A patient came to see me because she needed a heart operation. You may think that it is strange that someone would come to see a therapist because of a heart condition. She began explaining why she needed my help. Here is Sally’s story:
“I have a very serious heart condition,” she explained. “I need a heart bypass surgery as soon as possible, but my surgeon will not operate until I lose a significant amount of weight. I was put on a monitored liquid diet and started to lose weight. I went to my doctor appointments and he was impressed with my progress . . . at first.”
“I don’t understand why I left his office that day and went to a fast food restaurant drive-up window and order enough food to feed three people. I ate it all in a blur! I didn’t even think about what I was doing. This began a decent into a helpless, hopeless state. I began sneaking food while I continued my liquid diet. My weight started returning. My doctor asked if I was eating other foods in addition to the prescribe diet. I said “no.’” I have been lying to my doctor for the last two months. My family does not know. I am acting like a drug addict with my food. I don’t want to die. I love my family and want to be there to see my grandchildren. What is wrong with me?”
According to the CDC (http://www.cdc.gov/nchs/fastats/overwt.htm) more than 69% of America’s population is overweight and 35% are obese. We have an epidemic of Type 2 diabetes and children that are obese. We have children who are developing fatty liver disease, a disease that is usually not found in children.
The American Psychiatric Association only recently recognized Binge Eating Disorder as a diagnosable disorder. There is much controversy about this decision. Most arising from the belief that people who are overweight or have binge eating disorder will now be treated with a pill or do nothing about their condition because they have a disorder. I believe the condition can now be named instead of the world turning a blind eye to the devastating effects of disordered eating. With awareness, help and recovery can begin.
The American Psychiatric Association defines Binge Eating Disorder as 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. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior. This disorder occurs, on average, at least once a week over a three-month period.
This is different from occasionally overeating or eating too much during the holidays. Recurrent binge eating is much less common, far more severe, and is associated with significant physical and psychological problems.
People with binge eating disorder often have a mental obsession with food, weight, diet, or body image. These obsessive thoughts take over much of their waking moments. It has a profound effect on a person’s self-esteem, relationships, finances, daily activities, and quality of life. People often become depressed or anxious because of their eating patterns.
People with binge eating disorder develop a habit of relying on food to cope with life situations. They use food as a means to displace or “stuff down” uncomfortable feelings or thoughts. They may use food to avoid some part of life by grazing or eating all day. Some may binge, eating large amounts of food in a short time. Others may restrict their food intake with a rigid diet and then binge. It may not start out that way but eventually they lose control of eating.
For the successful treatment of binge eating disorder it is critical to identify why a person is turning to food or to the obsessive thoughts of disordered eating. Many times there are unresolved traumas or a lifetime of abandoning their Self, feelings or emotions. A study published in the Archives of General Psychiatry, (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757519) concludes that treatment programs with cognitive behavioral therapy were significantly more effective than weight loss programs in a two-year follow up. To fully recover from binge eating disorder a person must deal with the underlying, internal causes of the disorder.
In summary, dieting, using food for emotions, eating highly palatable, sugar dense, processed foods, excessive stress (i.e. high cortisol) and genetic expression have been implicated in binge eating disorders. You cannot tell if a person has binge eating disorder by the way they look look. Some people with binge eating disorder are overweight or obese but many people are of normal size. A defining characteristic of binge eating disorder is the obsessive thoughts of food, weight, diet or body image and a loss of control over food.