Binge Eating Disorder
It’s a label many of us may have suffered before. We’ve been called “unwilling” or “non-compliant” when it comes to following orders about what we “should” eat –whether it be from a doctor or a diet book.
It’s not a label that rests lightly on anyone’s shoulders. Because in all likelihood, it ignores what’s really going on.
Binge Eating Disorder Awareness
As part of Eating Disorder Awareness Week this week, whose theme is I Had No Idea… we wanted to bring attention to the fact that Binge Eating Disorder (BED) is the most overlooked and misdiagnosed of all eating disorders.
It rarely gets the attention that Anorexia and Bulimia receive, and yet BED is far more prevalent than both disorders combined, occurring in 1 of 35 adults.
Due to secrecy and shame surrounding binge eating, the illness can go undetected for long periods of time. Quite simply, if you’re already feeling judged for your size and stereotyped for being out of control with food, why would you tell anyone what, when and how much you are eating? Aren’t we humiliated enough?
The Result of Weight Stigma & Overlooking BED
Weight elicits emotionally charged responses in both those attempting to get help and those attempting to help them due to the extreme weight stigma our culture fosters. Although not all people considered “overweight” have BED, people with this problem typically struggle with maintaining a healthy weight. But while Anorexia and Bulimia are recognized as serious illnesses, a larger-bodied person with BED may be characterized as “just” having an overeating problem.
Physicians frequently do not assess for binge eating, therefore BED often goes unidentified in primary care settings. Unfortunately, weight is the focus and the prescription is typically a traditional weight loss strategy, often further complicating the course of BED.
In fact, national health insurance initiatives require physicians to assess for obesity through the body mass index (BMI) – which is a notoriously inaccurate measure of health — and prescribe weight loss methods if the BMI exceeds a certain level. In some cases, if physicians do not do that, they may not be reimbursed for the healthcare visit.
Treating Binge Eating Disorder
The problem is, the objective of weight loss is problematic for many people with BED, as it activates the restrict-binge cycle. The causes of BED are more closely tied to emotional regulation and escape from awareness of intrusive thoughts. Therefore focusing on a symptom such as weight doesn’t address the root cause and therefore doesn’t lend itself to a long-term solution.
Treatment programs that focus on food intake and the resulting weight response tend to have high attrition rates. At Green Mountain at Fox Run, we encourage instead a general “care of self-approach”, encouraging autonomy in a person’s choices around food and exercise.
Recognizing & Diagnosing BED
Those who have BED and don’t appear to be struggling with weight may have serious unexplained gastrointestinal distress. A physician may do many expensive tests trying to discover the cause of the distress and yet never know what a person is doing with food to cause the problem.
Opportunities for discovery of eating disorders could be solved by use of screening tools such as the BES, decreasing the focus on weight and asking more questions about emotions and eating behavior, and looking for symptoms of depression and anxiety which commonly accompany binge eating disorder.
This article from the Binge Eating Disorder Association can also equip you to get past the issue of weight and address the root causes of eating or health problems.