Binge Eating Disorder (BED)

Definition:
Almost everyone overeats on occasion, having seconds or thirds of a holiday meal or devouring an entire bag of chips while watching a scary movie. Sometimes, though, overeating becomes a regular occurrence, shrouded in shame and secrecy. It’s called binge-eating disorder(BED), a serious eating disorder in which you frequently consume unusually large amounts of food.

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Binge eating disorder is characterized by compulsive overeating in which people consume huge amounts of food while feeling out of control and powerless to stop.Even the best of us occasionally overeats, helping ourselves to seconds, and even thirds; especially on holiday or festive celebrations. This is not a binge eating disorder. It becomes a disorder when the bingeing occurs regularly, and the binger is shrouded in shame and secrecy. The binger is deeply embarrassed about overeating and vows never to do it again. However, the compulsion is so strong that subsequent urges to gorge themselves cannot be resisted.

Binge eating disorder (BED), is the most common eating disorder in the United States affecting 3.5% of females and 2% of males and is prevalent in up to 30% of those seeking weight loss treatment, Although it is not yet classified as a separate disorder it was first described in 1959 by psychiatrist and researcher, Albert Stunkard and was first termed Night Eating Syndrome (NES), Binge Eating Disorder was coined to describe the same bingeing type eating behavior without the nocturnal component. BED usually leads to obesity although it can occur in normal weight individuals. There may be a genetic inheritance factor involved in BED independent of other obesity risks and there is also a higher incidence of psychiatric comorbidity, with the percentage of individuals with BED and an Axis I comorbid psychiatric disorder being 78.9% and for those with subclinical BED, 63.6%.
Some experts say that binge-eating disorder is the most common of all eating disorders. Estimates suggest that up to 4 percent of the U.S. population has binge-eating disorder, with girls and women slightly more likely than boys and men to develop the condition. Both children and adults can develop binge-eating disorder, but it’s most common when in your 40s and 50s.

In many parts of the world binge eating disorder is not considered a distinct condition. However, it is the most common of all eating disorders. Perhaps as more research is published and scientists learn more about it, this may change.

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Signs & Symptoms:

You may have no obvious physical signs or symptoms when you have binge-eating disorder. You may be overweight or obese, or you may be of a normal weight. In fact, most obese people don’t have binge-eating disorder.

On the other hand, when you have binge-eating disorder you often have numerous behavioral and emotional signs and symptoms. These may include:

*Periodically does not exercise control over consumption of food.Eating large amounts of food
*Eats an unusually large amount of food at one time—more than a normal person would eat in the same amount of time.
*Eats much more quickly during binge episodes than during normal eating episodes.
*Eats until physically uncomfortable and physically feels like they’re on the verge of throwing up due to the amount of food just consumed.
*Eating even when you’re full
*Eats when depressed, sad, or bored.
*Eats large amounts of food even when not really hungry.
*Usually eats alone during binge eating episodes, in order to avoid discovery of the disorder.
*Often eats alone during periods of normal eating, owing to feelings of embarrassment about food.
*Feels disgusted, depressed, or guilty after binge eating.
*Feeling that your eating behavior is out of control
*Frequently eating alone
*Hoarding food
*Hiding empty food containers
*Feeling depressed, disgusted or upset about your eating.

After a binge, you may try to diet or eat normal meals. But restricting your eating may simply lead to more binge eating, creating a vicious cycle.
Causes:
No one knows for sure what causes binge eating disorder. As many as half of all people with binge eating disorder have been depressed in the past. Whether depression causes binge eating disorder, whether binge eating disorder causes depression, or whether the two have a common cause, is not known for sure.

The trigger point can be emotion such as happiness, anger, sadness or boredom. Impulsive behavior and certain other emotional problems can be more common in people with binge eating disorder. However, many people also claim that bingeing occurs regardless of their mood.It is also unclear whether 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.

As with many mental illnesses, it’s thought that a variety of factors are at play in binge-eating disorder and may include:

*Biological. Biological vulnerability may play a role in developing binge-eating disorder. Both genes and brain chemicals may be involved. In addition, researchers are studying appetite regulation of the central nervous system for clues, along with gastrointestinal changes that might shed light on causes.

*Psychological. Psychological and emotional characteristics may also contribute to the condition. You may have low self-worth and trouble controlling impulsive behaviors, managing moods or expressing anger.

*Sociocultural. Modern Western culture often cultivates and reinforces a desire for thinness. Although most people who have binge-eating disorder are overweight, they’re acutely aware of their body shape and appearance and berate themselves after eating binges. Some people with binge-eating disorder have a history of being sexually abused.

Researchers also say that binge eating disorder is more common among competitive athletes such as swimmers or gymnasts whose body form is regularly on public display. Affected athletes in these sports tend to compare their own bodies in a negative way with those of their teammates. There is a research into how brain chemicals and metabolism affect binge eating disorder, but this study is in its early stages.
Complecations & Risk Factors:

Complications that binge-eating disorder may cause or be associated with include:
*Depression
*Anxiety
*Panic attacks
*Substance or alcohol abuse
*Obesity
*High blood pressure
*Type 2 diabetes
*High blood cholesterol
*Gallbladder disease
*Heart disease
*Stroke
*Osteoarthritis
*Joint pain
*Muscle pain
*Gastrointestinal problems
*Headache
*Sleep apnea
Frequent consumption of large amounts of food in a short period of time usually leads to weight gain and obesity, even though sufferers can maintain a normal weight for extended periods of time due to naturally high metabolism. The most problematic health consequences of this type of eating disorder is brought on by the weight gain resulting from the bingeing episodes.

People with binge eating disorder may become ill due to a lack of proper nutrition. Bingeing episodes usually include foods that are high in sugar and/or salt, but low in healthier nutrients, and are usually very upset by their binge eating and may become depressed. Those who are obese and also have binge eating disorder are at risk for type 2 diabetes, high blood pressure, high blood cholesterol levels, gallbladder disease, heart disease, and certain types of cancer.

Most people with binge eating disorder have tried to control it on their own, but have not been able to control it for very long. Some people miss work, school, or social activities to binge eat. Obese people with binge eating disorder often feel bad about themselves and may avoid social gatherings. Those who binge eat, whether obese or not, feel ashamed, are well aware of their disordered eating patterns, and try to hide their problems. Often they become so good at hiding it that even close friends and family members don’t know they binge eat.

Mental health experts are still trying to understand what factors may increase the risk of developing binge-eating disorder. The risk factors may vary from those of other eating disorders, such as anorexia or bulimia. Risk factors for binge-eating disorder may include:

*Dieting. Dieting is often a risk factor for anorexia and bulimia, but it’s not clear what role it plays in binge-eating disorder. People with binge-eating disorder have a mixed history of dieting — some have dieted to excess dating back to childhood, while others haven’t dieted. Dieting may trigger an urge to binge eat.

*Psychological issues. Certain behaviors and emotional problems are more common when you have binge-eating disorder. As with bulimia, you may act impulsively and feel a lack of control over your behavior. You may have a history of depression or substance abuse. Binge eaters may have trouble coping with anger, sadness, boredom, worry and stress.

*Sexual abuse. Some people with binge-eating disorder say they were sexually abused as children.

*Media and society. A preoccupation with body shape, weight and appearance is common when you have binge-eating disorder. Messages in the media that equate thinness with success may heighten the self-criticism that’s common in binge eating.
*Biology – the development of binge eating disorder may be linked to a person’s biological vulnerability, involving genes as well as brain chemicals. Current research is looking at how the appetite regulation of the central nervous system may affect people’s eating habits. There may also be clues in how some people’s gut functions.

*Some jobs – there is some looming evidence that a higher percentage of sportsmen, sportswomen and models have binge eating disorder compared to other people. Although some people suggest that individuals who work in catering (making and serving food) may be susceptible, further studies are required.
Diagnosis:
Binge-eating disorder is not yet officially classified as a mental disorder, and not all experts think it should be. Mental health experts hope that ongoing research will determine if binge eating is a distinct medical condition, a nonspecific type of eating disorder, or simply a cluster of symptoms.

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Binge eating is similar to bulimia nervosa, another eating disorder, and some experts think it may be a form of bulimia. But unlike people with bulimia, who purge after eating, people with binge-eating disorder don’t try to rid themselves of the extra calories they consume by self-induced vomiting, overexercising or other unhealthy methods. That’s why most people with binge-eating disorder are overweight. In fact, some experts say that binge eating may be a type of obesity disorder.

In any case, when doctors suspect someone has an eating disorder, they typically run a battery of tests and exams. These can help pinpoint a diagnosis and also assess any related complications.

These exams and tests generally include:

*Physical exam. This may include such things as measuring height and weight; assessing body mass index; checking vital signs, such as heart rate, blood pressure and temperature; checking the skin; listening to the heart and lungs; and examining the abdomen.

*Laboratory tests. These may include a complete blood count (CBC), as well as more specialized blood tests to check such things as cholesterol levels, thyroid functioning, electrolytes and blood sugar, which may determine if you have metabolic syndrome.

*Psychological evaluation. A doctor or mental health professional will discuss your thoughts, feelings and eating habits with you. You may be asked about binge-eating symptoms, including when they started, how severe they are, how they affect your daily life and whether you’ve had similar issues in the past. You may also be asked to complete psychological self-assessments and questionnaires.

*Other studies. Other studies may be done to check for health consequences of binge-eating disorder, such as heart problems, gallbladder disease or sleep apnea.

Criteria for diagnosis:-
All these evaluations help doctors determine if you meet the criteria for binge-eating disorder or if you may have another eating disorder, such as bulimia. The criteria to diagnose mental health conditions are set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

The DSM says more research is needed before determining whether binge-eating disorder is truly a unique medical condition. However, it offers some criteria for diagnosing binge-eating disorder.

DSM diagnostic criteria for binge-eating disorder include:
*Recurrent episodes of binge eating, including eating an abnormally large amount of food and feeling a lack of control over eating

*Binge eating that’s associated with at least three of these factors: eating rapidly; eating until you’re uncomfortably full; eating large amounts when you’re not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating.

*Distress about your binge eating

*Binge eating occurs at least twice a week for at least six months

*Binge eating isn’t associated with inappropriate methods to compensate for overeating, such as self-induced vomiting

Some people may not meet all of these criteria but still have an eating disorder. As researchers learn more about eating disorders, the diagnostic criteria may evolve and change. Don’t try to diagnose yourself — get professional help if you have any eating disorder symptoms.

Treatment:-
People with binge eating disorder, whether or not they want to lose weight, should get help from health professionals including physicians, nutritionists, psychiatrists, psychologists, clinical social workers or by attending 12-step Overeaters Anonymous meetings. Even those who are not overweight are usually upset by their binge eating, and treatment can help them.

Although mental health professionals may be attuned to the signs of binge eating disorders, most physicians do not raise the question, either because they are uninformed about the condition or too embarrassed to ask about it. Because it is not a recognized psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders, it is difficult to get insurance reimbursement for treatments.[7]

There are several different ways to treat binge eating disorder. Cognitive-behavioral therapy teaches people how to keep track of their eating and change their unhealthy eating habits. It also teaches them how to change the way they act in tough 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.

Researchers are still trying to find the treatment that is the most helpful in controlling binge eating disorder. The methods mentioned here seem to be equally helpful. For people who are overweight, a weight-loss program to improve health and to build self-esteem, as well as counselling to pinpoint the root of their psychological problems triggering their binge episodes, might be the best choice.

Prevention:
While there’s no sure way to prevent binge-eating disorder, there may be ways to help. For instance, pediatricians may be in a good position to identify early indicators of an eating disorder and help prevent its development. During routine well-child checks or medical appointments, pediatricians can ask children questions about their eating habits and satisfaction with their appearance. Parents can also cultivate and reinforce a healthy body image in their children no matter what their size or shape. Be certain not to tease or joke about a child’s size, shape or appearance.

In addition, if you notice a family member or friend with low self-esteem, severe dieting, frequent overeating, hoarding of food or dissatisfaction with appearance, consider talking to him or her about these issues. Although you may not be able to prevent binge-eating disorder or another eating disorder from developing you can talk about healthier behavior or treatment options.
Lifestyle and home remedies:
Binge-eating disorder generally isn’t an illness that you can treat on your own. But you can do some things for yourself that will build on your treatment plan. In addition to professional treatment, follow these self-care steps for binge eating:

*Stick to your treatment. Don’t skip therapy sessions. If you have meal plans, do your best to stick to them and don’t let setbacks derail your overall efforts.
*Avoid dieting. Trying to diet can trigger more binge episodes, leading to a vicious cycle that’s hard to break.
*Eat breakfast. Many people with binge-eating disorder skip breakfast. But studies show that if you eat breakfast, you’re less prone to eating higher calorie meals later in the day.
*Don’t stock up. Keep less food in your home than you normally do. That may mean more-frequent trips to the grocery store, but it may also take away the temptation and ability to binge eat.
*Get the right nutrients. Just because you may be eating a lot during binges doesn’t mean you’re eating the kinds of food that supply all of your essential nutrients. Talk to your doctor about vitamin and mineral supplements.
*Stay connected. Don’t isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
*Get active. Talk to your health care providers about what kind of exercise is appropriate for you, especially if you have health problems related to being overweight.

Regular Exercise and Routine diet is the best form of  remedy for BED

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Binge_eating_disorder
http://www.mayoclinic.com/health/binge-eating-disorder/DS00608
http://www.helpguide.org/mental/binge_eating_disorder.htm
http://www.medicalnewstoday.com/articles/173184.php

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