BED, a Friend, and You

A previous post described the problem. The search for solutions is of course more complicated. Solutions are needed because BED is a disorder that seriously affects the quality of life for millions of humans. An individual who suspects a problem in the self might start by reaching out to a trusted friend, relative, clergy member, or an online community. Even if this is a difficulty not faced by the reader of this page, any one of us might be the trusted friend that someone reaches out to. What then?

Even if we are not experts, and even if we are not sure whether the upset person’s alarm is justified, this much is true: When someone we care about wonders whether their stubborn habit is a problem, the fact that they even suspect a problem is, in and of itself, a problem. The least we can do is validate their autonomy in some way, with verbal reassurances that they are correct to care about potential health conditions that might call for intervention.

Of course, depending on our own position and circumstances, we can offer practical help, like a ride to a clinic, or the money to pay for an appointment. Or we might do a little preliminary research to nudge them into action.

The particulars

For instance, we might sneak a peak at the Mayo Clinic’s very thorough page on binge-eating disorder and garner some facts to pass along. The object here is for the patient to feel more in control, and eventually, to actually be more in control. This sounds boring, but the key to control is the banishment of randomness, and the acquisition of healthy, regular habits.

The patient can probably expect to be dealing with a whole team of experts, including a mental health professional and a sleep disorder specialist (regular habits, remember?). Any large and respected medical institution will offer similar information and advice, along with both standard methods and specialized possibilities.

There will be blood and urine tests, and various other measurements of this and that. The prospective patient will be asked a ton of questions, both objective (“How often are you physically active?”) and subjective (“How often do you think about food?”). As the honest friend who is urging this person to seek help it might, depending on what kind of relationship you two have, be useful to remind them that in order to be effectively helpful, every professional they encounter will need accurate, up-to-date information.

Whoever conducts this interview will want to know about the patient’s typical daily intake of food, and how large the servings tend to be. They will be curious about whether the person tends to eat past the point of discomfort. Does consumption take place even when there is no actual hunger? Have they made previous efforts to lose weight, and of what did those efforts consist of?

Does the person subjectively feel that things are out of control? What about eating secretly, hiding food, lying to family members about what and how much they take in? Is the eating itself the larger concern, or is it the body weight and size? Does the person experience depression, shame or guilt related to eating? Is vomiting ever involved? What about laxatives or pharmaceuticals, prescribed or otherwise?

What’s out there

Speaking of drugs, Vyvanse, or lisdexamfetamine dimesylate (which was developed to alleviate ADHD) has been prescribed to treat moderate-to-severe binge-eating disorder, but it is only approved for adults. Of course as always, before prescribing anything the doctor must be told about any other drugs the patient is already taking, along with any supplements, herbs, etc. The Mayo Clinic page notes that a few other meds (officially approved to control depression and seizures) are sometimes prescribed, but interestingly, makes no mention of the recently fashionable GLP-1 drugs.

There are support groups designed for individuals and for families, and a painfully hesitant person might consider attending a meeting first just to dip a toe into the water. Even more distance can initially be maintained by making the first contact with any such organization online. Of course, there is talk therapy, both individual and group, in several different forms.

Cognitive behavioral therapy is of course mentioned, along with an enhanced variety called CBT-E that is “specifically designed to treat eating disorders.” Other formats are also mentioned:

Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating.

Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.

Your responses and feedback are welcome!

Source: “Binge-eating disorder,” MayoClinic.org, undated
Image by thekirbster/ATTRIBUTION 2.0 GENERIC

Binge-Eating Disorder and the Mayo Clinic

Strangely, for such a prevalent disorder, binge eating retains an aura of mystery. Even the esteemed Mayo Clinic can only offer guesses as to its cause. Certain constants are of course observable, including the fact that more women than men are victims. Other genetic factors are also suspected. Whether genetic or purely behavioral in origin, family history is a red flag.

People in their late teens and early 20s are vulnerable, along with those who have adopted the lifestyle variant known as “dieting,” or formalized restrictions imposed either by an outside program or a self-created plan.

Another predisposing condition is some kind of mental health problem, and this is a tough one because it feeds upon itself. The mental health element includes negative self-regard, and this works both ways because when one feels hostile toward oneself, and toward one’s own abilities and accomplishments, the answer always seems to be “Go eat a lot.”

Of course, this offers no alleviation at all, because afterward, the person is assailed by even more self-hate, and rushes to go eat another pile of food. Binge eating is in fact the legendary perpetual-motion machine, tirelessly maintaining itself through endless cycles of cause and effect, which then becomes the next cause, leading to the next effect, and so on into infinity. What can stop such an elegantly designed chain reaction?

A world of triggers

Certain situations will guarantee a binge, and depending on the individual, the trigger may be any size or shape, and wear any disguise. The binge reaction can be set off by an event as traumatic as a romantic breakup. Or it might be based on something as trivial as the habitual pairing of entertainment with eating — the conviction that watching a movie on TV must always be accompanied by a snack session that somehow winds up lasting for an hour and a half.

The trigger can be a certain food, which causes the person to apologetically or facetiously declare, “I’m addicted to chocolate-chip cookies, almost straight from the oven, with the chips still all melty.” Whether or not cookie addiction is recognized by the medical establishment, it becomes a fact in that person’s life.

There are social consequences of course, which include avoiding certain people who might identify the binge pattern and urge the eater to seek help. While social ramifications can be very upsetting, the real trouble starts when the body begins to break down. There is, obviously, weight gain.

But even if the person is not bothered by that, there are also, says the Mayo Clinic, “joint problems, heart disease, type 2 diabetes, gastroesophageal reflux disease (GERD), poor nutrition and some sleep-related breathing disorders.” On the mental side, watch out for depression, anxiety, substance abuse, and even suicidal ideation and behavior.

In the emotional equation, actual bulk is almost irrelevant. No matter what shape the body is in, the average binge-eater is dissatisfied with it.

This condition is defined by compulsion — the conviction of a simple inability to stop eating — and, generally, by excess. It is characterized by periods of resistance, alternating with episodes of simply giving in and letting the disorder have its way. Symptoms vary, but may include:

Eating even when you’re full or not hungry.
Eating very fast during eating binges.
Eating until you’re uncomfortably full.
Often eating alone or in secret.

(To be continued…)

Your responses and feedback are welcome!

Source: “Binge-eating Disorder,” MayoClinic.org, undated
Image by Fabrice Florin/CC BY-SA 2.0

Some Binge-Eating Basics

In the dawning days of civilization, there were different kinds of shelters, various food sources, and many ingenious ways to get hold of edible plant and animal products. The inhabitants of this Colorado cliff dwelling ate rice, maize, pine nuts, squash, beans, seeds, berries, nuts, and roots. Vegetables were sun-dried so they would last. Of course, the residents availed themselves of fish and small game, both of which would have been very difficult and labor-intensive to obtain even in the best weather, let alone when the ground was frozen and covered with snow for months on end.

Our source says, “Food was stored in large pits, often sealed in baskets or pottery for protection from insects, animals and moisture.”

But what about people? If binge eating existed then, that would make it one of the most ancient bad habits on Earth. Also, the earlier in human history it happened, the more serious the infraction would have been. In much of North America, early communities had one thing in common. When cold weather set in, sure, the occasional animal could be caught — but there were no guarantees. There was only a certain amount of stored food, and it had to be enough to last through the winter, for everybody.

One binge-eating episode, committed by one individual, could seriously affect the whole settlement. Of course, a factor in the community’s favor was the difficulty of sneaking food. In long-term storage, few casual munchies would be available. By and large, whatever you hoped to eat would need to be shelled, ground, parched, peeled, chopped, pitted, boiled, or in some other way prepared, as a prerequisite to consumption. This would not be easily accomplished on the down-low. In a small, close-knit population, sneaking food would be difficult, if not impossible.

More modern times

We will review (not in the sense of critical judgment, but in the sense of taking another look at) previous Childhood Obesity News posts that mentioned binge eating. For instance, it is a startling fact that some binge eaters don’t even get fat!

Some “make up for” binges by eating very frugally the rest of the time, to find a crude kind of balance and maintain normal weight. This can backfire — and usually does — because the enforced hunger is just as likely to trigger another binge.

How might you know if your consumption is at binge level?

Do you have episodes of eating a lot in a short time frame? Of eating until you are uncomfortably or even painfully stuffed? Does this happen once or twice a week? Do you hide food, or furtively consume it alone? Do you feel embarrassed and ashamed? Does this habit interfere with other aspects of your life? Do you feel like you just can’t stop, as if you are the pawn of some ungovernable force?

Binge-eating seems to run in families, although that could just be the “monkey-see, monkey-do” effect, rather than anything anatomically genetic. When kids grow up watching parents self-medicate with a particular substance, it should come as no surprise if they continue the family tradition.

Another thing about binge eating is how very easy it is for a person to rationalize, justify, defend, self-excuse, self-extenuate, self-validate, and self-vindicate. Even after seeking professional help, this is the sort of problem that a patient can waste a whole lot of time exploring the details of, rather than healing from.

Your responses and feedback are welcome!

Source: “Agriculture and Other Food Sources,” CliffDwellingsMuseum.com, undated
Image by Boston Public Library/CC BY 2.0 DEED

Binge-Eating Self-Talk

You’re out of balance, and definitely out of control. You want — no, you need — to eat ALL the food. A whole lot of it at once, until it hits the button that says “Enough!” Except, when is that going to happen? And then you coast through a good patch, where you seem to have some semblance of control, and everything just rolls along merrily for a while. Maybe that whole ghastly chapter of your life is over. Maybe you’ve outgrown it, or discovered some more healthy obsession to take its place. For a while, there is a degree of relief. Until…

And you know what? So what. Even at the best of times, the body doesn’t look that great, and maybe it’s time to just stop caring about that. It’s the mind that really matters, and the spirit. There is no real health problem going on, and instead of fretting and beating yourself up about the occasional food orgy maybe you should just sit back and be grateful that you’re not one of the millions of people on earth who are still starving.

Maybe it’s simply time to stop feeling “depressed, disgusted, ashamed, guilty or upset,” to quote the Mayo Clinic’s list of negative emotions. After all, it’s not like you’re vomiting the food up after you eat it. That would be really disgusting, and you’re not there yet. Not even close! You don’t dabble in laxatives, you’re not that far gone. You’re not out there compulsively exercising for six hours every day.

Okay, once in a while you get a little crazy and “put away” a whole bag of groceries, but not in the cupboard. There was that time last week when after about five minutes, you weren’t even hungry anymore, and you kept on eating for — what, two hours? Not quite two hours.

So what? Take a look at the world. People are out there shooting up schoolrooms full of kids, right in front of God and everybody. At least I keep my problems to myself. The door is closed, the shades are down, I’m eating a whole large pizza with breadsticks and dipping sauce on the side, and not hurting another soul. So, all you haters out there, just deal with it.

And what’s the big deal? Once in a while I slip up and eat too much. And okay, it’s been going on for decades, but here I still am, standing upright and able to tell the tale. Thanks for pointing out that my jeans don’t zip up all the way, but you know what? I have others. And if I still need some new ones, with an even bigger waist, I can afford another pair of pants. I got that stuff handled. I’m doing fine at my job, no complaints. Yeah, that one boss keeps looking at me sideways, but he’s retiring next year anyhow.

Anyway, my best friend growing up had monstrous eating orgies. Maybe I caught it from her. And she got over it. At least I think she did. I haven’t seen her in a few years, but I’m sure she’s fine. She did graduate, after all. Oh wait, I wasn’t going to think about how I lost that scholarship anymore. It’s making me think about that bag of chips I stashed in the basement to make it harder to get to. But you know what? Maybe I’ll just take a little walk down there right now. Stairs are good exercise.

I’m taking care of business. Sure, I have stress and maybe a negative self-image, but who doesn’t? None of us are perfect, and at least I’m not out there attacking strangers or dynamiting power stations. I get bored, sometimes I eat too much. At least I don’t drink. Shoot, I know people who should be institutionalized, and I’m nowhere near as crazy. Sure, I have anxiety and depression, who doesn’t? I don’t have insomnia or diabetes or sleep apnea. I’m not socially isolated, I got plenty of friends, and most of them are in worse shape than me…

And blah-blah blah, blahblah blah blah blah blah, and blah, blah-blah, blah-blah blah, blahblah blah blah blah blah, blah, and blah-blah, and blah-blah blah, blahblah blah blah blah blah, blah, blah-blah…..

Your responses and feedback are welcome!

Source: “Binge-Eating Disorder,” MayoClinic.org, undated
Image by Pat Hartman