Everyone overeats from time to time, and it usually happens during Thanksgiving or some other holiday where elaborate feasts are prepared. Yet for some people, overeating can become an ongoing habit that dominates daily life. In addition to the very real psychological concerns about this kind of food addiction, overeating can also become a cause of great concern for overall health and wellbeing. Treating compulsive overeating, however, is rarely as simple as activating willpower or adopting a restrictive diet.
DR. CHRISTOPHER MCGOWAN
Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.
What is Compulsive Overeating?
Compulsive overeating can be defined as an intense urge to consume large amounts of food in a short span of time. This condition can also be referred to as binge eating disorder (BED), a term recently added to the DSM-5 (a manual used by psychiatrists and therapists to diagnose mental health issues). The main difference between this disorder and the familiar impulse to eat a lot during a holiday meal, for instance, is that compulsive overeating is driven by entrenched emotional or psychological factors.
Compulsive overeating and binge eating disorder can be used somewhat interchangeably, but they are to be differentiated from other eating disorders like bulimia nervosa and anorexia. Even though some of the emotional drivers are similar, anorexia is almost the opposite of BED in that people who suffer from it avoid eating to the detriment of their health. Bulimia does indeed involve extreme binge eating, but the primary difference between it and BED is the followup impulse to counteract the bingeing. People with bulimia will purge (often through forced vomiting) or restrict calories after the binge, but people with BED only do the binge part.
A binge eating disorder is characterized by a significant loss of control over eating habits; rather than a simple dieting “cheat,” people with BED feel an overwhelming urge to eat long after satiety has been achieved. Additionally, these binge periods are marked by eating quickly and usually while alone; it can even feel as though they have been “taken over” by these strong emotions. Although it is somewhat more prevalent among women than men, it can affect people across all age, race, and ethnic groups. It is estimated that many millions of adults in the United States are affected by BED.
Signs and Symptoms of Compulsive Overeating
According to the American Psychiatric Association, the disorder is defined as binge eating at least once a week over a period of several months, though it can be categorized as mild, moderate, or severe depending on the frequency of the binge episodes in a week. Diagnosing this condition can be elusive, however, because of the subjectivity of “bingeing” as well as the fact that many compulsive overeaters are secretive about their eating behaviors. The following signs and symptoms are common, however:
- high weight gain or weight fluctuations
- social isolation or eating alone
- eating rapidly to a noticeable degree
- eating even when not hungry
- impulsively starting and stopping diets
- hiding food
- no longer participating in activities that were once enjoyable
- preoccupation with food
- preoccupation with weight or body image
- loss of sex drive
- depression or feelings of guilt or shame
- mood swings
In addition to the variety of behavioral and psychological signs, there are also a number of physical symptoms that point to compulsive overeating. Though some of the symptoms are similar to those of obesity in general, their relatively rapid onset may indicate a recent change in behavior; high cholesterol, high blood pressure, sleep apnea, and fatigue are examples of such symptoms. Over time, these physical symptoms can lead to several negative medical conditions such as heart disease, type 2 diabetes, kidney disease, or arthritis.
What Causes a Binge Eating Disorder?
While there aren’t really any specific “causes” of BED, there are various factors that can lead to someone being more susceptible to developing the disorder. A factor that has been identified recently because of new research is related to genetics; researchers have been able to identify a gene that seems to be associated with compulsive or binge eating. This research is still in its nascent stage yet, so the conclusions are preliminary at best; however, further research may more fully expand on the tendency of BED to run in families.
For the most part, though, the “cause” of BED can usually be attributed to environmental and psychological factors such as trauma or being the victim of abuse. In some cases, a traumatic event can create great inner turmoil, and the person finds comfort or even numbness by “eating the pain away.” This same impulse of using food to deal with pain can come from low self-esteem, bullying, neglect, or almost any other kind of emotional pain. Though this can happen at any time in life, it often begins during the turbulent years of adolescence when a young person’s identity is still being formed.
Compulsive Overeating Treatment Options
Unlike many other diseases and disorders, the treatment options for compulsive eating are as varied as the individuals who suffer from it. This is largely because the underlying cause is subjective and psychological; each person must walk their own path and confront their own personal reasons for bingeing. Here are some common practices and approaches for treating BED:
- Psychotherapy: Also known as “talking therapy,” psychotherapy is the use of guided psychological discussions aimed at helping people uncover and address the root causes of the problem. While this kind of therapy is important, research suggests that psychotherapy alone isn’t as effective as when it is paired with other approaches.
- Cognitive Behavioral Therapy (CBT): Though it is technically a type of psychotherapy, CBT is different in that it focuses on the relationship between thoughts, feelings, and behaviors; by uncovering negative or unproductive internal messaging (“I’m so disgusting,” for example) and replacing it with positive messages, feelings and behaviors can be modified.
- Medication: For moderate or severe cases of BED, a doctor may prescribe select medications. A medication called Vyvanse, normally used to treat ADHD, has been approved by the FDA to treat binge eating, but it has some complications (including the possibility of becoming habit-forming). Antidepressants and anticonvulsants may also be prescribed, but their effectiveness is questionable thus far.
- Weight Loss Program: Usually reserved until after the primary binge eating disorder has been addressed, weight loss programs can help reinforce more healthy views about food (seeing it as fuel rather than an emotional crutch, for instance).
The overarching truth about all treatment options for binge eating is that you can’t do it alone. Binge eating tends to be a solitary experience (usually because of feelings of shame or disgust directed at oneself), and so the first step is acknowledging the problem and seeking help. Whether you seek help from a doctor, therapist, family member, or friend, the important part is to be honest with yourself about the need to make a change.
Freedom is Waiting
Of course one of the most common feelings associated with compulsive eating is despair about weight gain. Indeed, it can become a self-reinforcing spiral: binge, feel bad, binge again. The first step in the process of finding freedom from this cycle is to get help in identifying and addressing the psychological causes of binge eating. Once you’re on that path, though, a time will come when actually losing that extra weight is appropriate and can even be part of the healing process.
At True You Weight Loss, we understand the many psychological and emotional components that can be involved in trying to lose weight. Being overweight can feel like having shackles that trap you in an overweight body. But that’s also why we are passionate about offering weight loss solutions that can finally bring freedom. If you are interested in learning more about our non-surgical weight loss procedures, please contact us to request a consultation. Our friendly and experienced staff is dedicated to helping you find the freedom you’ve been looking for!