As part of this trilogy on eating disorders, we covered anorexia nervosa (See article:Eating disorders: Anorexia nervosa), as well as bulimia nervosa (See article:Eating disorders: Bulimia nervosa).
The third installment in this series looks at binge eating disorder, a less well-known yet more common eating disorder. In Quebec, approximately 192,000 people are believed to be affected by binge eating disorder. In Montreal, 3.8% of the population suffers from this disorder, compared to 1% for anorexia and 2% for bulimia.
It was only recently, in 2013, that this disorder was incorporated into the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a separate entity, which may surely explain the fact that it is still unrecognized.
Here is the last part of this series: binge eating.
Definition of binge eating disorder
Along with anorexia and bulimia, binge eating is one of the three main eating disorders recognized by the DSM-5. This disorder affects about 3.5% of women and 2% of men. Unlike anorexia and bulimia, most people with binge eating disorder are overweight or obese. In addition, these people are generally older and more often than not are men.
Warning signs of binge eating
Some signs that may alert you to the presence of binge eating disorder in an individual include:
- Changes in body weight
- Clothing comprising several layers of clothing or the wearing of clothing aimed at camouflaging the shape of the body, even when the temperature is not suitable
- Signs of binge eating, such as food going missing or food accumulating in secret
- A feeling of guilt and anxiety about food or food
Symptoms of binge eating disorder
Binge eating disorder is characterized by recurrent episodes of binge eating, where people eat large amounts of food over a limited period of time. These episodes are accompanied by a feeling of loss of control. Unlike people with bulimia nervosa, individuals with binge eating disorder do not exhibit compensatory behaviors to eliminate overeating, such as excessive use of diuretics or laxatives, intensive physical activity, or fasting. . People with binge eating disorder may also experience depression and be concerned about their weight and body.
Diagnosis of binge eating disorder
Criteria for the diagnosis of binge eating disorder include:
- Bulimia attacks occurring on average at least once a week over a period of three months
- A feeling of loss of control over eating
In addition, at least three of the criteria below must be present:
- Eat faster than normal
- Eat until you feel uncomfortably full
- Eat large amounts of food without feeling physically hungry
- Eating alone due to the shame associated with the amount of food eaten
- Feeling disgusted, feeling guilty or depressed after eating too much
Treatment of binge eating disorder
The main treatment for binge eating is cognitive behavioral therapy. This therapy may help control binge eating attacks over the long term, but has no significant effect on weight. Treatment can sometimes include interpersonal psychotherapy, as well as the prescription of certain drugs, such as selective serotonin reuptake inhibitors (SSRIs) or drugs aimed at inducing weight loss.
Nutritional approach for binge eating disorder
A dietitian may also be involved in the treatment of binge eating disorder. As with other eating disorders, its role is to teach the basics of a normal diet, which may include planning three regular meals a day, consuming appropriate portions, etc. Similar to treatment for bulimia nervosa, the initial goal of treatment for binge eating disorder is also to maintain body weight. This is because it may be best to wait until people have normalized their eating behavior before embarking on weight loss strategies so as not to risk exacerbating binge eating.
To conclude this trilogy:
Going for help, or even becoming aware of an eating disorder is often very difficult. According to Dr. Mimi Israel, head of the Department of Psychiatry at the Douglas Institute and Associate Professor in the Department of Psychiatry at McGill University, people with an eating disorder cannot be forced to seek help. We must first help them to recognize their discomfort and the negative consequences that this entails (eg fatigue, etc.). You have to go there calmly and with respect, because it is a process that starts with trust. Then we can encourage them to go and ask for help.
For help requests:
A non-profit community organization, Anorexie et Boulimie Québec (ANEB Quebec), provides help to people directly or indirectly affected by an eating disorder.
References
- http://test.opdq.org/reinventez-vos-habitudes-alimentaires/lhyperphagie-boulimique/
- https://www.merckmanuals.com/fr-ca/accueil/troubles-mentaux/troubles-des-conduites-alimentaires/trouble-hyperphagie-boulimique
- https://www.merckmanuals.com/fr-ca/professional/troubles-psychiatriques/troubles-du-comportement-alimentaire/hyperphagie-boulimique
- https://www.merckmanuals.com/fr-ca/accueil/les-faits-en-bref-troubles-mentaux/troubles-des-conduites-alimentaires/trouble-hyperphagie-boulimique
- https://nedic.ca/eating-disorders-treatment/binge-eating-disorder/
- https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
- Coughlin, Janelle W., et al.Modern Nutrition in Health and Disease, by A. Catharine Ross, Wolters Kluwer / Lippincott Williams & Wilkins, 2014, pp. 13241325..
- https://quebec.huffingtonpost.ca/entry/troubles-alimentaires-demandes-aide-aneb_qc_60185fdac5b63b0fb2836d08
Article written by:
Marie-Noël Marsan, Nutritionist