End Binge Eating Now
Anorexia and bulimia nervosa and binge-eating disorder have strict diagnostic criteria set forth by the American Psychiatric Association. However, these three do not cover the entire spectrum of disordered eating patterns. Those people who induce vomiting after consuming only a small amount of food, for example, or those who chew large amounts of food and spit it out rather than swallow it, do not fit the diagnosis of bulimia. For such persons, a diagnosis of Eating Disorder, Not Otherwise Specified is used.
Anorexia nervosa is the rarest of the eating disorders, affecting fewer than 1 percent of adolescent and young women (that is, women ages thirteen to twenty-five) and a tiny proportion of young men. Bulimia nervosa, on the other hand, affects up to 3 percent of teenage and young adult women and about 0.2 percent of men. Even more of this age group, probably 5 percent, suffer from binge-eating disorder. In obese patients, fully one-third meet the criteria for this disorder. Binge eating is the most common eating disorder in men, although more women actually have this disorder. Eating Disorders, Not Otherwise Specified, are even more common.
Particularly impressive evidence for a cultural perspective comes from the fact that different types of disorders appear in different cultures. Anorexia nervosa, which involves self-starvation, and bulimia nervosa, which involves binge eating followed by purging, primarily strike middle- and upper-class women in Westernized cultures. In Western cultures, women may feel particular pressure to be thin and have negatively distorted images of their own bodies. Amok, a brief period of brooding followed by a violent outburst that often results in murder, strikes Navajo men and men in Malaysia, Papua New Guinea, the Philippines, Polynesia, and Puerto Rico. In these cultures, this disorder is frequently triggered by a perceived insult. Pibloqtoq, a brief period of extreme excitement that is often followed by seizures and coma lasting up to twelve hours, strikes people in Arctic and Subarctic Eskimo communities. The person may tear off his or her clothing, break furniture, shout obscenities,...
Eating disorders such as anorexia, bulimia, and compulsive overeating provide evidence of the complex relationship between the physiological and psychological components of hunger. Obesity has also been examined using medical and psychological models. The etiology of hunger's relationship to eating disorders has provided insight, if not consensus, by investigating the roles of hereditary factors, social learning, family systems, and multigenerational transmission in hunger as well as the socially learned eating patterns, food preferences, and cultural ideals that can mediate the hunger drive. Body image, eating restraint, and eating attitudes have been assessed by various methods. The focus of much of the research on hunger beyond the early animal experiments has been eating disorders. The findings confirm that hunger is more than a physiological need and is affected by a multitude of variables.
Studies suggest a genetic predisposition to eating disorders, particularly in those persons who engage in binge eating and purging behaviors. Their family histories typically include higher than expected numbers of persons with mood disorders and substance abuse problems. Dysfunctions in the pathways for the substances that transmit messages in the brain, the neuro-transmitters, are thought to play a role in the development and maintenance of eating disorders, although these dysfunctions are not sufficient to explain the entire problem by themselves. The psychological theories about the causes of eating disorders postulate that individuals with underlying feelings of powerlessness or personal inadequacy attempt to cope by becoming preoccupied with their body's shape and size. Finally, the incidence of sexual abuse is higher among persons with eating disorders, particularly bulimia nervosa, than among those in the general population.
Patients with eating disorders such as anorexia nervosa and bulimia nervosa often present with excessive concerns about their cutaneous body image in addition to concerns about their weight and shape (Gupta & Gupta, 2001a). The eating disorders can be associated with a wide range of dermatological (Gupta et al., 1987 Gupta & Gupta, 2000) complications related to starvation, bingeing and purging, abuse of laxatives and other related symptoms (American Psychiatric Association, 1994). Acne has a peak incidence during mid-adolescence, a life stage that is associated with a high incidence of eating disorders. In some vulnerable adolescents even mild acne may exacerbate or precipitate an eating disorder such as bulimia nervosa (Gupta et al., 1987 Gupta & Gupta, 2000). The endocrine changes associated with binge eating may cause a flare-up of acne (Gupta et al., 1992), which is frequently observed in patients with eating disorders (Gupta & Gupta, 2000). In these patients the disfigurement...
The two basic types of anorexia nervosa are the restricting type and the binge-eating purging type. The restricting type is characterized by an extremely limited diet, often without carbohydrates or fats. This may be accompanied by excessive exercising or hyperactivity. Up to half of anorexics eventually lose control over their severely restricted dieting and begin to engage in binge eating. They then induce vomiting, use diuretics or laxatives, or exercise excessively to control their weight. People who are in the binge-eating purging group are at greater risk for medical complications. As the weight loss in either type reaches starvation proportions, anorexics become more and more preoccupied with food they may hoard food or steal. They also experience sleep abnormalities, loss of interest in sex, and poor concentration and attention. In addition, they slowly restrict their social contacts and become more and more socially isolated. In general, anorexics of the binge-eating purging...
Persons who have bulimia nervosa are similar in behavior to the subset of anorexics who binge and purge, but they tend to maintain their weight at or near normal for their age and height. They intermittently have an overwhelming urge to eat, usually associated with a period of anxiety or depression, and can consume as many as 15,000 calories in a relatively short period of time, typically one to two hours. Binge foods are usually high calorie and easy to digest, such as ice cream. The binge eating provides a sense ofnumb-ing of the anxiety or relief from the depression. Failing to recognize that they are full, bulimics eventually stop eating because of abdominal pain, nausea, being interrupted, or some other non-hunger-related reason. At that point, psychological stress again increases as they reflect on the amount they have eaten. Most bulimics then induce vomiting, but some use laxatives, diuretics, severe food restriction, fasting, or excessive exercise to avoid gaining weight....
In comparing hunger and satiety sensation differences, increased hunger and disturbed satiety appear to be two different and quite separate mechanisms. Imbalance or dysfunction of either the hunger mechanism or the satiety sensation can lead to obesity, overeating, binge eating, and other eating disorders. It appears that the way hunger is experienced accounts, in part, for its recognition. Whether hunger is experienced in context with other drives or becomes a compulsive force that dominates all other drives in life is a complex issue.
Eating past the point of satiety is referred to as counterregulation or, more commonly, as binge eating or compulsive eating. Because the inhibitors of hunger restraint are not physiological in this zone, the restraint and Thus, there are both internal cues and external cues that define hunger and lead an individual to know when to eat and how much to eat. External cues as a motive for eating have been studied extensively, particularly in research on obesity and eating disorders such as binge behavior and compulsive overeating. External cues include enticing smells, locations such as restaurants or other kinds of social settings, and the social environment what other people are doing. When external cues prevail, a person does not have to be hungry in order to feel hungry.
Eating disorders are best thought of as problems involving body weight and distorted body image on a continuum of severity. The most serious is anorexia nervosa, a disorder characterized by weight loss greater than or equal to 15 percent of the body weight normal for the person's height and age. Bulimia nervosa is usually found in persons of normal weight and is characterized by consumption of large amounts of food followed by self-induced vomiting, purging with diuretics or laxatives, or excessive exercise. Binge-eating disorder, found usually in persons with some degree of overweight, is characterized by the consumption of large amounts of food without associated vomiting or purging. Other, milder, forms of eating disorders are at the least serious end of the continuum. Obesity may or may not be part of this continuum, depending on the presence or absence of underlying psychological problems. About one-third of obese persons have binge-eating disorder.
The American Psychiatric Association has developed provisional criteria for binge-eating disorder in order to study this disorder more completely. The criteria include compulsive and excessive eating at least twice a week for six months without self-induced vomiting, purging, or excessive exercise. That is, binge-eating disorder is bulimia nervosa without the compensatory weight-loss mechanisms. For this reason, most binge eaters are slightly to significantly overweight. In addition to the eating problems, many binge eaters experience relationship problems and have a history of depression or other psychiatric disorders.
We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.