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Friday, May 14, 2010

Stuffed! How to Stop Binge Eating

For every anorexic out there, four times as many women go on crazy binges and eat the whole kitchen. Finally, science has given this phenomenon a name—and the possibility of a treatment.

Maybe it was a tapeworm. There had to be a reason for her eating frenzies, Barbara Luebbers remembers thinking as a teenager. As she'd stuff down the boxes of marshmallow cookies, bags of potato chips, whatever was in the house, she says, it felt as if "another entity had taken over me." Now 60 and working at a nursing home in Amelia, Ohio, Luebbers has lived with the binges, the bloating, and the feelings of shame from age 12 until just a year ago, when for the first time in her life, she realized she had an eating disorder and found help. All that time, she says, "I thought I was the only person who ate this way."

Research shows that a lot of people struggle with the same urges. A study published in the journal Biological Psychiatry suggests that about 3.5 percent of women suffer from binge eating disorder, or BED—more than double the incidence of bulimia and four times that of anorexia—and fewer than half seek treatment. It wasn't until the 1990s that BED was proposed as a separate eating disorder. The new study reveals it's more common than previously recognized, and increasing in incidence. It's time BED earned official status, says one of the study authors, Harrison Pope Jr., MD, a professor of psychiatry at Harvard Medical School. "This is a genuine disorder, not a temporary pattern of eating. People who have it describe distinctive and dramatic symptoms."

What Counts as a Binge
Depending on how out of control it gets, a single bout can include fast food meals, pizzas, cakes, even half-thawed frozen pies. Pope has talked to hundreds of people with BED: "Typically they'll say, 'I had a normal dinner, then around 9 or 10, I went to the kitchen intending to have one cookie, and I ate all the cookies and all the ice cream. Then I wanted something salty, so I ate all the pretzels. Then I wanted something sweet again.' They eat quickly, are disgusted with themselves, yet they do it night after night." A binge can rack up 2,500 to 20,000 calories. Considering that the average woman is supposed to eat about 2,000 a day, it's no surprise that the majority of those with BED also struggle with obesity.

Why It Happens
Cynthia Bulik, PhD, director of the University of North Carolina Eating Disorders Program and coauthor of Runaway Eating, sees two different patterns among her patients. One group, like Luebbers, has been bingeing since childhood; the other comes to it later in life, usually following an extreme diet. "The body rebels and overcompensates with the first binge," she says. "The bingeing starts intermittently and eventually becomes more frequent." In one study, Bulik and colleagues found that obese people with BED were twice as likely to have relatives with the disorder as similarly obese subjects who were not binge eaters. Other research suggests that those with BED often suffer from anxiety and depression in addition to bingeing. Some experts believe that the episodic stuffing behavior is to some extent written into our genes. Deirdre Barrett, PhD, an assistant clinical professor of psychology at Harvard Medical School and author of Waistland: A R/evolutionary View of Our Weight and Fitness Crisis, says we're programmed for eating in the African savanna, where it was necessary to consume a lot of food because most of it was high in fiber and low in calories. Those ancestors who felt full on too little were less likely to survive and pass on their genes

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