I am sure most of us have at one time or another gone back for that second or third serving of a favorite meal, whether or not we’re still hungry. During a holiday party or special occasion, it’s common to overindulge. But for millions of Americans, it’s a daily occurrence that they feel powerless to control, one that is surrounded by secrecy and shame. While most people have heard the terms anorexia and bulimia, the most common eating disorder is the least talked about: eating disorder not otherwise specified, which includes binge eating disorder (also referred to as compulsive overeating). Binge eating disorder affects more than 20 million Americans, and is rarely recognized along with the other serious co-occurring psychiatric conditions it often accompanies.
As I mentioned in a previous blog about the biology of eating disorders (link to previous blog), millions of individuals use binging on food to manage emotions like shame, fear, anger, loneliness and sadness in the same way those addicted to alcohol or drugs abuse other substances. When compulsive overeaters consume large amounts of food, they experience a relaxed or calming sensation very similar to the feeling alcoholics or substance abusers receive when they use.
That’s why it’s so critical that physicians, family members and individuals themselves understand and recognize when their normal eating patterns are replaced by disordered eating experiences on a regular basis. These may include:
Signs of Binge Eating Disorder
- Very strong feelings about food, which may overwhelm and overshadow important emotions in relationships and other areas of life
- Strong sense of shame or guilt during and after meals, which may be more acute following binges
- Intense physical discomfort following meals, often to the point one feels sick
- Significant increase in the amount of food consumed in one setting, and in the rate at which one eats
- Increasing reliance on food to deal with everyday stresses
Compulsive overeating can be difficult to recognize, particularly if the affected individual does not experience noticeable changes in their health or appearance. There are several tell-tale signs, though, that may be early indicators of binge eating disorder:
The Misunderstood Eating Disorder
- Missing or hidden food, often in large quantities
- Effort put forth to hide food wrappers and empty containers after binging
- Excessive spending on food, to the point one may fall behind on other bills
- Stealing food
- Eating alone, both during binges and during period of normal food consumption
- Skipping out on spending time with friends and relatives in social settings
The biggest problem is compulsive overeating or binge eating is rarely recognized as its own illness, and often only the symptoms are treated, without appropriate attention to root causes and related co-occurring disorders. In fact, most physicians and mental health professionals fail to properly diagnose compulsive overeating and binge eating as an eating disorder, and insurance companies rarely regard it with the same level of medical severity as anorexia or bulimia. That’s one of the main challenges we encounter in our efforts to assist binge eating disordered patients: difficulty demonstrating the severity of the problem to insurers using the same tools and standards they apply to anorexics and bulimics.
Too often, patients who seek help are advised by their physician to modify their diet and increase exercise, with a primary focus on losing weight, or taking medication to lower blood pressure, lower cholesterol, and control blood sugar levels. Unfortunately, that not only fails to address the patient’s real illness, but also makes them feel ashamed of their lack of self-control, which can exacerbate the disorder and trigger even more advanced symptoms.
I also see too many patients who have been victimized by the stigma that binge eating disorder is only a concern for the overweight or obese. In fact, anyone, regardless of size or body type, can be vulnerable to this cycle of emotional eating, which is ultimately rooted in much more complicated and overwhelming feelings. Eating disorders are equal opportunity offenders that cross the barriers of race, education level and socio-economic status. Speaking the truth about these diseases and the effectiveness of available treatment is one way to decrease the stigma that blocks so many people from seeking help. I commend Monica Seles, a hall of fame tennis player, who disclosed in her new book that she suffered from binge eating disorder during the prime of her career. Seles, like so many compulsive overeaters, sought comfort from food following the death of her father, a traumatic event that occurred not long after her career was interrupted by another trauma – her on-court stabbing at the hands of a deranged fan.
It’s important for individuals who think they may suffer from compulsive overeating to be honest with themselves, their family and their physician about their relationship with food and to find help from someone who understands that their struggle is a serious illness. In addition to consulting with an eating disorder specialist, I highly recommend that those struggling with binge eating seek out Overeaters Anonymous. This 12-step mutual support fellowship has chapters in many cities across the U.S., and I’ve seen it help many patients to connect with others who have faced and overcome the same challenges.