Some life experiences are harsh, and it's not only the victims that suffer, but also the people close to them. My interest in binge eating disorder research developed from the effect it had to a lady close relative and her family. It affected all of us in general because unfortunately there was no one in the whole family or even neighbors had the knowledge of how to handle her 'abnormal appetite' case. Whenever she had had a rough time, she would eat uncontrollably, and she stockpiled food to consume secretly at a later time. We only came to learn later by chance that it was indeed a psychological condition. She fell ill, and she was diagnosed with hypertension. The doctor declared it was due to being overweight; we thought it was ‘normal’ considering her appetite and love for food, but no one understood that it was a way to escape from her emotions and frustrations, a disorder called binge eating. The doctor sent her to a professional who specialized in binge eating disorder immediately. The treatment included seeing psychiatrists, nutritionists, and therapists, all of which ultimately proved very effective. It was clear that with family support nutritional and psychotherapy binge eating disorder can be managed. It would have been easier for the family had anyone knew about this disorder.
Binge eating disorder is the most frequent of eating disorders. Binge eating victims exhibit two distinctive features which include consuming more food than normal people and the lack of self-control while eating food. It has been recommended that treatment of pathological eating disorders should come before treatment of obesity (De Zwaan 2001); however, treating both conditions at the same time could help lose and maintain weight. Previously researches have indicated that emotions play an important role in binge eating disorders (BED) and that people with severe binge disorder have more negative emotions. Binge eating temporarily eliminates the aversive negative emotional state. Therefore, they try to cope with their emotional distress through eating. Overweight people experience negative emotions; hence they are more susceptible to BED (Eldredge & Agras, 1996).
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Different types of medical approach have been suggested and tested for treating BED. Effects of pharmacotherapy on weight loss and improving BED have suggested that medication could only help weight loss and improve BED for a short while, however, when pharmacology and behavior therapy are carried together simultaneously, the results are long-lasting. Dialectical behavior therapy is a treatment that has proven effective for borderline personality disorder. This type of behavior therapy targets emotion regulation by teaching adaptive skills to improve patient emotion capabilities. BED and obesity are major health issues and cannot always be treated through pharmacological means. Therefore, psychological treatment may be a better option (Aronne, 2002; Balsiger et al., 2000). After being diagnosed with BED the medical care provider may decide to perform other health examination due to BED effects, this test may include high cholesterol test, high blood pressure tests, heart problems tests, diabetes, GERD and some sleep-related breathing disorders. To administer the doctor may perform a physical exam, blood urine test, and sleeping disorders. The goals of BED treatment are to achieve healthy eating habits and to reduce binge eating, since these habits are as a result of negative emotions and shame which in the results to depression. The best approach is to see a psychiatrist, where the patient will learn how to exchange unhealthy habits for healthy ones and reduce bingeing episodes.
Apart from dialectical behavior therapy, other types of therapies may be included. For example, cognitive behavioral therapy, which helps the patient better cope with problems that trigger binges such as depressed mood or negative feeling about your body, and as a result, the patient learns the skill of behavior control which aids in regulating eating patterns. The other type of therapy is interpersonal psychotherapy; this therapy focuses at the patient relationship to people. It aims at improving interpersonal skills which helps reduce binge eating from problems triggered by poor communication skills and problematic relationships.
Though the exact causes of binge eating are unknown, there are some factors that influences the development of this disorder. Firstly, biological factors such as irregularities of hormones and genetic mutations, which are associated with food addictions. Social and cultural factor, such incidents of trauma like sex abuse, are also known to increase binge eating.
While 70% of people who have BED are obese, not everyone with binge eating disorder is obese. The criteria for BED treatment developed in consultation to the American Psychiatric Association's Work Group on Eating Disorders for the DSM-IV was conducted using a self-administered questionnaire. The first criterion is repeated episodes of binge eating. An episode of binge eating is characterized by the following: eating in a discrete period of time (e.g., within any two-hour period) an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances, and a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating). The second criterion is that during most binge episodes, at least three of the following behavioral indicators of loss of control are present: eating much more rapidly than usual, eating until feeling uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of being embarrassed by how much one is eating, feeling disgusted with oneself, depressed or feeling very guilty after overeating. The third criterion is that binge eating causes marked distress. The fourth criterion is that binge eating occurs on average at least two days a week for six months. And the last one, binge eating does not currently meet the criteria for anorexia nervosa or bulimia nervosa, purging or non-purging type (Spitzer R.L., Devlin M.J., Walsh B.T. et al.).
Prescribing weight loss to a BED patient is not a cure. It can only be advised to prevent the occurrence of diseases that come with one being obese, and in such a case the advice should be given carefully so as not to provoke the patient's self-esteem. When they develop low self-esteem, BED comes into action and worsens the situation by having the patient eat some more and more. BED can be managed by creating a friendly environment, both in school and at home, where the patient doesn't feel judged based on, e.g., their body size. Children who are overweight are likely to be victims of bullying, which would quickly trip down their self-esteem, and sometimes worse, to develop thoughts of harming themselves. Hence, close monitoring is required, and good follow up too. Research in weight-based teasing showed that binge eating cases received at least five years of follow-up among both men and women (Eisenberg M.E., Neumark-Sztainer D., Story M., 2003).
To conclude, it is important for families to be keen on noticing certain habits, such as binge eating, and if it’s a case of concern, seek medical attention so that it can be handled early in its stages of development. BED patients are sensitive and should be accorded special attention without making them feel like they are being put on spotlight because of their condition. Listening to them and close care to them would be good to show support and encouragement. Sometimes these patients seclude themselves from other people. Family and friends should join and actively participate in the therapy sessions in order to develop and maintain close relationships and freeness to make the patient feel comfortable sharing. Nevertheless, by taking appropriate steps towards treatment and working alongside professionals and specialists, the patient will not only better understand and beat his or her struggles, but feel empowered to share them with the family.
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