Binge Eating – When the Soul Starves

29. September 2022

During a cozy movie night on the sofa, it happens to almost everyone at some point that the entire bag of chips or the entire bar of chocolate is emptied after dinner. Common consequences: Stomach ache and a guilty conscience. The next day, we complain to our colleagues and friends that we had a food attack. But was it really a binge? Is this already binge eating?

Binge eating from a clinical perspective

The above question is not so easy to answer. In our affluent society, many people constantly struggle not to eat too much, eat unhealthily or go on diets. However, not everyone is immediately afflicted with binge eating. From a clinical point of view, this is only the case when at least one eating attack occurs every week over a period of three months. Moreover, binge eating often no longer has anything to do with the pleasure we still feel when we have our first bar of chocolate after a meal. A real eating attack usually comprises 4000 to 10000 calories. The quantities described certainly do not sound consumable for many, but the stomach expands more and more in the course of the disease. Affected persons gulp down the food excessively hastily in the shortest possible time and describe eating as a kind of intoxication with the feeling that they can no longer stop. Mostly the Essattacke finds only an end, if the fullness feeling is so strong that the persons have the feeling, they do not get a little more down or feel already strong nausea. Immediately afterwards, feelings of guilt, disgust and great shame usually appear.

Course of the disease

Repeated feelings of shame and guilt result in low self-esteem and gradual social withdrawal. Eating attacks basically already take place secretly, but eating in public is often avoided. As a rule, the course of a binge eating disorder is very variable. Those affected usually manage to regulate themselves for days, weeks or even months and then lapse again into phases with more severe symptoms. During periods without binge eating, they often try to diet in order to prevent weight gain or to reduce weight.

Who is affected?

Statistically, the age at which binge eaters first become ill has two peaks – once around the age of 20 and again between the ages of 45 and 54 – and is thus significantly higher than for other eating disorders such as bulimia nervosa or anorexia nervosa. Overall, around three percent of the German population currently suffer from binge eating. Just as with all other eating disorders, women are more frequently affected, but the imbalance, at 3:2 in favor of men, between the sexes is significantly lower than with other eating disorders.

Danger of confusion! Differences with bulimia and obesity

Binge eating has parallels with the disease bulimia (binge eating with subsequent compensation) as well as obesity (severe overweight). Since the three clinical pictures are often mixed up, differences and similarities are listed below:Body weightWhile those affected by binge eating tend to be overweight, bulimics are usually in the normal weight range. Obesity, as mentioned earlier, only exists when people are severely overweight.Eating BehaviorBoth binge eating disorder and bulimia involve regular binge eating. Obesity does not necessarily result from such attacks.Body imagePatients with binge eating and bulimia often have a negative body image, whereas obesity does not necessarily result from dissatisfaction with one’s own appearance.CompensationWith binge eating, no compensatory measures are taken, which is the case with bulimia in the form of vomiting or the use of laxatives, among other things. People with obesity also usually do not take any weight-regulating measures or do not do so regularly, which is why the excess weight occurs.Important: Unlike binge eating and bulimia, obesity is not a mental illness and therefore does not necessarily have to be triggered by mental problems.

What causes binge eating?

As always with mental illnesses, the causes of binge eating are very diverse. They are composed of:

  • Psychological reasons: Low self-esteem, dissatisfaction with figure, great importance of external appearance, problems with emotion regulation or conflict management, trauma, low frustration tolerance, inability to perceive feelings, and more.
  • Social reasons: Environment with disordered eating behaviors, little support, exclusion, social comparisons, and more.
  • Biological / physical reasons: Increased BMI, frequent dieting, dysregulation of the hypothalamus (appetite control), low serotonin levels, and many more.

The causes mentioned often do not occur alone and are mutually dependent. Eating initially serves as a good problem-solving strategy for the affected individuals, but is enormously harmful in the long run.

Serious consequences for those affected

As already mentioned, binge eating has various long-term consequences if left untreated. Physically, binge eating often leads to chronic stomach and intestinal problems. Especially if people are also overweight, the risk of diabetes, cardiovascular disorders and joint problems also increases. Breathing and sleeping disorders also often increase. In addition to the physical consequences, the psyche is often further burdened. The constant feelings of guilt and shame carry a risk of depression and anxiety, as well as an increased risk of suicide. It is not uncommon for social contacts and interests to be neglected because the topic of nutrition takes up so much space. A further underestimated risk is the financial burden caused by high food consumption. The variety of consequences as well as the severity underline at this point the relevance of a treatment of the disease.

Helpful forms of treatment and therapy

Those who feel that they cannot get out of the binge eating disorder on their own should urgently seek psychotherapeutic support. If the symptoms are severe, inpatient stays are also advisable in order to receive sufficient help in regaining control over one’s own eating behavior. Cognitive behavioral therapy is particularly suitable as a therapy method for this disorder. Cognitive behavioral therapy is of the opinion that patients can unlearn the eating behavior they have learned to regulate their feelings or can train themselves better strategies for coping. This should be done on a very individual basis to see what is behind the excessive craving for food. Patients often keep a food diary to see exactly which events or feelings trigger an eating attack. Most therapy offers also focus on a lot of exercise and give patients more self-confidence again. And finally, to come back to the initial question: As already mentioned, the disorder pattern of binge eating extends much further than eating one too many bags of chips or bars of chocolate. It is much more the regularity in which something like that happens and the reasons for eating. In any case, there is a lot of professional support and it is always good to act early so that none of the many long-term consequences can occur.

References
  • Landesfachstelle Essstörungen NRWUniversität Bonn: https://www.landesfachstelle-essstoerungen-nrw.de/fileadmin/contents/Datenbank/Essstoerungen_-_Was_ist_das_BzgA.pdf, accessed on 26.09.2022.
  • Federal Center for Health Education: https://www.bzga-essstoerungen.de/habe-ich-eine-essstoerung/wie-haeufig-sind-essstoerungen/?L=0, accessed on 26.09.2022.
  • Munsch, Simone; Wyssen, Andrea; Biedert, Esther: Binge eating: cognitive behavioral therapy for binge eating. Weinheim, 2018.

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Limes Schlosskliniken
Author Limes Schlosskliniken
"LIMES Schlosskliniken specializes in the treatment of mental and psychosomatic illnesses. With the help of the blog, we as a clinic group would like to examine the various mental illnesses in more detail and present different therapies as well as current topics."

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