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VERIFIED CONTENTAuthor: Dominika Wilk

Compulsive overeating is not an expression of weak will or greed. This is often the only way to discharge accumulated emotions. Therefore, when working on this disorder, it is necessary to cooperate with a psychotherapist, and sometimes also a doctor who will prescribe pharmacological agents that improve the work of the brain.

Compulsive overeating (BED)is an eating disorder that affects 2-5% of the general population, and as much as 30% obese. In the American psychiatric classification, the DSM-5 is a separate disease entity, defined as "binge eating disorder" and marked with the symbol 307.51 (F50.8).

What is binge eating?

This disorder is the act of overeating, usually on impulse, rather than on a genuine feeling of hunger. Unlike bulimia nervosa, it does not cause the following acts of cleansing, such as vomiting or reaching for laxatives.

The amount of food consumed by an individual during one meal far exceeds the amount of food that would be eaten by another, average person, of the same sex, with the same body weight.

A characteristic symptom of the disorder is the appearance of a strong feeling of shame after the act of gluttony, as well as a strong feeling of guilt about what happened. There is also a depressed mood and a negative assessment of oneself.

To determine if someone has a binge eating problem, check that the person has binge eating at least once a week for the next three months. If these phenomena are repetitive, and the amount of food consumed significantly exceeds what most people would eat, then you should seek help from a specialist, e.g. a psychodietician or psychotherapist.

When you know it's binge eating?

The criteria to help determine if a person has a compulsive overeating problem are as follows:

  • eating too much in the absence of hunger,
  • ending eating feeling very overeated,
  • eating alone,
  • reaching for foodcompulsively, suddenly, despite the fact that, for example, half an hour ago another meal was eaten,
  • eating much faster than usual for a given person,
  • guilt after eating a meal, as well as feeling ashamed and disgusted with yourself,
  • no vomiting and no cleansing after eating.

Criteria for the severity of ailments:

  • 1-3 episodes of gluttony in a week means we are dealing with a mild condition,
  • 4-7 episodes indicate moderate impairment,
  • 8-13 episodes of over-consumption indicate severe disorders,
  • 14 or more episodes make the condition very severe.

Compulsive overeating. Where does it come from?

The emergence of eating disorders is usually the result of many factors. On the one hand, they may be genetic predispositions, and on the other hand - disorders of the satiety center located in the hypothalamus, and more precisely - in its ventromedial part. Scientific research also shows that people suffering from BED have changes in the striatal cortex circuits, very similar to those that occur in people addicted to, for example, psychoactive substances.

Patients also have partial attention to food, perceiving it as a reward more satisfying than others, and at the same time they are characterized by excessive impulsiveness, which means that in times of stress they reach for food quickly, as if something to eat. is supposed to quickly suppress stress or relieve negative emotions.

Besides, one of the biological reasons for the appearance of compulsive overeating may be excessive activation of the system:

  • dopaminergic,
  • alpha-2-adrenergic
  • and the GABA related circuit.

People with BED have too much dopamine to seek stimuli that are supposed to provide pleasure, and the lowered serotonin levels make them improve their mood through the most accessible means of rewarding themselves.

Other factors that will determine the increased risk of BED are psychological factors:

  • tense relationships with close people,
  • mood disorders in parents and the pattern of regulating this mood with psychoactive substances,
  • unmet needs for closeness,
  • wrong attitude towards one's own body,
  • stressful atmosphere at work,
  • decreased self-esteem,
  • depression etc.

In turn, the nutritional factors that may affect binge eating include :

  • too strict diet,
  • toolarge breaks between meals,
  • diet low in nutrients - even with adequate caloric value.

Ways to deal with compulsive overeating

Cognitive Behavioral Therapy

Since binge eating is often the result of an inability to regulate your emotions, it is imperative to take care of this area of ​​your life. It has been noticed that people with BED succumb to moods of sadness more easily and it is more difficult for them to regulate their emotions, therefore a necessary element of treatment should be a visit to a psychotherapist and establishing an individual action plan with him.

Compulsive overeating is often the result of prolonged tension as a result of, for example, the inability to set limits.

When the boss floods us with an excess of duties, when other co-workers throw their work on us, and we are unable to set limits and say "no" out loud, then we are drowning under the pressure of the amount of things to do, while suppressing anger at the situation , and we discharge all the tension and accumulated emotions at home through compulsive acts of gluttony.

If this is what happens and it is the main reason for BED, then in therapy, we learn how to set limits, how to be assertive, how to take care of ourselves so as not to feel the tension that we later regulate by eating.

On the other hand, when we have a toxic relationship, bad relationships with our parents, partner and it translates into a feeling of constant tension, then the sessions discuss ways of better communication with loved ones, considering leaving the toxic relationship, or some other way to normalize family matters and interpersonal contacts.

The basis of successful therapy is, first of all, removing the source of tension, and at the same time teaching the patient in a different, he althy way, can vent his emotions, e.g. by running, going to the cinema with a friend or any activity that gives pleasure, and which discharges excessive voltage.

An important element of CBT is teaching the patient the ability to delay eating. When the patient feels the desire to reach for food, and it is not dictated by hunger (during the session, the patient acquires the ability to recognize real, physiological hunger and distinguish it from craving), then he should take up another activity that involves him. He can start cleaning, painting, writing, talking on the phone, playing board games - anything that distracts him from eating.

Some patients are concerned that it is just postponing the compulsions in time, that they will end up eating and possibly eating even more than they would if they had not put it offfor an hour or two, however, this is wrong.

Postponing a seizure is teaching the brain not to be driven by a sudden impulse and always head towards the refrigerator when you feel tense. It is a slow habit change that is designed to reduce episodes of compulsive overeating and slowly diminish this type of behavior.

Drug treatment

If the underlying cause of binge eating is other mental disorders such as depression, then one of the ways to reduce binge eating is the use of SSRIs.

In addition, patients are treated with tricyclic drugs TCAs, as well as pharmacological agents used in epilepsy, such as topiramate. The substances that regulate the satiety center - e.g. sibutramine, also have a positive effect on the reduction of BED.

Working with a dietitian

Some compulsive eating bouts have to do with irregular eating. There are people who eat a hearty breakfast, then throw themselves into work and eat another meal only in the late afternoon or evening.

It is too long a time interval for the body, which often causes these people to throw themselves on the refrigerator after returning home, trying to eat what they did not eat during the day. Over time, this can turn into a compulsive overeating, which will exceed the caloric value of the meal above 1000 kcal and will be associated with a later feeling of embarrassment.

People who are slimming and follow diets that are too calorific in terms of calories are also at risk of compulsive eating. When the body does not get the right amount of calories for a long time and fasts from Monday to Friday, usually on the weekend you suddenly release the brakes and binge into unconsciousness.

It causes a great feeling of guilt, causes a lack of a sense of agency (because we compensate for the weekend caloric deficit and do not lose weight as we intended), and it also lowers the mood. The longer this situation lasts, the greater the risk of binge eating recurrence.

A calorically restrictive diet is not the only reason when the body wants to compensate for vitamin or mineral deficiencies with the help of binge eating. It can also be a nutritionally poor diet.

This means that we can consume up to 2000 kcal per day, but if they come mainly from processed food, carbohydrates: bars, chips, etc., at some point the body will want to compensate for the deficiency of nutrients, which will result in impulsive eating anything that comes.

In order to prevent binge eating, it is necessary to cooperate with a dietitian,which will arrange for us a caloric and dense-nutritious diet, which, in turn, will take away the specter of the appearance of BED. In addition, thanks to the regular meal times determined by the specialist, the body will stop making the periods of starvation and eating too much food at once.

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