Compulsive overeaters, or binge eaters, engage in short feasts wherein they consume a large amount of calories. Unlike bulimics, they do not purge after these episodes, and thus tend to gain weight. They often struggle with feelings of shame and depression.
Compulsive overeaters, also known as binge eaters, overeat but do not purge, which usually leads them to become overweight. Binge eating is characterized by eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances, as well as by a sense of lack of control over eating during the episode.
Almost everyone overeats occasionally, and sometimes, depending on the circumstances, individuals may need to eat a large amount of food. What separates these situations from binge eating is the loss of control. Other characteristics include eating what most people think is an unusually large amount of food, eating that amount quickly, eating to the point of discomfort and eating even when not hungry. Additionally, someone eats alone due to embarrassment about how much he or she is eating or feels depressed, disgusted or embarrassed about their eating habits. The binge eating occurs, on average, at least two days a week for six months.
Binge eating also occurs in the eating disorder bulimia nervosa. In the strictest sense, binge eating is separate from bulimia nervosa, because people with bulimia often perform some activity to keep from gaining weight after they overeat. Either they purge by vomiting or using diuretics; they fast, not eating for long periods of time; or they exercise strenuously.
Compulsive overeating might be the most common eating disorder in the United States, where as many as 4 million adults struggle with the disorder. About 15 percent of the mildly obese, those who try to lose weight on their own or with commercial products, have the disorder. The rates are said to be higher among the severely obese. Although most people with this problem range from overweight to obese, binge eating disorder is a little more common in women than in men. Three women for every two men have it. The disorder affects Blacks as often as Caucasians. No one knows how often it affects people in other ethnic groups.
People who compulsively overeat sometimes isolate themselves from public gatherings because of their embarrassment and depression over the disorder. It may even lead to missed work and school. The ability to hide their habits becomes so good that often the people closest to them don't even know they have the disorder.
The depression associated with the disorder is a constant health difficulty. The obesity that regularly arises from the disorder can also lead to diabetes, high blood pressure, high cholesterol, gallbladder disease, heart disease and certain types of cancer.
Depression is one hypothesis for why people become binge eaters. But no one is really sure if depression comes first and leads to binge eating, or vice versa. It is common for people with the disorder to behave impulsively and have other emotional problems, however. And many report being angry, sad, bored or worried—all of which sufferers say can cause them to binge eat. Also, researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Research also suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family.
It is also unclear if dieting and binge eating are related. Some studies show that about half of all people with binge eating disorder had binge episodes before they started to diet.
There are several options for people who want help with controlling this disorder. Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits, as well as changing the way they react in difficult situations. Interpersonal psychotherapy helps people look at their relationships with friends and family and make changes in problem areas. Drug therapy, such as antidepressants, may be helpful for some people.
The methods mentioned here seem to be equally effective, but researchers are still trying to find the most helpful treatment for binge eating disorder. Other therapies include dialectical behavior therapy, which helps people regulate their emotions; drug therapy with the antiseizure medication topiramate; weight-loss surgery (gastrointestinal surgery); exercise used alone or in combination with cognitive-behavioral therapy; and self-help. Self-help books, videos, and groups such as Overeaters Anonymous have aided some people in controlling their binge eating.
Many people with eating disorders respond to outpatient therapy, including individual, group, or family therapy, as well as medical management by their primary care provider. Support groups, nutritional counseling, and psychiatric medications taken under careful medical supervision have also proven helpful for some individuals.
Hospital-based care (including inpatient, partial hospitalization, intensive outpatient and/or residential care in an eating disorders specialty unit or facility) is necessary when an eating disorder has led to physical problems that may be life-threatening, or when it is associated with severe psychological or behavioral problems.
Exact treatment needs will vary from individual to individual. It is important for anyone struggling with an eating disorder to enlist a trusted health professional in coordinating and overseeing his or her care.