Webinar: Understanding The Facts About Binge Eating Disorder
Presented by: Allan S Kaplan MD MSc FRCP is currently a Senior Clinician/Scientist, Chief of Research at the Center for Addiction and Mental Health in Toronto, and Vice-Chair for Research and Professor in the Department of Psychiatry, University of Toronto. He is also Director of the Institute of Medical Science, School of Graduate Studies, Faculty of Medicine. He was the inaugural Loretta Anne Rogers Chair in Eating Disorders at Toronto General Hospital and is currently Senior Scientist, Toronto General Research Institute. He received his medical, psychiatric, and graduate school training at the University of Toronto. He has worked in the field of eating disorders for 30 years, has lectured widely on various topics in the field, published 150 peer-reviewed articles, two books, 50 book chapters, and over 200 abstracts. He is the Past President of both the Academy for Eating Disorders, the largest organization of eating disorder professionals in the world and the International Eating Disorder Research Society. He has been a continuously funded peer-reviewed investigator since 1992 and has received grant support from the National Institute of Mental Health in the USA and the Canadian Institutes of Health Research in Canada.
There are also three types of therapy that can be especially helpful in the treatment of BED. These therapies are:
Can Binge Eating Disorder Be Prevented
Although it might not be possible to prevent all cases of binge eating disorder, it is helpful to begin treatment as soon as symptoms start. In addition, teaching and encouraging healthy eating habits and realistic attitudes about food and body image might be helpful in preventing the development or worsening of eating disorders.
Tips For Helping Someone With Binge Eating Disorder
Encourage your loved one to seek help. The longer an eating disorder remains undiagnosed and untreated, the more difficult it will be to overcome, so urge your loved one to get treatment.
Be supportive. Try to listen without judgment and make sure the person knows you care. If your loved one slips up on the road to recovery, remind them that it doesnt mean they cant quit binge eating for good.
Avoid insults, lectures, or guilt trips. Binge eaters feel bad enough about themselves and their behavior already. Lecturing, getting upset, or issuing ultimatums to a binge eater will only increase stress and make the situation worse. Instead, make it clear that you care about the persons health and happiness and youll continue to be there.
Set a good example by eating healthily, exercising, and managing stress without food. Dont make negative comments about your own body or anyone elses.
Get more help
Binge Eating Disorder Symptoms, causes, and treatment options for binge eating disorder.
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Who Does Anorexia Affect
Anorexia can occur in people of any age, sex, gender, race, gender, ethnicity, sexual orientation and economic status and individuals of all body weights, shapes and sizes. Anorexia most commonly affects adolescents and young adult women, although it also occurs in men and is increasing in numbers in children and older adults.
How Is It Treated
Treatment for binge eating disorder includes getting counselling and taking medicine. You may need treatment for a long time to fully recover. You also may need treatment for other problems that often occur with binge eating disorder. These can include bipolar disorder, depression, anxiety disorders, obesity, or problems with being overweight.
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How Common Is Binge Eating Disorder
The National Institute for Health and Care Excellence highlights that while estimates show over 700,000 people in the UK have an eating disorder, this is likely to be an underestimate. It is almost impossible to estimate an exact figure, because not everyone is aware that their eating is disordered and many are reluctant to seek help. Other studies estimate that 1.23-3.4 million people in the UK have some type of eating disorder.
Despite anorexia and bulimia often being the most discussed eating disorders, there’s evidence to suggest that people with binge eating disorder are far more common. In fact, anorexia nervosa only represents approximately 10% of all eating disorders.
The estimated lifetime prevalence of binge eating disorder in Europe is around 1.9% for women and 0.3% for men. However, this is merely an estimate, since it is difficult to establish a full picture, as not everyone seeks help for their ED, or acknowledges the problem.
Elena Kunicki is a dietician who helps people overcome binge eating disorders.
She thinks many people struggle on a spectrum of binge eating behaviours, although most will not be officially diagnosed.
What To Think About
Medicines and counselling may help you quit binge eating and lose excess weight. But this will take some time and patience. Some people find that they still have trouble losing excess weight, even after they stop binge eating. Talk to your doctor about what results are realistic to expect from treatment.
Unfortunately, many people don’t seek treatment for mental health problems. You may not seek treatment because you are embarrassed about your eating, you think the symptoms are not bad enough, or that you can work things out on your own. But getting treatment is important.
If you need help deciding whether to see your doctor, read about some reasons why people don’t get help and how to overcome them.
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Anxiety Depression & Other Co
78.9% of those with BED experience a co-occurring diagnosis, as BED behaviors can be a maladaptive coping skill or increase symptoms of other mental disorders such as depression or anxiety.
Anxiety Disorders: Many individuals that struggle with clinical anxiety present with disordered relationships to food. This could be a result of using food to cope with emotional dysregulation. It is also likely that the opposite is true and that the shame, guilt, secrecy, and feelings of loss of control that occur with binge eating result in increased anxiety symptoms.
Mood Disorders: Mood disorders, such as Major Depressive Disorder or Bipolar Disorder, are experienced by 46.4% of those with a BED diagnosis. This is unsurprising, as, similar to anxiety disorders, many individuals seek to cope with uncomfortable emotional states using food. This correlation may also occur due to an individuals self-view and self-worth being impacted by their binge eating behaviors. Binge eating episodes can also lead to feelings of hopelessness or despair as one feels they cannot control their behaviors.
Other Co-Occurring Diagnosis: The relationship between BED and other diagnoses are similar to those with mood and anxiety disorders, with the disorders fueling one another. Some other disorders that commonly co-occur with BED include impulse control disorders and substance use disorders.
Who Is At Risk For Binge Eating
Given the close association between eating and emotional comfort, many people are at risk for binge eating at some point in their lives. It is rarer for people to develop a chronic binge eating disorder. Specific risk factors associated with the development of BED include:
- Low self-esteem or recurrent feelings of guilt or shame
- Sudden or prolonged work-related or interpersonal stress
- A history of dieting, restricting calories or altering metabolism
- Co-occurring mental health conditions like depression or anxiety
- A history of childhood trauma or abuse, including shaming or ridicule
- A family history of eating disorders or unusual eating styles or schedules
- A family pattern of using food instead of communication to resolve conflict
The people most at risk for BED are those with low self-esteem whose families used food as an alternative to emotional intimacy. Their risk increases even further when they have a history of repeatedly dieting and causing long-term changes to their metabolism, including inducing specific food cravings through deprivation.
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Signs And Symptoms Of Binge Eating Disorder
Binge eating is more than just overeating, and many of the people who struggle with binge eating disorder are unable to stop engaging in their behaviors, even in face of devastating and harmful consequences. Some of the marked characteristics of binge eating disorder include but are not limited to the following :
- Eating beyond a point of fullness
- Consuming large quantities of food even when not experiencing physical hunger
- Eating food in a rapid manner or fashion
- Experiencing feelings of guilt, depression, shame, and/or disgust after a binge
- Eating in isolation due to feelings of shame and embarrassment
Binge eating is often a reoccurring behavior, occurring on average once per week for a duration of three months minimally. A person who binge eats often feels out of control during a binging episode, with some describing what might be an out of body experience, as it is easy to become disconnected from the reality of what is occurring. A large quantity of food may suddenly disappear without recollection of what was eaten.
How Does Someone Develop An Eating Disorder
Many factors can influence the development of an eating disorder. These factors can be biological , psychological , and social . Individuals who are struggling with their identity and self-image can be at risk, as can those who have experienced trauma. Because eating disorders and mental illness are still stigmatized, some people who have disordered eating may be secretive or ashamed and go to great lengths to hide their disorder.
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Why Do People Binge
Binge eating is often a mechanism for coping or an attempt to manage emotional pain or stress. Individuals often describe a feeling of being zoned out, unaware of the magnitude of food being consumed and lacking the ability to stop eating.
While certain thoughts and feelings can be temporarily relieved by a binge eating episode, it is often followed by intense emotional turmoil. Feelings of guilt about eating certain foods or eating in a certain way can contribute to the shame around having binge eating disorder. Shame and guilt can affect attention and concentration at school or work and can result in secretiveness around behaviors. It affects relationships and increases social isolation.
Although binge eating disorder has been an official clinical diagnosis for only four years, its a condition that has left a lasting impact on nearly eight million Americans.
Treatment For Binge Eating
Most people recover from binge eating disorder with the right support and treatment, but it may take time.
The main treatments are:
- guided self-help programmes
- a type of talking therapy called cognitive behavioural therapy , which is in group sessions or individual sessions
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How Can You Take Care Of Yourself
Feeling stressed makes it more likely that you’ll binge eat, so you’ll need positive ways to manage that. Yoga, meditation, exercise, and massage therapy can help you feel calm. Some self-help strategies such as keeping a journal and meditation can help you identify and tolerate difficult feelings that can lead to binge eating.
Ask your doctor or therapist to recommend a nutritional counselor who can teach you about healthy eating. If you have type 2 diabetes or high cholesterol, you may need to limit certain types of foods or lose weight. You need your doctor’s advice on how to lose extra weight without triggering binge eating.
The goal is to get healthier. It’s not about numbers on a scale or serving sizes. It’s also about how you relate to food and to your own body.
How Do I Know If I Need Inpatient Treatment
If you think you have an eating disorder, if your symptoms have persisted or worsened despite attempts at outpatient treatment, or if you feel constantly preoccupied by thoughts of food and weight, then a good place to start is with a comprehensive evaluation in our Consultation Clinic. To safely provide the best possible care during the COVID pandemic, we have expanded our outpatient telemedicine services to include remote clinical consultation and outpatient visits with our eating disorders doctors by videolink across multiple states. Video visits allow patients to connect face-to-face in real time without leaving their home by using their smartphone, tablet or computer. Virtual connections are secure and HIPAA compliant.
You will be seen by a psychiatrist who will perform a thorough review of your history and symptoms, medical tests and past treatment. We recommend you forward any past treatment records ahead of your appointment for the doctor to review. Whenever possible we ask that you attend the consultation with a close family member or significant other, since we believe family support and involvement is very important when you are struggling with an eating disorder. The doctor will also be interested in any medical or psychiatric problems you may have besides the eating disorder.
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How Can I Care For A Loved One Who Has Anorexia
There are multiple things you can do to help and support someone with anorexia, including:
- Learn about anorexia: Educate yourself about anorexia to better understand what they are going through. Dont assume you know what they are experiencing.
- Be empathetic: Dont downplay or dismiss their feelings and experiences. Let them know that you are there to listen and support them. Try to put yourself in their shoes.
- Encourage them to seek help and/or treatment: While having an understanding and supportive friend or family member is helpful to a person with anorexia, anorexia is a medical condition. Because of this, people with anorexia need treatment such as therapy and nutritional counseling to manage their condition. Encourage them to talk to their healthcare provider if they are experiencing the signs and symptoms of anorexia.
- Be patient: It can take a while for someone with anorexia to get better once theyve started treatment. Know that it is a long and complex process and that their symptoms and behaviors will eventually improve.
Losing Your Job To A Binge Eating Disorder It Can Happen
You spend about half of your life at your job. It is a big part of your social interaction and provides a platform to boost your self-esteem. So what does a binge eating disorder have to do with your job? Lots of people struggle with BEDs. Studies show as many as 2.6% of our adult population binge eat. Can it really put your job at risk? The answer is yes, and in more ways than you think.
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How Is Binge Eating Disorder Diagnosed
Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help.
Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder.
What Is The Difference Between Anorexia Nervosa And Bulimia
Both anorexia nervosa and bulimia are characterized by an overvalued drive for thinness and a disturbance in eating behavior. The main difference between diagnoses is that anorexia nervosa is a syndrome of self-starvation involving significant weight loss of 15 percent or more of ideal body weight, whereas patients with bulimia nervosa are, by definition, at normal weight or above.
Bulimia is characterized by a cycle of dieting, binge-eating and compensatory purging behavior to prevent weight gain. Purging behavior includes vomiting, diuretic or laxative abuse. When underweight individuals with anorexia nervosa also engage in bingeing and purging behavior the diagnosis of anorexia nervosa supercedes that of binge/purging type.
Excessive exercise aimed at weight loss or at preventing weight gain is common in both anorexia nervosa and in bulimia.
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What Are The Complications Of Binge Eating Disorder
The poor eating habits that are common in people with binge eating disorder can lead to serious health problems. The major complications of binge eating disorder are the conditions that often result from being obese. These include:
- Sleep problems
In addition, people with binge eating disorder can be extremely distressed by their binge eating. And in some cases, people will neglect their jobs, school, or social activities to binge eat.
Anorexia Recovery Binges: You Do Not Have Binge Eating Disorder
This blog is based on my personal experience. We are all individuals, and you should always do what is right for your own body.
This is just a short blog. In my book, Rehabilitate, Rewire, Recover!, I have chapters and chapters on the concept of feasting after a time of restriction.
When in recovery from a restrictive eating disorder such as Anorexia Nervosa or a subset of it, many of us experience something I like to refer to as recovery binges. This post is written from the point of view of a person who has recovered from Anorexia, but could be true for any person with any type of restrictive eating disorder.
Recovery Binge? Say What?
If you dont know what is up with these, and if nobody has ever told you that they are even a thing, you will feel devastated if it happens.
I was the first time. I thought I was the only person in the entire world who had failed so badly at Anorexia recovery that I had morphed into Binge Eating Disorder in the first couple of weeks. I thought that my penance for even trying to recover was binge eating. I thought that what I had done was so wildly abnormal that it was a sign that I had been doing the right thing indeed by restricting so heavily because well, look what happened when I tried to eat normally!
So I went back to restriction. And then when I ate, I binged again. And so then I restricted. etc etc. Hey-ho, the good old binge-restrict cycle.
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