From Anorexia to Binge Eating

For More ED Information:  www.addictions.net

One of the great ironies of Anorexia Nervosa is that somewhere along the line a certain number of people with this disorder switch from starvation to binge eating and obesity. This is not true of everyone and the numbers and percentages are unclear but I have treated some of the people who, as adolescents are now binge eaters and over weight in their twenties. Binge Eating Disorder is a serious illness because of the dangerous impact that binge eating have on health.

The Different Eating Disorders Compared:

First, it is important to define and distinguish between some of the eating disorders already discussed on the log.

1. Bulimia is characterized by self starvation followed by binge eating and purging or using laxatives. While bingeing the bulimic stuffs as much food into their mouths as they can fit and eat as fast as they can. Carbohydrates are the main aim of the binge and taste is amazingly unimportant. Soon after the binge there is alarm about the amount of food that was ingested. In an attempt to reverse the damage, the bulimic purges or uses laxatives, sometimes both, under the hope that they can get rid of the extra calories. Purging results in a feeling of calm and peacefulness not unlike that experienced by drug abusers. However, soon after the calm wears away there are intense feelings of disgust and self hate. This self hate does not prevent the cycle from beginning again either later the same day or the next day. Similar to those with Anorexia, the Bulimic spends a lot of time doing intense exercise. Bulimics lead a secret life about these activities due to the amount of shame they feel about their activities. Physically, binge eating and purging result in damage to the esophagus, teeth and heart, and digestive system. Bulimia can result in death.

2. In Anorexia Nervosa is characterized by rigid restriction of food intake, loss of weight equal to or more than 15% of total body weight considered normal for the height and age of the individual. What is important to note here is that there is a variety of Anorexia Nervosa that includes purging and using laxatives. These individuals might consider themselves to have bulimia as their diagnosis but in reality their low body weight and rigid food restriction places them squarely under the diagnosis of Anorexia. In some way, they convince themselves that Bulimia is less harmful than Anorexia. In point of fact, they are equally dangerous to health and threatening to life.

3. Binge Eating Disorder is somewhat similar to Bulimia Nervosa except that there is no purging. There are recurrent episodes of binge eating, even during a single day. The binge eating is rapid and has little to do with flavor. Rather, it is the rapid intake of food (stuffing) that seems to provide some type of hypnotic pleasure. The binge episode stops when the person feels discomfort or even pain due to the food intake. After the binge the individual feels self hatred and fear about having been out of control. They hate the weight gain they inevitably experience along with terrible shame about what they have done. The entire episode is characterized by a compulsive drive over which the individual feels no sense of control. Depression, guilt, self hate and disgust are the accompanying feelings after the binge. However, these negative emotions do not prevent a repeat binge later in the day or the next day.

There are dangerous physical symptoms that accompany binge eating and among these are:

1. Diabetes

2. GERD or Gastro Esophageal Reflux Disease

3. Obesity

4. High Blood Pressure

These are just a few of the types of physical problems resulting from Binge Eating.

In all cases that I have worked with, whether Anorexia, Bulimia or Binge Eating Disorder, people do not seem to know how to eat and to have disordered "eating lives." In other words, they did not grow up in homes in which the family met together at the table to jointly enjoy breakfast, lunch and dinner and at a set time each day. Often times, each member of the family fended for themselves for each meal and ate alone in their rooms and in front of the television.

In my experience, control is a major issue in all three eating disorders. As much as the binge eater wants to control their eating habits, they also resist counseling, whether it is from the therapist, nutritionist, medical doctor or anyone else. Work with those with the binge type of disorder often feels like a struggle between client and therapist over control of the dinner plate, with the therapist pulling the plate away from the client and the client pulling back.

Treatment for Binge Eating includes anti depressant medication including a particular medication named Topomax that seems to help some individuals gain control over their impulsiveness. In addition, individual psychotherapy and regular visits with a nutritionist who is expert in the field in order to educate about how to eat, have the client do a daily log of food intake and even do weigh-ins. In addition to this, attendance at self help groups such as Over-Eaters Anonymous (OA), that follows the twelve step addiction approach.

Many but not all people who were either bulimic or anorexic during their younger years experience binge eating disorder when they are older. However, there are many people who have this disorder without any history of the other eating disorders.

Why Do People Binge Eat?

This is a difficult question to answer. Some theories suggest that the binge eater is attempting to fill a deep void that they feel in their psyche. Perhaps this is one reason why bingeing occurs when the person is alone. However, there is evidence that binge eating is connected to other impulse disorders and may be due to some type of malfunction in the brain or in the digestive system. For some reason, the "switch" that tells the average person that they have eaten enough does not work in the binge eating resulting in the consumption of huge amounts of food until pain is felt.

Whatever causes this disorder, binge eaters are not deliberately engaging in and enjoying eating or dining. In fact, the concept of "fine dining" is alien to them because the binge has nothing to do with flavor or with gourmet cooking. One patient of mine had a major break through in her treatment when she was able to go out to dinner, sit at table with a table cloth and fine dinner ware, and enjoy the flavors connected with the excellent foods available at the restaurant. It had such a profound effect that, at least in her case, it helped her to move away from compulsive bingeing because she came to realize what she had always missed out on.
For More ED Information:  www.addictions.net

Binging & The Holidays

In this guest column by Andrea Roe, she talks about her experience binge eating during family holidays. Vacations are the hardest time of the year for people with eating disorders. Here’s Andrea’s experience:

While I struggled with eating disorders, and all through my recovery process, vacations were always the most difficult time for me. I got nervous whenever a family holiday approached. I was scared of what would happen. I was scared of losing control. I was scared of all the food and what it would do to me.

In my family, vacations meant family dinners. But not just one family dinner, we had a couple of family dinners for different family holidays. And there was food EVERYWHERE– and all kinds of food. And even worse, when the dinner was over, there were always leftovers and we would have cookies and cakes in the house for the next couple of days to follow.

I also hated eating in front of people. Even though most of them did not know about my eating disorder, I felt like as if they were watching me. Sometimes my relatives would tell me what to eat and say, “You have to try a piece of this cake and try that one too!” And if I said no, they would ask again and maybe make comments like “one piece of cake does not hurt” or “you are young, you don’t have to worry about your weight”. Oftentimes it was hard for me to stay strong and say no.

Sometimes I even pretended I was sick so I would not have to join the dinner table or go to someone’s dinner. I felt bad for doing this but I knew I would feel even worse if my eating habits got out of control.

To be honest, I can’t think of too many family holidays on which I did not binge. Sometimes I made it through the family holiday dinner fine enough– and was proud of me for that accomplishment- but then there was all this food left over for days, lying around in the kitchen, and at some point it just happened… I lost control and started binging.

Today I am recovered, and for the first time in years I enjoy vacations and am actually looking forward to them. I no longer get stressed out during family holidays and do not experience anxiety about the meals.

I want you to know that your life does not have to continue like that. You can learn to love yourself and your life again. Please don’t give up on yourself and keep on fighting. I know you can do it! And one day, you will be able to think of holidays as a time to gather with loved ones, you can make your own special memories, and you may even be able to start looking forward to them. I believe in you, please believe in yourself too!

Find support with us! http://www.addictions.net