WHEN FOOD RULES YOU
Binge eating disorder isn’t just about scoffing a few too many biscuits now and then. It’s a mental disorder that’s most common among the middle-aged. So how do you know when occasional overeating is tipping over into something serious ?
When we consider eating disorders we usually think of anorexia and bulimia nervosa, which are both typically associated with teenagers and young adults. But there’s another disorder that’s under-reported and little understood, despite being more common than anorexia, called binge eating disorder (BED).
According to a report from eating disorder charity Beat, it’s estimated that around 725,000 people in the UK are affected by an eating disorder. Just under half of these people suffer with BED and the other half with bulimia (anorexia accounts for just under 1% of eating disorder sufferers). Yet it’s only in the past few years that BED has been recognised as a disorder in its own right.
“Binge eating disorder is much more common than you might think,” says GP and Healthy Food Guide expert Dr. Dawn Harper, “Although we have an estimated figure for how many people suffer, we still don’t know the true incidence because so many hide it.”
It can effect both sexes, too. Although it’s thought that eating disorders in general affect many more women than men (around 90% of sufferers are estimated to be women), the number of men and women affected by BED is more equal than for other eating disorders such as anorexia and bulimia. And, while it tends to develop first in young adults, many people don’t seek help until they reach their 30s or 40s.
THE WARNING SIGNS
“It’s difficult to recognise a binge eater,” says a spokesperson for eating disorder charity Beat. “They many still eat in a very ‘normal’ way around family and friends, at home and in social settings, because their bingeing will be done in secret. They may become overweight, but not everyone who is overweight is bingeing.”
Some indicators of binge eating disorder include:
- Bingeing at least once a week for 3 weeks or more
- Planning binges and buying ‘special’ binge foods
- Anxiety or depression
- Secretive behaviour, such as hiding food
- Feelings of extreme guilt after overeating
AN INSIDER’S VIEW
Kimberley, 44, links her BED with anxiety
“We all have foods we find comforting, but when you have BED you have an uncontrollable urge to eat them – in my case I’m overwhelmingly attracted to processed foods that are high in fat and sugar. I binge to alleviate negative emotions, eating too much quickly, to the point of feeling physically unwell.
If I receive a minor bit of bad news, a binge can last just a few minutes, then I’m back on track. But when something is causing continued feelings of anxiety, I’ll binge regularly over a long period. After every binge, I feel guilty and that I’ve let myself down. It’s not simply a matter of willpower. BED always goes hand-in-hand with another underlying issue, which needs to be treated as well. For me, it’s anxiety.
Exercising makes me less anxious, and I’m now doing more things that make me feel good: walking in the fresh air, eating mindfully, being organised. Although I’m not yet in recovery, self-help has helped me to manage my condition. The better I feel about myself, the less frequent the binges.
My advice to anyone suffering is to see a GP – the more of us who talk about this disorder, the more it will be recognised as a real problem. To deal with it, first you need to step back and admit there’s something wrong.”
OVEREATING VERUS BINGE EATING
We’ve all had times where we’ve eaten to excess and felt uncomfortable for it. We tend to indulge when it comes to holidays and celebrations, opting for extras we know we don’t really need, or use food to comfort negative emotions during periods of stress or upset.
But there’s a very clear distinction to be made between these sorts of infrequent behaviours and binge eating disorder. BED is not about indulgence – it’s a mental illness. Binge eaters regularly consume huge quantities of food in a short period, usually in private and regardless of hunger. The disorder is characterised as bingeing at leat once a week over a period of 3 months or more.
“Sufferers will rapidly eat vast amounts of food until they’re uncomfortably full, often reporting that they’re unable to stop themselves,” explains Healthy Food Guide dietitian and eating disorder expert Jennifer Low. “Although the actual binge consists of a lot of food in a short amount of time, binges can happen several times a day, often in response to stress.”
WHY DOES IT HAPPEN ?
It’s associated with a lack of confidence, self-esteem, anxiety and depression. “It’s often about coping with negative emotions,” says Low. Although the causes aren’t entirely clear, contributing factors may include:
- genetics or a family of eating disorders
- hormone imbalances in the brain
- stressful or traumatic life events
- body dissatisfaction
- depression or anxiety
- low self-esteem or lack of confidence
- stress, anger, boredom or loneliness
- strict dieting
THE EFFECTS ON YOUR HEALTH
“Binge foods are typically convenience foods, such as high-fat and high-sugar foods like crisps and chocolate,” says Jennifer.
Given the volume of food eaten and the absence of purging (see Bulimia, below), regular bingers are likely to gain weight and are more likely to suffer associated health risks, including:
- type 2 diabetes
- high blood pressure
- high cholesterol
- osteoarthritis and muscle pain
- sleep disturbances
- heart disease
- increased risk of cancer
The disorder affects mental health, too. Emotional and psychological issues are a huge part of BED, and studies have shown that as well as experiencing high levels of anxiety and depression, sufferers have a lower quality of life. As binges are done in secret, people may become socially withdrawn and isolated. “It can be difficult to spot binge eating in others as they may go to extreme lengths to hide the behaviour,” says Jennifer.
THE MOST COMMON EATING DISORDERS
- BULIMIA NERVOSA: Sufferers tend to restrict food intake, followed by excessive eating and a loss of control. Unlike BED, it involves vomiting or using laxatives to control weight gain. An estimated 1.6 million people in the UK suffer (up to 25% may be male).
- ANOREXIA NERVOSA: This commonly affects young girls and women, although boys and men can also suffer. It’s characterised by extreme food restriction, excessive exercise with a goal of weight loss and a distorted body image.
- EATING DISORDER NOT OTHERWISE SPECIFIED (EDNOS): This diagnosis used to be given to those who didn’t meet the criteria for anorexia or bulimia , or showed a mix of symptoms – including a significant number with binge eating disorder. The term was replaced with BED in 2013.
HOW TO GET HELP
If you recognise the warning signs (see earlier in the blog) in yourself, it’s important to seek help from your GP. “Record your triggers and the frequency of bingeing,” says Dawn. “The more information you can give your GP the better. Don’t be frightened to be completely honest – your doctor will have heard it all before.” If you feel embarrassed, Dawn recommends taking a friend and showing your symptom diary to your doctor. You may be offered any of the following:
- self-help programmes such as books and online courses
- cognitive behavioural therapy
- referral to a psychologist or psychiatrist
- medication, including antidepressants or anxiolytics
“If your condition has led to significant weight gain your doctor may also want to check you for diabetes and high cholesterol and may offer to help with weight management,” says Dawn.
WHERE TO FIND SUPPORT ONLINE
If you’re concerned about yourself. a family member or friend, find help and information at:
References: Beat (2015). The costs of eating disorders: Social, health and economic impacts Beat. www.b-eat.co.uk/about-eating-disorders/types-of-eating-disorder/binge-eating-disorder EDNOS. www.b-eat.co.uk/about-eating-disorders/types-of-eating-disorder/ednos NHS Choices. Binge eating. www.nhs.uk/Conditions/Binge-eating/Pages/Introduction.aspx Masheb, R.M. & Grillo, C.M. (2004). Quality of life in patients with binge eating disorder. Eating & Weight Disorders 9 (3), 194-199. NHS Choices. Anorexia nervosa. www.nhs.uk/conditions/Anorexia-nervosa/Pages/Introduction.aspx NHS Choices. Bulimia. www.nhs.uk/Conditions/Bulimia/Pages/Introduction.aspx
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