Compulsive overeating: recommendations from a psychotherapist

What is compulsive overeating?

Binge eating disorder (or binge eating disorder ) is a condition characterized by episodes of eating larger quantities of food than usual in a short period of time. These episodes occur every week for three months. This is an individual diagnosis, distinct from bulimia nervosa. Binge eating disorder is associated with a variety of psychological and nonpsychological problems, some degree of disruption of daily life, and some serious medical conditions. Common medical disorders such as obesity, diabetes, hypertension and chronic pain are some of the associated diseases. Psychogenic binge eating most often occurs in obese people, but is not limited to them. People with binge eating disorder complain of weight gain. The prevalence of this disorder increases with increasing body weight, and obesity is a common comorbidity.

Mental health and binge eating disorder

Binge eating disorder is another eating disorder. Eating disorders are serious mental health disorders in which emotional and thought patterns lead to unhealthy eating habits such as overeating or starvation. Often these habits are a path to depression, stress or anxiety.

Learn more about binge eating disorder

Binge eating disorder is a serious disorder characterized by uncontrolled eating, which leads to weight gain. People with binge eating disorder eat large amounts of food (much more than they need to feel full), becoming out of control while eating. Although binge eating disorder is similar to bulimia nervosa, people with binge eating disorder usually do not vomit or use laxatives.

Many people with binge eating disorder use food as a way to cope with unpleasant feelings and emotions. These are people who don’t know how to deal with stress properly and who find comfort in food. Unfortunately, they are often plagued by sadness and guilt due to the fact that they cannot control the amount they eat, which in turn increases their stress levels, and everything starts all over again.

What are the symptoms of compulsive overeating?

Most people overeat from time to time and feel that they have eaten more than they should. Eating large amounts of food, however, does not mean that a person has compulsive overeating. Most people with severe binge eating disorder have some of the following symptoms:

• Frequent episodes of overeating, eating unreasonably large amounts of food.
• Feeling unable to control what and how much you eat.
• Eating large amounts of food faster than usual.
• Eating until you feel overeated.
• Eating large amounts of food even when you don't feel hungry.
• Eating alone due to embarrassment regarding the amount of food consumed.
• Feelings of disgust, depression and guilt due to overeating.
• Weight fluctuations.
• Low self-esteem.
• Loss of sexual desire.
• Frequent diets.

What are the causes of compulsive overeating?

The exact cause of compulsive overeating has not been established. Scientists are only understanding the factors that influence its occurrence. Like other eating disorders, binge eating disorder occurs as a result of a combination of psychological, biological, and environmental factors.

Binge eating disorder is associated with other mental disorders. Almost half of people with binge eating disorder have a history of depression, although a direct link has not yet been established. Many people who feel angry, sad, bored, anxious, or other negative emotions may experience episodes of binge eating disorder. Impulsive behavior and certain psychological problems are also common in people with binge eating disorder.

Eating disorders, including binge eating disorder, often run in families, suggesting that the disorder may run in families. Scientists are also studying how brain chemicals and metabolism (the way the body burns calories) affect binge eating disorder.

People with binge eating disorder often come from families that overeat or place an unnatural emphasis on food; for example, they used food as a reward or a way to calm down and gain comfort.

How common is compulsive overeating?

Binge eating disorder is probably the most common eating disorder. Most people with binge eating disorder are obese (weighing more than 20% above healthy body weight), but people of normal weight may also suffer from this disorder.

Binge eating disorder affects about 2% of adults, or about 1-2 million Americans. Among Americans who are mildly obese, about 10%-15% have compulsive obesity. The disorder is more common in people with severe obesity.

Compulsive obesity is slightly more common in women than in men. The disorder is more common in African Americans than in Caucasians; the frequency in other ethnic groups has not yet been studied. Obese people who suffer from binge eating disorder often gain weight at a young age. They also often lost weight when they were young and then gained it back.

How is compulsive gluttony treated?

Treating binge eating disorder is difficult because most people feel shame and try to hide their problem. They are often so successful that even family and friends don't know they have binge eating disorder.

Treating an eating disorder requires comprehensive treatment that is tailored to the needs of the patient. The goal of treatment for compulsive obesity is to help the patient gain control over eating behavior. Treatment often involves a combination of the following treatments:

• Psychotherapy:

  This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with an eating disorder. Treatment includes practical techniques for developing a healthy relationship with food and weight, and changing the way a person responds to challenges in life.

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• Medicines:

  Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be used to control anxiety and treat depression associated with eating disorders.

• Nutritionist consultations:

  This strategy is designed to teach healthy relationships with food and weight, help develop healthy eating patterns, and teach you how to eat a balanced diet.

• Group and/or family therapy:

  Family support is very important for the success of treatment. It is important for family members to understand the eating disorder and recognize its signs and symptoms. People with eating disorders may benefit from group therapy, where they can receive support, openly discuss their feelings, and share their experiences and concerns with others.

What are the complications of binge eating disorder?

Poor eating habits, which are common among people with binge eating disorder, can lead to serious health problems. The main complications of compulsive overeating are the following diseases resulting from obesity:

• Diabetes.
• Hypertension.
• High cholesterol.
• Gallbladder disease.
• Heart disease.
• Dyspnea.
• Certain types of cancer.
• Problems with menstruation.
• Reduced mobility (inability to move actively) and fatigue. Sleep problems.

Additionally, people who suffer from binge eating disorder are often stressed by their problem. In some cases, they may ignore work, school and social activities.

What's the outlook for people with binge eating disorder?

Like other eating disorders, binge eating disorder is a serious problem that can be resolved with appropriate treatment. With treatment and a desire to heal, many people with this disorder can overcome their overeating habits and establish healthy eating patterns.

Is it possible to prevent compulsive overeating?

Although there is no way to prevent binge eating disorder, it is important to begin treatment as soon as symptoms of the disorder are noticed. Additionally, teaching healthy eating habits and being realistic about food and body weight may also help prevent the development or worsening of an eating disorder.

Causes and risk factors

Binge eating disorder can be the result of a variety of psychological, social, cultural and biological factors. Some of the risk factors for binge eating include:

• childhood obesity;
• lack of controlled nutrition in childhood;
• perfectionism;
• behavioral problems;
• substance abuse;
• family problems with obesity and eating problems;
• family conflicts and problems with raising children;
• parental psychopathology;
• physical and sexual violence;
• mental health disorder;
• involvement of Mu opioid receptor genes (eg, OPRM1) and dopamine (eg, DRD2);
• distorted perception of body image;
• changes in intestinal microbiota.

Causes

The causes of the violation lie in 4 groups of factors:

• physiological;
• genetic;
• emotional;
• social.

Physiological

The first group is closely associated with pathological changes in hormonal balance and metabolism. In this case, the brain sends a signal of hunger, resulting in an attack of gluttony. Also, with somatic pathology, a person is able to confuse the feeling of thirst and hunger. The logical result is the absorption of sandwiches, although you can cope with the feeling simply with a glass of water.

Genetic

Genetic predisposition is expressed in the mutation of several genes that cause compulsive overeating. The effect of mutagenic changes is:

• stimulation of increased appetite;
• inhibition of the saturation process;
• tendency to be overweight and overeat even in the absence of problems.

Psychological

Psychological preconditions are the most common group of causes of eating disorders. Overeating becomes a pathological reaction to:

• breakups;
• conflict situations;
• difficulties at work;
• pronounced fear and anxiety;
• a feeling of powerlessness in a given situation;
• constant feeling of guilt;
• consequences of extremely low self-esteem.

Social

Social factors are associated with the cult of slimness in modern society. Non-compliance with the standard provokes 2 types of psychological response:

• protest, which consists in the desire to bring oneself to grotesque completeness;
• a feeling of total powerlessness when it is impossible to correct weight, which is expressed in “eating” negative emotions.

A separate group includes reasons related to the characteristics of upbringing. They may suddenly appear after adulthood or provoke a disorder in adolescents:

• a chain fixed by parents: you ate a full lunch - an obedient child, refused to finish a portion - you will be punished;
• dysfunctional family situation;
• lack of emotional closeness with family members.

Epidemiology

Binge eating disorder is more common in women than men and usually begins around age 23. The lifetime prevalence of this disorder is 2.6%. Approximately 79% of patients with binge eating disorder have one mental disorder; 49% of patients had two or more comorbid disorders throughout their lives. Common comorbid conditions with binge eating disorder include:

1. Specific phobia (37%).
2. Social phobia (32%).
3. Post-traumatic stress disorder (26%).
4. Alcoholism or addiction (21%).

Pathophysiology

Binge eating disorder shares the same neurobiology as substance use disorder. Research has proposed several models to explain the pathophysiology of binge eating disorder. This occurs due to the complexity of reward processing and inhibitory control. A prominent model of affect regulation highlights the role of negative affect in binge eating disorder. According to this model, binge eating episodes are caused by negative affect and help to get rid of them. Difficulties in emotional regulation and decreased emotional awareness are correlated with compulsive overeating. In addition, interpersonal problems are associated with this disorder. In addition, neuroimaging studies have shown hyperactivity of the medial orbitofrontal cortex and hypoactivity of the prefrontal network in people with binge eating disorders.

Consequences of bulimia nervosa

All manifestations of this disease have their consequences, serious physical problems for the body. These include the following manifestations:

• damage to tooth enamel caused by constant exposure to stomach acids
• damage to the gastric mucosa
• cardiac and vascular pathologies
• bleeding from stomach to throat
• problems with vocal cords
• eye and skin diseases
• hair loss

Often people begin to struggle with the consequences of bulimia nervosa, but it is important to get rid of the underlying disease and the causes that cause it. A bulimic may not consult a doctor on his own, because such a disease is an addiction that stands alongside alcohol or drug addiction. A person may not understand that he is sick, so he needs help.

Important: Prejudices and instructions from relatives will not help. It is necessary to contact a specialist who will correctly diagnose and prescribe treatment that is correctly selected for a particular patient.

Diagnostics

- History.

Clinicians should be aware of the following points to assist in diagnosing patients with binge eating disorder.

1. Age at onset of binge eating episodes.
2. Frequency of binge eating episodes.
3. Length of episodes.
4. Amount of food.
5. Feelings associated with overeating.
6. Any compensatory behavior (vomiting, taking laxatives).
7. Comorbid conditions (psychological problems, obesity, diabetes).
8. Emotional triggers (rejection and stress).
9. Social pressure.
10. Emotional abuse in childhood.
11. Childhood calorie restriction or childhood eating disorder.
12. Suicidal thoughts.
13. Substance abuse.
14. Physical and sexual violence.
15. Body image perception.
16. Family history of binge eating.

— Physical examination.

The patient should be evaluated to identify comorbidities associated with obesity caused by overeating.

1. Regular blood pressure checks are required.
2. Blood glucose levels require regular monitoring.
3. An assessment for physical or sexual abuse is required if there is serious suspicion.

Psychological aspect of the problem

Although physiological and genetic causes may be involved in the development of a food-related illness, the psyche plays a central role.

Leading psychotherapists, in describing clinical cases of compulsive overeating, note that the onset of the disease is often preceded by negative life events. Moreover, such stress can be caused by both social and physiological factors.

To understand whether you have this problem and whether you need professional help from a psychotherapist, you should honestly answer a number of questions.

• Have you recently noticed that your diet is difficult to control?
• Are all your thoughts somehow related to food?
• Do you prefer to eat alone, hiding your food intake from others?
• Do you tend to overeat due to stress, distracted from current problems?
• Do you feel guilty, which affects the pleasure of eating?
• How often do you start a meal without feeling hungry?
• Do you find it difficult to refuse food if you are given a treat?

If you answered yes to 4 or more questions, it makes sense to contact a specialized medical institution for consultation and clarification of the causes of your nutritional problems.

Treatment

The following treatments may help:

• Cognitive behavioral therapy can help control binge eating over the long term, but does little to help with weight loss.
• Interpersonal therapy is as effective as cognitive behavioral therapy, but it also does little to help with weight loss.
• Stimulant medications (such as those used to treat ADHD) and selective serotonin reuptake inhibitors (one antidepressant), such as fluoxetine, can help people stop binge eating for a short period of time and lead to weight loss.
• Weight loss medications (such as orlistat) or appetite suppressants (such as topiramate) may help you lose weight.
• Organized self-help groups , which are based on the same principles as Alcoholics Anonymous (such as Overeaters Anonymous or Food Addiction Anonymous), are widespread, but their effectiveness has not been proven.
• Traditional behavioral weight loss programs can help people lose weight and stop binge eating in the short term, but people tend to return to binge eating.
• Surgery may be performed , but its effect on binge eating disorder is uncertain.

WITH OVEREATING DISORDER, IT IS IMPORTANT TO IMPROVE WELL-BEING, NOT TO ACHIEVE PERFORMANCE

Take the time to spend a few minutes a day thinking about how eating different foods affects your well-being. How do you feel when you eat a lot of pizza or cupcakes? Do you feel heaviness? Lethargy? Saturation? If eating any food makes you feel anything other than delight, stop eating it. Promise yourself to eat only foods that are good for your body.

Don't you feel light after eating natural organic foods, fruits and vegetables? Don't they charge you with energy and positivity? So eat them more often, and other foods less often. It will be much more beneficial for you to think about what brings you pleasure, focusing on the actions you need to take in this direction. Here's an example of what you can do:

• Keep a stock of real food in your kitchen, such as whole grains, fruits and vegetables.
• Try to eat slowly.
• Eat lower calorie foods at night.
• Appreciate your body positively every day.
• Learn to be grateful.

Forecast

Long-term studies demonstrate that the prognosis of binge eating disorder is better than that of other eating disorders, with more favorable remission rates. The progression of psychogenic binge eating to other eating disorders is very low. Only a few studies report an increased likelihood of progression to bulimia nervosa . Depressive symptoms and substance abuse are two important adverse mental health outcomes in binge eating disorder.

Binge eating in childhood predicts excess weight gain in adolescents and young women. It also independently increased the risk of obesity-related complications such as metabolic syndrome.

Symptoms

The clinical picture of compulsive overeating can be noticed both by the person himself and by people from his close circle. Signs of the disorder are as follows:

• food is perceived as the only source of inspiration, improving mood and fighting depression;
• the habit of eating even in the absence of hunger;
• desire to eat large amounts of food after suffering stress;
• the need to eat to capacity to cope with hunger;
• a feeling of self-loathing due to the food consumed and the appearance of guilt after this;
• reluctance to tell your loved ones about your food problem and become aware of it yourself;
• a person engages in gluttony only when alone; in company with other people he eats normally;
• eating large amounts of food in short periods of time;
• lack of control over appetite and the amount of food consumed.

The main symptom of an eating disorder is loss of control over one's appetite. If a person eats a large amount of food every time he experiences nervous tension, stress, depression or resentment, then this condition is a reason to contact a specialist.

Since compulsive overeating is most often observed in people with a vulnerable psyche and those who take everything to heart, they can become prisoners of this disorder for a long time. The risk group most often includes teenagers and young girls. Men are also affected by this disorder, but they prefer not to talk about it, and in such cases, overeating manifests itself in eating salted fish and washing it down with a lot of beer.

Another characteristic feature of psychogenic overeating is that during times of stress a person leans on unhealthy foods (sweets, baked goods, carbonated drinks, fast food), rather than eating fresh vegetables and fruits, soups and cereals, the benefits of which for the body are undoubted. All this leads to a rapid gain of excess body weight, and if left untreated, to obesity and related diseases.

Girl eats sweets

Complications

Most patients with binge eating disorder are obese. Binge eating disorder and obesity coexist in most cases and share common complications. Complications of these two disorders include:

• muscle pain;
• pain in the neck, shoulder and lower back;
• deterioration due to physical health problems after BMI adjustment;
• arterial hypertension;
• diabetes;
• asthma is a respiratory disease;
• coronary heart disease and heart failure;
• hyperlipidemia;
• weight gain;
• menstrual irregularities (amenorrhea, oligomenorrhea);
• imbalance of cortisol hormones (blunted cortisol response to a stress test and decreased levels of cortisol in the urine);
• oncology (colon, breast, endometrial cancer, gall bladder cancer, etc.);
• osteoarthritis;
• sleep apnea;
• obesity-hypoventilation syndrome;
• non-alcoholic fatty liver disease;
• gallbladder disease;
• metabolic syndrome.

Who should I turn to for help with bulimia and compulsive overeating?

You can eliminate many of the causes of your disease on your own, but only a qualified doctor can provide high-quality treatment with effective results. Complex treatment includes:

• drug treatment
• psychological assistance

Individual or group psychotherapy has an effective effect on a person and solves many of his problems. Having plunged into the depths of consciousness, an experienced psychologist finds the reasons for your overeating and tries to eliminate them. The medication side includes taking antidepressants, if necessary, and hormonal medications. Consultations with nutritionists who can adjust your diet and diet are also important.