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Q
Overcoming Overeating?
Do you have any advice for overcoming eating disorders - including compulsive overeating?
A
Answer (Published 1/21/2003)

(Reviewed 1/24/2005)

Compulsive overeating, also known as "binge eating disorder," is similar to bulimia, another eating disorder in that it involves frequent binging on huge amounts of food. As you probably know, bulimia also involves purging - vomiting or using laxatives to rid the body of the excess food to avoid gaining weight. Some people who suffer from bulimia exercise compulsively to work off their binges. No purge is involved with compulsive overeating so the end result is weight gain and, potentially, medical problems associated with obesity. An estimated two to five percent of Americans experience binge-eating disorder in a six-month period. An estimated 0.5 to 3.7 percent of women will suffer from anorexia nervosa and 1.1 percent to 4.2 percent of women will suffer from bulimia at some point in their lifetime.

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Compulsive overeating usually begins during adolescence although many of those affected don't seek help until they become adults and try to lose weight. Symptoms include:

  • Recurrent binges during which those affected eat much more rapidly than normal; eat until they're uncomfortably full; eat large amounts of food when not physically hungry; eat alone because of embarrassment about the amount of food consumed; feel disgusted, depressed or guilty afterwards.
  • Distress about the bingeing.
  • Bingeing on average at least two days a week for six months.
  • Binges are not associated with purging, fasting, or excessive exercise afterward.

Experts suspect that in some cases binge-eating is learned behavior, the outgrowth of the use of food in some families for comfort and to deal with stress. However, another theory holds that it may be due to a glitch in the brain's appetite control apparatus - the failure of the hypothalamus to signal hunger and fullness appropriately. Serotonin, a brain chemical involved in mood and some compulsive behavior, may also play a role.

All eating disorders are serious medical conditions that can have a long-lasting impact on health and should be treated by experts in the field. Each may require a slightly different approach. For example, treatment of anorexia nervosa, characterized by a distorted body image and low body weight, begins with efforts to restore lost weight. I encourage you to ask your physician for a referral to psychologist, psychiatrist or treatment facility that specializes in eating disorders. For more information about eating disorders and organizations that can help you, you might want to visit the Harvard Eating Disorders Center at www.hedc.org.

Andrew Weil, M.D.

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