As a Dietitian working in private practice I often come across patients struggling with Binge Eating Disorder (BED). The following are comments I hear that often lead me to investigate the possibility of BED;
‘ I’m never hungry in the morning and don’t feel like eating until afternoon, then I just can’t stop eating’
“I throw away the evidence (food wrappers) in different locations so that no one finds out.”
‘Once I start I just can’t stop, I feel out of control and just keep eating. I am embarrassed about my behaviour, I didn’t know how to stop and control it.”
‘After my partner goes to bed, that is when I start pigging out.’
“I hide lollies/choc/biscuits in my drawers so no one can see my secret stash.”
Binge eating is the consumption of an unusually large amount of food coupled with a feeling of loss of control over eating. Binge eating disorder is characterized by recurrent episodes of binge eating without inappropriate compensatory behaviours (i.e.; self-induced vomiting, misuse of laxatives, diuretics, or other agents, excessive exercise).
The primary difference between bulimia nervosa (BN) and binge eating disorder is that there are no regular compensatory behaviours in BED. In some patients there may be some occasional compensation however it isn’t a regular part of the illness.
The diagnosis falls within the DSM-5 category of ‘Eating Disorders not otherwise specified’ and meets the following criteria:
a) Recurrent episodes of binge eating
b) Binge eating episodes are associated with three (or more) of the following:
– Eating much more rapidly than normal
– Eating until feeling uncomfortably full
– Eating large amounts of food when not feeling physically hungry
– Eating alone because of embarrassment
– Feeling disgusted with oneself, depressed, or very guilty after overeating
– Marked distress regarding binge eating is present
– At least once a week for 3 months
– The binge eating is not associated w/ the recurrent use of compensatory behaviours.
BED is not only common in overweight and obese patients it is also common in those with a healthy Body Mass Index. It is slightly more common in females however this may be due to underreporting by males. Associated health risks include increased risk of metabolic syndrome, insomnia, anxiety, osteoarthritis and chronic kidney disease.
How an Accredited Practicing Dietitian can assist in treatment of Binge Eating Disorder?
Address weight and shape concerns discourage unrealistic weight loss goals
Prevent excess weight gain, assist with weight stabilisation or modest weight loss
Analyse food records, timing and location of eating, thoughts and feelings
Assist patients to identify their own cues or triggers for binge episodes and work with the patient to develop strategies to decrease binge eating episodes
Assist the patient with appetite regulation and identifying physical hunger
Educate patient on appropriate and inappropriate eating behaviours
Educate on the relationship between optimal nutrition status, mood and mental health
Develop individualised nutritionally adequate meal plans and practical ideas to prevent hunger and fluctuating energy levels which suit the patient’s medical concerns, cooking skills, budget, time restraints and conflicting demands from family.
If you feel you or someone you may know is suffering from Binge eating disorder then seek help from an Accredited Practicing Dietitian.
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