Research shows that a lot of people struggle with the same urges. A study published in the journal Biological Psychiatry suggests that about 3.5 percent of women suffer from binge eating disorder, or BED—more than double the incidence of bulimia and four times that of anorexia—and fewer than half seek treatment. It wasn't until the 1990s that BED was proposed as a separate eating disorder. The new study reveals it's more common than previously recognized, and increasing in incidence. It's time BED earned official status, says one of the study authors, Harrison Pope Jr., MD, a professor of psychiatry at Harvard Medical School. "This is a genuine disorder, not a temporary pattern of eating. People who have it describe distinctive and dramatic symptoms."
What Counts as a Binge
Depending on how out of control it gets, a single bout can include fast food meals, pizzas, cakes, even half-thawed frozen pies. Pope has talked to hundreds of people with BED: "Typically they'll say, 'I had a normal dinner, then around 9 or 10, I went to the kitchen intending to have one cookie, and I ate all the cookies and all the ice cream. Then I wanted something salty, so I ate all the pretzels. Then I wanted something sweet again.' They eat quickly, are disgusted with themselves, yet they do it night after night." A binge can rack up 2,500 to 20,000 calories. Considering that the average woman is supposed to eat about 2,000 a day, it's no surprise that the majority of those with BED also struggle with obesity.
Why It Happens
Cynthia Bulik, PhD, director of the University of North Carolina Eating Disorders Program and coauthor of Runaway Eating, sees two different patterns among her patients. One group, like Luebbers, has been bingeing since childhood; the other comes to it later in life, usually following an extreme diet. "The body rebels and overcompensates with the first binge," she says. "The bingeing starts intermittently and eventually becomes more frequent." In one study, Bulik and colleagues found that obese people with BED were twice as likely to have relatives with the disorder as similarly obese subjects who were not binge eaters. Other research suggests that those with BED often suffer from anxiety and depression in addition to bingeing. Some experts believe that the episodic stuffing behavior is to some extent written into our genes. Deirdre Barrett, PhD, an assistant clinical professor of psychology at Harvard Medical School and author of Waistland: A R/evolutionary View of Our Weight and Fitness Crisis, says we're programmed for eating in the African savanna, where it was necessary to consume a lot of food because most of it was high in fiber and low in calories. Those ancestors who felt full on too little were less likely to survive and pass on their genes.
In addition, some people may be particularly vulnerable to junk food. Mary Boggiano, PhD, an associate professor in the department of psychology at the University of Alabama at Birmingham, discovered that all her lab rats ate about the same amount of their standard bland chow, yet when presented with Oreos, some weren't particularly interested, and others just couldn't stop. Boggiano has also found that a junk food binge in these animals set off the same pleasure receptors in the brain that get stimulated when drug addicts take opiates. "Patients think they don't have discipline, willpower," says Boggiano. "But you're fighting biology, and it's therapeutic to know that junk food can trigger this reaction. The knowledge may make it easier to abstain."
A number of approaches—especially in combination—can bring runaway eating under control. Cognitive behavior therapy, the short-term treatment that focuses on changing dysfunctional thought patterns and habits, has been shown to be effective. Another option involves working with a weight loss specialist to get on a structured, healthy eating plan. Bingers must break the cycle, Bulik says, where they wake up with such a food hangover from the previous night's spree that they skip breakfast, have only a minimal lunch, and then are set up perfectly for another evening of free-fall gorging. A third option many people swear by is Overeaters Anonymous. But because it asks members to acknowledge that they are powerless over food, the 12-step program is controversial among therapists, who usually want to help patients feel they are in control of their behavior. Drugs may also be useful. Antidepressants such as Prozac have been shown to reduce bingeing episodes, and Topamax, an anticonvulsive medication, appears to dim the desire to overeat, although it's not FDA approved for this use.
Barbara Luebbers finally found relief by working with Ellen Shuman, a specialist in eating disorders and founder of the Cincinnati program A Weigh Out, a therapy-based approach. Through weekly sessions, Luebbers has come to realize that "when my emotions got too intense, I would disconnect and stuff myself. Ellen has taught me to be mindful of these moments and at least make a conscious decision about eating." More often than not, when Luebbers recognizes that the choice to binge is hers, she can resist.
Recently, driving home after a bad day at work, Luebbers automatically thought of consuming everything she had in the fridge and cupboards, including the entire pie she was planning to serve for dessert. But suddenly her coaching kicked in: "I said to myself, 'What good is this going to do? I can't change other people, but I can change my own approach, my feelings.' By the time I got home, I had soothed myself." That night she had a normal dinner and a single slice of pie.
The author of Crave: Why You Binge Eat and How to Stop has more solutions for BED