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The Lowdown on Compulsive Eating and Binge Eating Disorder

Having an active eating disorder hugely affects our self-confidence and self-worth.

Binge eating disorder and compulsive eating are treatable, with full recovery possible. Binge eating disorder is more common than other eating disorders and is thought to affect 1 in 4 adults who are trying to control their weight. Most of us suffering from binge eating disorder will put on weight, but it is also possible to suffer from it and be within a healthy weight range. Those of us with an eating disorder will focus obsessively on our weight and be affected by the way we think we look versus the way we think we should look, which hugely affects our well-being.

Definition and Symptoms

Compulsive Eating and Binge Eating Disorder Definition and Symptoms

Binge eating disorder is where we are driven to consume large amounts of food, sometimes exceeding 2000 calories, often in a mindless state over a short period of time, and we feel out of control with our eating. Far from being indulgent or enjoyable, these binges are very distressing.

Compulsive overeating is a milder form of binge eating. We may describe ourselves as emotional eaters or food addicts. These labels describe much the same compulsion to varying degrees. They all have in common strong food cravings, difficulty controlling weight and a troubled relationship with food. Fifty per cent of adults who seek help for weight control describe themselves as compulsive eaters.

Binge eating disorder symptoms include eating a very large amount of food very fast, eating well past the point of fullness, eating when not physically hungry and eating alone or in secret. We might try to compensate by dieting or restricting food, but if we purge to get rid of calories, we have Bulimia Nervosa. For a diagnosis of binge eating disorder, this will have been happening at least once a week for at least three months.

We may have various emotional and behavioural symptoms of binge eating disorder, including feelings of guilt or disgust which may lead to restriction and further binge eating; feeling driven to eat as if we have been possessed; feeling out of control with food; feeling addicted to food; feeling bad about the body; feeling low and depressed; having mood swings; feeling increasingly desperate; buying and hoarding lots of food; organising our life around bingeing sessions; avoiding eating around others; isolating ourselves and thinking about food most of the time.

Dieting and Binge Eating

Dieting and Binge Eating

Eating disorders tend to surface after restrictive eating or dieting behaviour, often caused by pressures from society and the media to be thin. Too much restriction triggers the body into starvation mode where the body battles to maintain its weight by lowering its metabolism, increasing hunger hormones and decreasing satiation signals, This, in turn, directly affects subsequent weight gain and can lead to reactive binge eating.

Research has shown that too much food restriction has long-term side effects such as cravings, depression and poor body image, which continue well after we have stopped restricting food. Behaviour becomes reinforced as weight gain and symptoms worsen and binge eating has an effect on the reward pathways in our brain. So dieting can trigger a binge eating disorder pathway.

Risk Factors

Risk Factors

  • Pressure to lose weight from family, friends, society in general, or the media. Dieting ensues, triggering binge eating. Dieting mothers are associated with daughters who have body image issues.
  • Stress creates hyper-vigilance and overwhelming emotions and there can be a powerful pull to turn towards previously successful (but short-lived) sources of relief, such as food, which then stimulate our opioid system and we start to rely on them. Also, an eating disorder is stressful in itself, and excessive release of the stress hormone, cortisol, can also trigger an increase in appetite and cravings for high-fat/carbohydrate foods.
  • Some of us suffering from binge eating disorder have been affected by trauma, which chronically triggers our stress response.
  • Excessive use of alcohol and drugs. Drinking alcohol moderately or heavily also raises cortisol levels, which triggers an increase in appetite and cravings.
  • A family history of addictive behaviour.

Night Eating Syndrome

Night Eating Syndrome

There is a condition that is different to binge eating disorder called Night Eating Syndrome (NES) where we have difficulty sleeping and we overeat at night. We wake up at night to eat, feel out of control during eating, and have a belief that we can only go to sleep or back to sleep after eating food. With NES, we tend to eat smaller amounts throughout the night rather than bingeing in a single sitting. We experience a low mood that gets worse during the evening and we experience a lack of appetite in the morning. There is also a dissociative version of NES called Nocturnal Sleep-Related Eating Disorder (NSRED), where we do not realise we have eaten during the night and only become aware of this in the morning.

Lack of sleep can then have a direct impact on weight, and excess weight can be a risk factor for leptin resistance. Leptin is the hormone produced by our fat cells to signal to our brain that we’ve had enough food, and leptin resistance means the signal is not received. We also need leptin to suppress orexin, which is a chemical that keeps us awake. It’s thought that leptin fails to suppress orexin in those of us with NES. Leptin resistance can be reversed though, by changing dietary and behavioural habits. Relaxation therapies can be really helpful in the treatment of NES, as well as adrenal-supporting supplementation and perhaps a natural sleeping remedy, on the recommendation of a registered nutritionist.

Physiological Imbalances

Physiological Imbalances

Binge eating leads to high blood glucose status, which results in a huge spike in insulin. This sucks too much sugar from the blood, leading to low blood glucose levels and strong cravings again, and the cycle continues. When average daily blood glucose levels and hence daily insulin levels are increased, this can lead to weight gain, further keeping the eating disorder cycle going.

Part of the recovery process involves addressing and correcting the physical imbalances that result in abnormal cravings, low mood and weight gain. Nutritional considerations are important in psychological treatment for binge eating disorder.

Certain ‘feel-good’ neurotransmitters, such as endorphins, serotonin and dopamine would have served us well in the hunter-gatherer environment that our bodies are still primed for, but in our current environment, they are often not so helpful. In a diet where excess sugar or highly refined flour foods are regularly consumed, frequent surges of serotonin can result in a down-regulation of serotonin receptors and drive us to crave and consume more carbohydrates and sugars to achieve the same effect.

Treatment

Treatment

We may have tried all sorts of diets in an attempt to control binge eating disorder, or even tried slimming pills but without success, and our harmful relationship with food has continued.

The goal of binge eating disorder treatment is to help you to eat a wide variety of foods without being scared to lose control, to see no food as forbidden, and to lose your cravings. Weight loss is not the goal of binge eating disorder treatment, as weight change is only possible once your relationship with food has changed. The aim is for you to feel in control from within.

You’ll need to complete a detailed questionnaire before starting our first session, which helps to inform the support that’s right for you. We will focus on: the physical effects of dietary chaos; the urges and cravings; discovering what preceded the original development; managing unhelpful thoughts which maintain it; identifying and exploring coping mechanisms; exploring and managing emotions; adopting dense nutrition; increasing the domains of self-worth, and preventing relapses.

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