Eating disorders, often not discussed, really should warrant more attention and research into the causes, complications, and appropriate treatment, but ideally, prevention before they can begin. These serious, potentially life-threatening conditions affect all aspects of a person’s emotional and physical health and should not be thought of as just a fad.
“This stems from one’s relationship with food,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. “Eating disorders occur when people have extreme emotional and behavioral issues with food and their weight. Developing an eating disorder can have serious physical and emotional effects on a person, which can even become life-threatening.”
There are many forms an eating disorder can take. Probably the most well-known eating disorders are anorexia and bulimia. However, another eating disorder is actually more common among adults in the United States than anorexia and bulimia combined, affecting both women and men – binge eating disorder.
Binge eating disorder (BED) is defined by the American Psychiatric Association in this manner, “Binge eating disorder is characterized by recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. This disorder is associated with marked distress and occurs, on average, at least once a week over three months.”
BED sounds very similar to bulimia except that in bulimia, after a person binges on food, they will “purge” or get rid of the food by self-induced vomiting, taking laxatives or excessive exercising. People with BED binge but do not purge.
Prevalence of BED in the United States
About 5 million or 3.5 percent of women in the U.S., and 2 percent of men, about 3 million, are estimated to have BED.
- It is more common in early adulthood for women and midlife for men.
- It can occur in normal-weight, overweight or obese adults
- It occurs at comparable rates among racial and ethnic groups: Whites (1.4 percent), Asian (1.2 percent), and African-American (1.5 percent).
“Both men and women get eating disorders, however, women are much more likely than men to develop them, a fact proven by the numbers around adults and binge eating,” said Dr. Samadi.
What causes BED?
The root cause of BED is unknown but there are many theories that suggest brain chemistry may be affecting the inability to regulate food intake, the increase of “wanting” a particular food, and the increase of “liking” a certain food.
Other causes include:
- Genetic influences, as eating disorders can run in families.
- Very stressful situations occurring either at home or work that affect the person.
- Depression – this is very high in people with BED.
Symptoms of BED
To accurately diagnosis BED, a skilled healthcare professional who works with eating disorder patients should be consulted. There are specific symptoms that do characterize BED and if they are noticed by a family member or friend, they should seek help for the person with BED.
A person may have BED if they have three or more of the following symptoms and this behavior happens at least weekly for three months:
- Eating extremely fast.
- Eating beyond feeling full.
- They feel a lack of control over their eating.
- Eating large amounts of food when not hungry.
- Eating alone to hide how much they are eating.
- Feeling disgusted, depressed or guilty after a binge.
- They don’t purge or get rid of the food they’ve eaten by throwing up or over-exercising.
Keep in mind that all of us at times will overeat such as at a party or a holiday family gathering, but this is not considered BED, neither is snacking on small amounts of food continually throughout the day.
“The major concern around this disorder amongst others is that it can be hard to recognize or identify and adults most likely ignore or choose not to view it as a problem,” said Dr. Samadi. “The most important part of treating binge eating disorder starts with family and friends taking notice of something being wrong and urging the patient to see a physician.”
Health consequences of BED
Most people who have BED will often be overweight if not obese. Because of their excessive ingestion of food without purging, they will be prone to many health risks associated with excessive weight gain. Some of the health consequences they may develop include:
- High blood pressure
- High cholesterol levels
- Heart disease
- Type 2 diabetes
- Gallbladder disease
- Some types of cancer
- Metabolic syndrome
- Sleep apnea
- Treating BED
Once a person has been diagnosed with BED, it will be important to work with healthcare professionals who are familiar with treating eating disorders. The health care team that should be involved is a physician trained in treating eating disorders, a mental health professional, and a dietitian.
Commonly used treatments may involve psychotherapy and medication, either in outpatient care or possibly at an inpatient facility depending on the severity of the condition. Treatment plans should always be individualized. Family members should be involved in the treatment care process so they become educated on knowing best how to help their loved one overcome and prevent a relapse of this disorder.
In 2013, BED was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a free-standing diagnostic category. DSM is published by the American Psychiatric Association and is used by health professionals to classify mental disorders, helping to provide a common set of criteria for diagnosing BED. This now means that insurance companies will be more likely to approve appropriate treatment and insurance coverage.
There are not exact numbers on how many people, young or old, suffer in silence with an eating disorder as it is often kept secret. Surprisingly, there’s a good chance there are people we know personally who either have an eating disorder or did have one in the past.
“While it may seem eating disorders are about food and weight, they often develop as a way to cope with some type of emotional pain a person is suffering from inside, such as a person feeling overwhelmed by something they cannot control in their life,” Dr. Samadi said. “Even further, they may use it as a coping method – they take control of what they eat, how much or little they eat, and ultimately how much they weigh. Adults suffering from binge eating disorder may believe this makes them feel better, but in reality, they are doing serious damage to their emotional and physical health. It’s up to those around to take charge and recognize the dangerous cycle that binge eating creates.”
Whether it’s BED or another type of eating disorder, all need to be taken seriously. Having empathy and understanding of this condition and getting appropriate medical care can go a long ways to helping a person find their way back to more normal, healthy eating and to keep it that way.