Binge Eating: When Eva turns into Pac-Man

15. December 2010
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If the soul is suffering: Binge eating patients are tortured by uncontrollable eating attacks. Particularly difficult: In addition to the psychological pressure, associated diseases threaten due to the gain of weight.

It overcomes them several times a week: Binge eating patients wolf down food: Thus the name – the English phrase “binge eating” means “excessive feast”. The persons suffering from it prefer food with a high content of carbon hydrates and fats. Mostly they eat behind closed doors, without any self-control. That goes on until the stomach hurts; then comes the guilt feeling. But contrary to bulimia, these people don’t initiate vomiting or do excessive sports. The result: You gain weight fast and parallel to it the psychological pressure increases more and more. In addition the risks for diabetes respectively the metabolic syndrome, for high blood pressure, heart attack or stroke.

A clinical picture becomes modern

Already in 1959, binge eating was described in psychological professional literature. But only in recent years, systematic research started. One of the triggers was the recommendation of the American Psychiatric Association, to classify binge eating as an independent eating disorder.

New surveys in the US revealed that approximately two percent of all citizens suffer from binge eating. Among obese patients, this value is even four to nine percent and in therapy groups for weight reduction, nearly 30 to 40 percent of the participants suffer from it. Experts expect that this diagnose might be made even more often in the future once the attention might be drawn more to it by more intensive research and according professional publications.

Women suffer from binge eating disorder 1.5 times more frequent than men but contrary to bulimia or anorexia, the supposedly stronger sex is not spared here, as well as people in all age groups. According studies discovered that the risk is relatively high in the life phases between 20 and 30 as well as 40 to 50. There are no detailed figures available for children and youth. And adolescents showing only a part of the symptoms, most of the time develop the full picture of a binge eating disorder as an adult.

Overweight: Is binge eating in the game?

A binge eating disorder might hide behind severe overweight. Experts estimate that up to 45 percent of the adult obese persons are suffering from it – a high number of unrecorded cases is estimated: “Periodically occurring eating attacks are kept secret and thus remain undiscovered”, knows Prof. Dr. Heinrich Wernze at the Wurzburg University. A test during anamnesis can remedy: For example if questions about a rapid feeling of satiety are answered negatively but the uncontrollable urge to eat is checked, the alarm bells are going off. Especially in overweight children, pediatrics should take a close look, in particular because children and youths often don’t show all criteria of the binge eating disorder yet.

Night eating syndrome: Night owls at the fridge

Especially in young patients, experts observe the night eating syndrome: Ravenous appetite at night leads the youngsters to the fridge. Those eating attacks are by far less pronounced than with binge eating – but exact figures are missing yet. The insight of psychologists: If sleeping disorders are reported for children with overweight, it might be a signal for the night eating syndrome.

Therapy: Personally or online?

Psychologists get good results with the cognitive behavior therapy. The target: Patients learn to normalize their eating habits themselves and to reduce their weight by regular eating without dieting. They also practice to orientate themselves by feelings such as satiation or hunger. They make the experience to enjoy their meals. Another support tool, exercise therapy, provides additional help developing a positive body feeling and reducing excess weight.

Psychologist Sarah Weber
at the Ruhr University Bochum/Germany reminds: “Therapy in single sessions are very time- and money consuming and are not offered everywhere”.

The INTERBED-study, which is an internet-based, guided self-help for example for overweight patients suffering from the binge eating disorder, i supposed to solve the problem. Wagner: “If it turns out that the internet-based offer works just as good, it would make a real alternative or an interim solution for patients waiting for a therapy place.”

The study design: Whilst the group of conventional single therapy meetings enjoys 20 single sessions within four months, patients in the internet group retrieve mainly psychotherapeutic units via an online portal. It contains contents about nutrition, about the own perception of the body and about a constructive handling of stress and eating impulses. In addition the people communicate once a week by eMail with therapists. Psychologists of the health insurance company Kaiser Permanente, the Wesleyan University and the Rutgers University, USA tested another self-help model. Their program targeting on behaviour therapy helps patients with binge eating disorder to control their attacks of ravenous appetite themselves. At first, the participants received detailed information about their disorder and an own constructive handling of it. They also participated in eight sessions during twelve weeks where a therapist explained the principles of cognitive behaviour therapy and provided guidelines for self-help. At the end of the program, 63.5 percent after all had no further eating attacks, in the control group we are talking about only 28.3 percent. And those results lasted for more than plus/minus one year.

But in order to grant lasting success, experts recommend getting to the roots of the problems which caused the eating disorder. In addition to other procedures of psychotherapy and depending on the medical records, the treatment with selective serotonin-reuptake-inhibitors (SSRI), tricyclic antidepressants or Topiramat migh help.

Research: Trailing down the causes

Physical and psychological factors are considered as triggers for the binge eating disorder.
Dr. Simone Munsch at the Institute for Psychology at the Basel University says: “In general we have to say, that genetic mechanisms are the least researched in this regard.”

Now first hints exist towards a family accumulation – potential approaches for research. Munsch: “But it turned out that affected people often are particularly vulnerable regarding psychological disorders like depressions or anxiety attacks”. Researchers also consider burdening factors, trouble, boredom or a fundamental dissatisfaction as potential triggers.

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