Binge Eating Disorder Deserving of More Recognition and Treatment Options
Eating Disorder Awareness Week is February 1–7, 2015 and Bellwood Health Services is using this opportunity to raise awareness of Binge Eating Disorder – the most common but least talked about type of eating disorders.
When asked about eating disorders, most people immediately think of Anorexia Nervosa. Although anorexia is a very serious and sometimes life threatening eating disorder, years of movies, and magazine articles focusing on celebrities struggling with this issue, has given us the idea that it is also the most common of all eating disorders. In fact, it is actually the least prevalent of the eating disorders.
Research has found that binge eating disorder affects 3.5% of women and 2% of men, with an average lifetime duration of 8.3 years (Hudson, Hiripi, Pope & Kessler, 2007). This means that binge eating disorder affects more people than anorexia and bulimia combined, and can be life-long problem.
The primary symptoms of binge eating disorder are consumptions of large quantities of food, and the individual feels as though they have no control over this consumption. The individual often eats large amounts quickly, and secretively. Unlike bulimia, the individual does not attempt to compensate for food intake through purging or over-exercising. Binge eating disorder affects men and women fairly evenly, and the affected age group is broader than other forms of eating disorders.
According to Lauren Goldhamer, Eating Disorders Therapist at Bellwood Health Services, there are many misconceptions about binge eating that have helped keep it in the shadows. “Most people feel shame, and hide the problem from others. In fact, in front of others, they may eat normally or even appear to be dieting to conceal the problem. You usually cannot determine if someone is struggling with binge eating based on their body size. For these reasons, the problem can be ‘invisible.’”
Bellwood Health Services is one of the few residential eating disorders treatment programs in Canada that treat binge eating disorder. “The lack of quality or available treatment options are often reasons why there are not more people seeking help for the problem,” states Ms. Goldhamer. Other reasons why few people tend to seek treatment include:
- Feelings of shame and guilt that could result from others learning about the problem
- A belief that it is not a serious issue and that they do not deserve help the way those with anorexia or bulimia do
- Difficulty in discussing their concerns with their family physician
Understanding Emotional Eating
We all deal with our emotions in different ways. One may seek refuge in a friend, while others may withdraw and seek solitude. Some people turn to food as a source of comfort and pleasure. This scenario is not typically ruled by physical hunger, but rather an emotional hunger that is satisfied by specific foods, such as potato chips, ice cream or chocolate. Most comfort foods have something in common; they contain sugar, fat and/or sodium. It may be difficult to control how much we eat during these times, as ‘comfort foods’ elicit a calming feeling and ultimately improve our mood – fueling us to continue eating. We have all engaged in this behaviour on occasion in the past, but at what point does this behaviour become problematic? When one eats to create a feeling, or to manage emotions regardless of hunger levels, this creates an unhealthy relationship with food.
Food in the Reward System
Food, music and sex are stimuli that naturally release dopamine, initiating the reward center in our brain, which deem them as rewarding and worth repeating. Dopamine, the neurotransmitter commonly known as the ‘pleasure molecule’ is increased in our brain nerve endings and creates feelings of happiness and pleasure. While food does not affect dopamine levels to the degree that addictive substances such as drugs and alcohol do, it triggers the brain to repeat the rewarding behaviour, in this case – eating. Refined foods that are heavily processed are often higher in sugar and sodium, and these are broken down and absorbed into our bloodstream quickly, giving the brain a sudden rise in dopamine levels. These refined foods are more likely to stimulate dopamine levels, versus foods that our body has to work harder to process – such as complex carbohydrates or protein including whole grains or meat.
Food is much more than just a source of energy for our bodies. It is an integral component of sustaining life. However through habit and our own experiences, we have learned that we can manipulate how we feel by choosing certain foods. For some, this can become an all-consuming behaviour in ones’ life.
Emotional Hunger vs. Physical Hunger
Food is commonly a source of stress relief for many. People may indulge in food cravings in hopes of easing stress and anguish, or to feel happy. However, many who find themselves in these scenarios are left with feelings of regret or guilt.
How do we differentiate between emotional hunger versus physical hunger? There are many differences that can help identify whether food may improve or harm the situation.
Physical hunger is a biological signal indicating a need for food to provide our body with energy. Physical hunger is gradual, whereas emotional hunger is sudden. Emotional hunger is usually urgent, and often involves very specific foods, which are often unhealthy. However physical hunger can be delayed or addressed at a later time, and we are open to more choices in what will be satisfying.
Often emotional eating leaves one unsatisfied, which encourages more food in order to feel content. Whereas in physical hunger, our body registers food consumed and we feel satiated. It is common to experience feelings of guilt over the food choices made when emotional eating, while still feelings of stress remain unresolved.
Structure is an integral part of addiction recovery, and this practice is applicable to practicing healthy eating as well. It is common to eat sporadically and consume unbalanced meals when eating to fulfill feelings. These maladaptive behaviours can impact the way our brain responds to foods, which affect ones mental and physical health.
So what does balanced and structured eating look like? While there is no ‘right’ way of healthy eating, there are many principles that we can practice that allow us to enjoy food in moderation.
Balancing each meal with a good source of grain/starch, protein and vegetable/fruit allow us to get the necessary nutrients from our food. Most ‘comfort’ meals are high in carbohydrates and fat, but often lack fiber or protein. Each macronutrient has its role within our body.
Carbohydrates provide us with immediate energy, and also supply us with many vitamins and minerals.
Protein helps our body repair damage and produces certain neurotransmitters.
Polyunsaturated fats play a role in heart health, cognition as well as producing feelings of fullness and satiety. These are a few examples of the importance of including balanced meals in overall health.
2. Timing and Eating
While balanced meals are important, another component of structured eating is timing. Abstaining from food for long periods of time can trigger negative feelings such as anxiety, irritability and fatigue. Small snacks are beneficial, as they allow us to refuel our body before the onset of those negative symptoms. It can also deter us from impulsive eating or acting on food cravings, as we feel satisfied and full. Three meals and three snacks a day provide us with long lasting energy throughout the day, and promote optimism, concentration and alertness. Establishing structure in one’s meal plan is beneficial in creating a healthy relationship with food, as well as improving one’s overall mental and physical health.
3. Habit & Learned Behaviours
While practicing balance and moderation are an important part of breaking the cycle of emotional eating, there are other components that lead one to rely on external sources of pleasure in times of need. Habit and learned behaviours also factor into how we utilize food during these periods. Identifying triggers can help to determine the underlying cause of stress. Boredom, stress and loneliness are often prime times when food can be an outlet for distracting one from these negative emotions.
Being able to recognize these triggers and time frames in the moment can help us make healthier choices including balance and moderation, seeking support and utilizing healthy coping mechanisms.
How to Break the Cycle of Emotional Eating
If you would like to learn more about emotional eating, or you need help, talk to your family doctor who can refer you to a nutritionist/ dietitian. Here are some places, you can visit too:
- Heart & Stroke Foundation: https://www.heartandstroke.com/site/apps/nlnet/content2.aspx?c=ikIQLcMWJtE&b=4016859&ct=12044291
- Dietitians of Canada: https://www.dietitians.ca/
- Canadian Diabetes Association- The Plate Method:https://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/basic-meal-planning
If you or someone you know is struggling with overeating, please call Bellwood to speak to one of our counsellors to get help: 1-800-387-6198
How Sugar Affects the Brain: Video Highlights Similar Effects Between Drugs & Sugar
Food is one of our primary sources of pleasure, and critical to our survival. In a healthy reward pathway of the brain, food is a natural stimulus that produces feelings of pleasure from the release of dopamine. This gratifying feeling makes this activity worthy of repeating, as we want to experience it again. However, not all foods have the same effect on the brains’ reward system. So why do certain foods activate the brains’ reward system more than others? Sugar, salt and fat are three substances that ‘hijack’ the brains’ reward system, by releasing a burst of dopamine, similar to the effects of drugs and alcohol. As more research emerges, we gain knowledge about how a diet of large portions of refined and processed foods affect the way our brain responds to food. Some individuals develop a dependence on these foods to feel happy and satisfied, and eventually develop a tolerance by needing more of these ‘addictive’ foods to experience feelings of pleasure. Dependence and tolerance are fused with the fundamentals of addiction, reinforcing the link between food and addiction. This video from the TED Talks series highlights how foods high in sugar can have a similar effect on the brain as drugs, alcohol and other addictive behaviours.
Binge Eating Disorder is Now Recognized as an Eating Disorder in the DSM V
As clinicians and researchers learn more, categorization of various mental health issues and disorders changes to reflect more precise diagnostic criteria, thus helping those who are seeking treatment and understanding. For example, the tool that mental healthcare professionals use to help guide their diagnoses and treatment plans – the Diagnostic and Statistical Manual of Mental Disorders (DSM) is revised from time-to-time to ensure that updates are made as more information about various disorders becomes clearer. In its latest edition, the DSM-5 has included an important revision in the chapter involving Feeding and Eating Disorders.
Definition of Binge Eating Disorder According to the DSM-5
In the latest edition of the DSM, Binge Eating Disorder has now been recognized as separate and distinct from the “catch-all” category of eating disorders labeled “Eating Disorder Not Otherwise Specified (NOS).” In the past, this category was used for individuals who had disordered eating and behavioural patterns that did not fit into the DSM-IV criteria of anorexia nervosa and bulimia nervosa. However, it is now recognized that a large number of individuals diagnosed with Eating Disorder NOS category may actually have Binge Eating Disorder. This is an important distinction because diagnostic criteria for this disorder can be more clearly articulated. According to the DSM-5, Binge Eating Disorder causes distress and significant physical and psychological problems. It is defined as:
- Recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances
- Eating episodes marked with feelings of lack of control
- Eating too quickly, even when not hungry
- Feelings of guilt, embarrassment, or disgust
- Eating alone to hide the behaviour
The Implications of this New Diagnosis
This new distinction of Binge Eating Disorder in the DSM has important implications for individuals seeking help. The DSM criteria associated with the disorder will hopefully be associated with a more meaningful and accurate diagnosis. In addition, healthcare professionals can improve communication among service providers and improve treatment planning given their shared understanding of what the disorder represents, as compared to the previous diagnosis of an eating disorder, “not otherwise specified.”
In addition, the formal categorization of binge eating disorder may also reassure individuals who are attempting to seek help for this cluster of behaviours that causes them a significant amount of pain and distress. Family members or others may have told individuals with binge eating disorder that they simply are “overeating,” making the individual with the problem feel like the problem should be within his/ her control to fix. The diagnosis of binge eating disorder, when indicated, may help the individual to realize that seeking help for the problem is necessary and appropriate. It may also provide the individual with insight into the fact that binge eating disorder is more than simply “overeating” – that it is far more severe and requires treatment by professionals who can help. When an accurate diagnosis is made, an appropriate treatment plan can then be developed. With the appropriate treatment plan and guidance and support from professionals, an individual can begin to recover from their binge eating disorder.
Think you might have an eating disorder? Do you have a family member or friend who may require help with a binge eating disorder? Bellwood Health Services can provide you with you information, resources and support needed to recover from an eating disorder.
Contact Bellwood to learn how we can help.
Killing Ourselves to Be Thin: An Eating Disorder Infographic
Eating Disorder Awareness Week is February 2-8, 2014. At Bellwood Health Services, bringing awareness about Addiction and Eating Disorders is part of our mandate. Thousands of women and men suffer from this deadly mental health illness with little or no support.
So much pressure is being placed by the media, friends, work, or sometimes family to look a certain way. For some, developing an eating disorder can be a way of dealing with the daily pressures of life. Men and women are getting caught in a cycle of weight gain and dieting to the point of self destruction.
To add to the plate, there is so much stigma being faced by these individuals, that it’s no wonder that instead of seeking help to get well, they begin to turn to drugs, sex or alcohol to cope with the uncontrollable in their lives.
At Bellwood, we have an eating disorder and addiction treatment program to help individuals struggling with an eating disorder and addiction for women and men 19 years and older.
Help Bellwood bring awareness about bulimia, anorexia, binge eating and overeating by sharing this post.
Here is a mind-boggling INFOGRAPHIC developed by Rader Programs, a treatment facility in US.
What Are the Signs of a Binge Eating Disorder or Compulsive Overeating?
What is the difference between overeating and binge eating?
How is this different from normal eating? Are these serious issues? Is change possible? Some post-holiday thoughts.
If you are asking yourself:
- Do I have a ‘real’ problem or do I just lack the willpower to stop?
- Should I just ‘try harder’ to stop?
- Will a different diet do the trick?
- Does my eating problem qualify as an eating disorder?
- What’s the difference between binge eating and overeating?
This blog post may help you sort out some of those questions and help you understand better what type of treatment you need.
It is very common and normal, in fact, to sometimes overeat. Everyone with easy access to food does this at times. We overeat at holiday time, parties, good restaurants, and even occasionally for emotional reasons. It is also common and normal to gain a small amount of weight over time. This may be due to overeating and/or slower metabolism associated with aging and decreased energy expenditure. Simple overeating and weight gain can be dealt with in a healthy way by making modest adjustments to your eating habits and/or increasing your activity level. In addition, self- acceptance of having a less than perfect body weight or less than perfect eating habits can prevent these issues from escalating and interfering with your overall happiness, well-being or self-esteem. The personal philosophy that “no body is perfect” and food and weight while important, are only a part of what makes a healthy, happy, and meaningful life, help to put perspective on weight and eating issues.
For some people, however, these issues can become overwhelming. Eating can feel out of control. Attempts to lose weight may feel desperate.
The following are some signs that you may have an overeating problem:
- While wishing to lose weight, you may actually end up overeating or binge eating.
- You may find that instead of losing, you are gaining weight and this can add to feelings of discouragement and depression.
In this context overeating is not normal. Problematic overeating is overeating that occurs regularly, from once a week to many times each day. Problematic overeating involves eating food and feeling guilty. It is often associated with feelings of being out of control.
Binge eating disorder is a specific type of overeating. The following are signs that you may have a binge eating problem:
- You eat an amount that is clearly very large, within a relatively short amount of time, rather than spread through-out the day or at just one meal.
- Large amounts of food intake are frequently done in secret due to shame.
- There is generally a sense of loss of control during a binge eating episode and the feeling that the eating episode could not be prevented.
Sometimes people experience both overeating and binge eating, while others do one or the other. If you try but cannot seem to stop these behaviors and feel that weight and body image issues are negatively affecting your self-esteem or other important aspects of your life, such as relationships or social life, it is clear that your problems are worth addressing.
You don’t need a formal diagnosis of eating disorder to warrant help. In this situation, just “trying harder” is seldom the answer. A new diet is seldom a long- term answer. On the other hand, understanding yourself emotionally, feeling supported, and learning specific tools to address behaviours can be extremely helpful.
Treatment, whether in individual or group therapy, or in residential treatment, can help you re-learn or sometimes learn for the first time, how to become a normal eater and address the underlying issues that are at the core of the eating problem. An assessment at Bellwood could help identify which type of help would be most effective.
Written By: Lauren Goldhamer, M.Ed, has been on staff at Bellwood as an Eating Disorder Therapist since 2001 and has been working with clients with eating disorders and related issues since 1995. She has a M.Ed. in Counselling Psychology, and training in both Cognitive-Behavioural Therapy and Emotion-Focused Family Therapy for eating disorders. Her involvement with Bellwood’s Eating Disorders Treatment Program includes clinical assessments, group and individual therapy, outpatient therapy and meal supervision.
Her previous work with eating disorders includes: facilitating groups at Sheena’s Place; Eating Disorders of York Region, and a collaboration with the University of Toronto’s Health Services where she initiated their first body image groups supporting students at risk of developing an eating disorders. In addition to her work at Bellwood, Lauren maintains a private practice.