More than 7 million Americans struggle with binge eating disorder (BED), according to a recent Harvard-based study, yet few of us know much about the condition. Cynthia Bulik, PhD, director of the University of North Carolina Eating Disorders Program and the author of a new book, Crave: Why You Binge Eat and How to Stop, helps shed light on the problem. 

O: What is binge eating disorder?

A binge is when you feel out of control while eating a large amount of food—you're eating past any need, shame, or embarrassment. It can be a response to stress or anxiety; instead of turning to a solution that speaks directly to a problem—like calling a friend or doing some physical activity—a person with BED manages anger or happiness or boredom with food. Officially, BED is defined as bingeing that occurs an average of at least two times a week for six months. And unlike people with bulimia, BED sufferers don't try to undo the binge by purging or fasting.

O: Is the condition genetic?

There is a genetic component, which is why battling it can be so challenging. But I like to say that genes load the gun and the environment pulls the trigger.

O: Have you found that BED interferes with relationships?

Absolutely—people feel that they would rather stay home and binge than go out with friends. Or they let their partner go to bed alone so they can binge in private. They prefer spending time alone bingeing rather than with the people they love or care for. BED can also cause substantial financial pressures in a relationship if the disorder begins to tax the food budget.

O: So what's the first step in treating BED?

I tell people to track their binges for a week. What set them off? What are the cues? Was it a call from your boss? People think their binges come out of the blue, but once they start writing them down, they're surprised to find out that they have clear patterns.

O: What should they do next?

Something I nearly always see with BED is skipping breakfast. They have to retrain their stomach to wake up with them in the morning. Missing breakfast sets up a binge eater both biologically and psychologically: Extending the fasting period from the night before intensifies hunger later in the day, making it more likely that they'll overeat and justify it by telling themselves, "It's okay; I skipped breakfast."

The next thing to do is find a better solution for dealing with emotional triggers. One of my favorites is to create a music playlist to help manage each mood—anxiety, depression, anger, boredom. When you feel the urge to eat, listen to the appropriate music or podcast instead. Cognitive behavioral therapy may also be necessary. It will take work, determination, and planning, but binge eating disorder can be overcome.

Next: How to stop binge eating

As a reminder, always consult your doctor for medical advice and treatment before starting any program.


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