Binge Eating and Overeating

Uncategorizedon June 9th, 2014No Comments

What is an eating disorder?

An eating disorder refers to an abnormal relationship with food and pattern of eating. Most people struggling with an eating disorder will fear gaining weight, with weight loss as a primary goal and will take on certain behaviours in order to lose weight and sustain weight loss. The two most common types of eating disorders categorized by the Diagnostic Statistical Manual of Mental illness (DSM) are anorexia nervosa and bulimia nervosa. Other eating disorders include binge eating disorder and eating disorder not otherwise specified (Sadock &Sadock, 2003).

Anorexia Nervosa is diagnosed when there is a strong refusal to maintain body weight at or above the minimally normal weight for the person’s age and height. The person is intensely afraid of gaining weight and has a disturbed self-perception of their body shape and size (Sadock & Sadock, 2003). Most people struggling with anorexia will restrict their intake of food and engage in excessive exercise or purging activities to reduce calorie intake.

Bulimia nervosa is diagnosed when there are recurrent episodes of binge eating (eating an amount of food that is much larger than they would normally eat and experiencing a lack of control while eating), and recurrent inappropriate behaviour to prevent weight gain suc
h as self induced vomiting and misuse of laxatives or enemas (Sadock & Sadock, 2003).

Binge eating disorders are diagnosed when the person does not suffer from anorexia nervosa as their body mass index is at or above the normal mark and they do not suffer from bulimia nervosa because they do not use inappropriate methods of weight control such as vomiting or laxative misuse (Telch & Agras, 1996). In this sense, it seems that binge eaters make use of food to regulate their moods and to manage difficult emotions, particularly anger, sadness and feelings of inadequacy (Telch & Agras, 1996).

Understanding compulsive eating disorder

Another way of understanding binge eating disorder is as a compulsive eating disorder. In this sense, the person who is struggling feels compelled to over eat and struggles to maintain control while eating. Compulsive eating, or binge eating is characterized by eating very rapidly until feeling over-full and uncomfortable, eating large amounts of food, mostly eating alone and then feeling disgusted with oneself and depressed about the overeating (Mantle, 2003).binge eating perth

Due to the large amounts of calories consumed during compulsive eating episodes, binge eaters normally gain weight quite rapidly. Remember that there is no attempt to regulate weight through excessive exercise or calorie restriction as in anorexia, or self-induced vomiting and laxative misuse as in bulimia. As such, the binge eater is likely to gain weight and can face serious health consequences such as diabetes, obesity, heart disease, high blood pressure and high cholesterol (Smith, Segal & Segal, 2014).

There are many theories around the maintaining factors of binge eating disorders, namely affect-driven models, which suggest that the binge eating episode induces a more manageable emotion (such as guilt) than the emotion preceding the binge (depression) (Stein, Kenardy, Wiseman, Dounchis, Arnow & Wilfley, 2007). Alternate affect driven theories posit that the binge eating focusses attention to the exclusion of all else and thereby offers an escape from uncomfortable feelings and moods, or theorize that negative emotions can now be blamed on the binge eating rather than require any self-awareness or insight (Stein et al., 2007).

Treating compulsive eating

There have been a range of treatments available for eating disorders ranging from Cognitive Behavioural therapy through to ego state therapy. The most important issue here is that binge eaters do not know how to stop eating. Therapy, therefore, often focusses on the emotional regulation aspect, teaching more effective coping skills and teaching problem solving so that the patient can learn how to stop eating. In the last 30 years or so there has been the addition and encouragement of the use of hypnotherapy in the treatment of binge eating and other eating disorders, although this is still a relatively new form of treatment and still in the trial and error phase (Vanderlinden & Vandereycken, 1988).

The most common difficulty in treating eating disorders is that most patients are in denial regarding their condition and are, therefore, treatment resistant. In this sense, hypnotherapy can be a useful treatment modality in using ideomotor signaling, age regression and ego-state therapy to identify the origins of the persons distorted cognitions and emotional difficulties that precipitate their eating disorder (Mantle, 2003). Learning how to stop eating is about identifying the triggers to the compulsive eating episodes and learning more effective coping skills to dealing with difficult emotions and moods. Hypnotherapy is also useful here to assist patients to gain control over their emotions, as well as their thoughts and behaviours. In fact using hypnosis to supplement weight control through the use of visualization (Mantle, 2003) to encourage healthy eating styles and the use of relaxation to learn more effective coping skills also assists binge eating patients to gain efficacy over their eating behaviours and emotional coping strategies.

There are different types of eating disorders including anorexia, bulimia and binge eating disorder. Compulsive eating occurs when the person loses control while eating and eats more than they usually would and to a point of feeling uncomfortably full. The person does not know how to stop eating and often uses the binge to cope with difficult emotions and thoughts. Binge eating can lead to serious health conditions and, as such, it is important to treat the condition. In recent years, hypnotherapy has become a recommended treatment approach in that it is effective, despite the patient’s resistance, in identifying the triggers to the binge eating episodes and helps to teach more effective coping skills in dealing with negative emotions and thoughts. Relaxation techniques are taught and visualization techniques assist in encourage more healthy eating patterns and teaching the patient how to stop their compulsive eating.

References

Mantle, F. (2003). Eating disorders: The role of hypnosis. (Cover story). Paediatric Nursing15(7), 42-45

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Smith, M., Segal, R. &Segal, J. (2014, February): Binge Eating Disorder Symptoms, Causes, Treatment, and Help. Retrieved from http://www.helpguide.org/mental/binge_eating_disorder.htm

Stein, R. I., Kenardy, J., Wiseman, C. V., Dounchis, J., Arnow, B. A., & Wilfley, D. E. (2007). What’s driving the binge in binge eating disorder?: A prospective examination of precursors and consequences. International Journal Of Eating Disorders40(3), 195-203.

Telch C, Agras W (1996) Do emotional states influence binge eating in the obese? International Journal of Eating Disorders. 20, 271-280

Vanderlinden, J., & Vandereycken, W. (1988). The use of hypnotherapy in the treatment of eating disorders. International Journal of Eating Disorders7(5), 673-679.

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