When Eating Becomes out of Control
National Eating Disorders Awareness Week is February 26th-March 4th. For the month of February, I will be posting weekly on the different types of eating disorders and where to get help. To start, let's take a look at Binge Eating Disorder....
When people think about eating disorders, they typically don’t think about somebody struggling with out of control binging. In fact, the American Psychiatric Association did not give Binge Eating Disorder (BED) its own unique diagnosis code until 2013. What most people don’t realize is that Binge Eating Disorder is the most common of all the eating disorder diagnosis and close to 3 million people in the US suffer from BED.
So, if BED is so common, why is it often missed by healthcare providers? One contributing factor is that a large percentage of those who struggle with BED also struggle with obesity and feelings of shame related to their weight. Think about all the medical conditions related to weight gain and obesity and how this is often addressed with medical providers. The conversation typically focuses on reducing caloric intake, making healthier food choices and the need to lose weight.
If you struggle with BED, this simple diet prescription does not work. The intervention is not to just “make better food choices”. In fact, this can sometimes intensify the binging episodes and lead to increased feelings of shame, guilt, distress and hopelessness. I’ve had many clients who have tried to rid their kitchen of all the foods they perceive to be unhealthy only to find themselves binging on whatever is left. Or, they find themselves making impulsive runs to the grocery store or a drive through restaurant.
When your medical provider says “you need to change your diet” or “you’re not losing the weight I need you need to lose”, it’s hard for someone with BED to tell them that you understand this, but the eating feels out of control. Over time this feeling of failure and frustration can lead to avoidance of future medical appointments and some medical conditions can become life threatening.
What are the symptoms of BED?
Eating a large amount of food, often in a very short period of time.
Eating beyond the sensation of fullness, often to the point of feeling uncomfortably full.
Feeling shame and frustration about eating. This can lead to primarily binging when alone or in secret.
Episodes of binging become recurrent.
Significant emotional distress related to the binge episodes.
Absence of compensatory behaviors like purging or fasting after a binge episode.
For more information on the prevalence of BED and symptoms, check out these facts from the National Eating Disorders Association:
https://www.nationaleatingdisorders.org/binge-eating-disorder
What do you do if you or someone you love may be struggling with BED?
Find a local therapist who specializes in the treatment of eating disorders and schedule an assessment. A clinical assessment will help identify if BED is the appropriate diagnosis and can help develop a comprehensive treatment plan to reduce symptoms and work towards full recovery. An eating disorder therapist can also help coordinate a treatment team that involves working with your medical provider(s) and a registered dietitian that has experience working with eating disorders.
Talk to your medical provider about the binge episodes. Explain the symptoms and be honest. Most times, this will lead to a change in the medical plan that involves also treating the BED symptoms both in the office and referral to an eating disorder specialist. It’s a hard topic to bring up, but helping your medical provider really understand what is going on with your eating will allow them to better support you. Remember, your medical provider can’t treat what you don’t tell them!
The most important thing to remember is that BED is treatable. Getting an appropriate diagnosis can be incredibly freeing. It allows one to work on letting go of the guilt and shame associated with the eating behaviors while simultaneously working on recovery and improved health. Freedom from suffering from an eating disorder is always worth it!
For additional information on Binge Eating Disorder:
Binge Eating Disorder Association - https://bedaonline.com