving for food and favors the development of binge eating.

Immediate triggers and sustaining factors

In particular, stress plays an important role in the development of binge eating. In case of tension and negative mood, eating on food addicts has a relaxing effect for a short time. Since those affected have no other coping mechanisms to deal with stress, they stuff themselves with food. After that, they develop feelings of shame and disgust that further damage their self-esteem. This in turn increases the risk of a binge eating.

The conditioning model assumes that the fragrance, taste and taste of food, but also feelings of loneliness or depression, cause a physiological reaction that causes strong craving for food in those affected. If a binge occurs in such a situation, it is coupled with the appropriate stimuli and feelings. The likelihood increases that similar stimuli and sensations then trigger a binge again.

Another theory points to the connection between the diet style and the binge eating. Eating addicts often avoid high-fat and carbohydrate foods between binge eating. First, the low-carbohydrate diet increases the susceptibility to stress. On the other hand, the calorie-related eating deficit increases the feeling of hunger and thus the risk of unrestrained food.

Binge-eating: examinations and diagnosis

Since the characteristic feeding takes place usually secretly, the food addiction is difficult to recognize for outsiders. As with other mental disorders, early diagnosis of food addiction increases the chances of a quick cure. Therefore, it is important for people with binge eating to seek help if they experience symptoms of food addiction.

The first contact person can be the family doctor. This tries to find out in an anamnesis conversation whether actually a food addiction exists. The family doctor could ask you the following questions:

• Do you have binge eating that makes you feel like you can not stop eating?
• Do you eat faster than usual during the binge eating?
• When will you stop eating?
• How do you feel during and after these binge eating?
• How often do these bouts occur?
• Do you vomit the ingested food again?
• Do you use laxatives to reduce your weight?
• Are you satisfied with yourself and with your body?

Physical examination

The family doctor will also perform physical examinations. So he can find out if there are physical food addiction causes. There is, for example, a mostly benign tumor of the pancreas, which leads to an overproduction of insulin to hypoglycaemia and thus food cravings. This very rare disease is called insulinoma.

Furthermore, the family doctor can determine whether consequential damage is due to the binge eating disorder. He will calculate the person’s BMI and test the blood for blood sugar, blood lipid and uric acid levels. In overweight patients, it is useful to check the cardiovascular system using an ECG. If there is any indication of a disorder, a specialist may perform further examinations.

Psychological examination

If the suspicion of a binge eating disorder is confirmed, the family doctor will refer the patient to a specialized clinic or outpatient psychotherapist or psychiatrist. The specialist or psychologist can make an accurate diagnosis through a structured clinical interview. He can also determine if there are any other mental disorders.

As a food addiction test, clinics like to use the Eating Disorder Examination (EDE) test from Fairburn and Cooper. This questionnaire is based on the criteria of the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and has proved to be a very reliable diagnostic tool. He captures the following topics:

• Restrained eating behavior
• Thoughtful occupation with the food
• Worried about the weight
• Worried about the figure

There are also self-assessment questionnaires available as a binge eating test that can be found on the internet as well as being used by doctors and psychologists. However, the compliance of these questionnaires with the clinical diagnostic tools is rather low. They are therefore not a substitute.

Binge eating: treatment

Cognitive behavioral therapy and interpersonal therapy have been shown to be effective in the treatment of binge eating patients. In addition, a behavioral treatment to reduce weight is necessary. Binge eating can be treated both inpatient and outpatient. If the person is severely affected by the eating disorder and there are significant physical or psychological problems, it is advisable to stay in a clinic. If the symptoms of binge eating disorder are not so pronounced, outpatient therapy may be sufficient.

The therapeutic methods

For a long time, the same therapeutic methods as for the treatment of bulimia have been used to treat binge eating. Although they are effective, since binge eating is an independent mental disorder, special treatment concepts have been developed in recent years. Doctors and psychologists hope for even higher success rates. The main focuses of the Essucht therapy are among other things:

• Inform the person concerned about the clinical picture and inform
• Change the eating habits
• To bring physical exercise into everyday life
• To change the negative thinking about your own body and to increase self-esteem
• Learning strategies for relapse prevention for the home

The Cognitive behavioral therapy (KVT) assumes that the unhealthy eating behavior has been learned and can also be unlearned again. In order to make the disorder and its mechanisms comprehensible to the person concerned, he should keep a diary of his eating habits and feelings. The documentation can help uncover the triggers of binge eating such as stress and negative emotions.

With the help of nutritionists, the patient learns to eat a balanced diet and take regular meals. Therapy hours work to improve self-esteem. Instead of continuing to compensate for stress through eating, patients are learning alternative stress management strategies. In this way, the patient regains control of his actions and can combat his food addiction. During therapy, the patient learns the necessary self-help skills, takes responsibility for himself and can actively contribute to his healing.

The Interpersonal therapy (IPT) deals with the current life situation of the patient and his interpersonal relationships. IPT is working on the social context in which binge eating occurs. The person concerned should learn how he can better resolve conflicts with other people and thus gain more security in social interaction. Increasing social skills reduce his desire to compensate for the problems of uncontrolled eating. This form of therapy is also well suited for outpatient treatment.

Medication

In addition, if the patient suffers from an affective disorder, such as depression, it may be treated first. For a patient suffering from severe depression is unable to actively work on overcoming the eating disorder.

Serotonin reuptake inhibitors (SSRIs) have an antidepressant effect. They increase the concentration of the neurotransmitter serotonin in the brain, which increases the drive. SSRIs also reduce the frequency of binge eating in the short term. Since the risk of a relapse with the discontinuation of the medication is very high, a combination of psychotherapeutic and drug treatment is recommended.

Binge-eating: disease course and prognosis

Binge eating disorder often occurs in phases. Some addicts can eat almost normal for several weeks, then the binge eating attacks return. In the long term, the fewest affected people can handle binge eating without professional treatment on their own.

Since the binge eating disorder has only recently been recognized as an independent mental disorder, there are only a few studies on the course and prognosis. Studies have shown that the course of the disease is more favorable in the short term than with bulimia, but in particular significantly better than with anorexia. One year after the end of therapy, between 30 and 79 percent of patients are significantly better, investigations show.

Experts estimate that about 70 percent of sufferers have overcome the craving for food after twelve years. The recidivism rate is about six to eight percent after this period. However, about 25 percent still suffer from mood disorders and anxiety disorders after twelve years, nine percent engage in substance abuse, for example they overly consume alcohol. The prognosis depends on how pronounced the food addiction is. Become Binge Eating and treat possible comorbidities early and professional, the chances of recovery are good.