Binge Eating to Become an Official Mental Disorder

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By: , SparkPeople Blogger
2/17/2010 5:13 PM   :  150 comments   :  20,242 Views

The American Psychiatric Association (APA) has just released a preliminary draft of the revisions planned for it’s Diagnostic and Statistical Manual of Mental Disorders (DSM). This is the manual that medical and mental health professionals use to determine when individuals are suffering from a mental illness, rather than a temporary emotional or situational problem. It’s also used by insurance companies to determine which illnesses and treatments they will cover.

The new Manual (DSM 5) will include binge eating as a distinct eating disorder, alongside anorexia nervosa and bulimia nervosa, which have been included in previous editions of the DSM.

Does this mean that, if you sometimes have trouble stopping after two or three cookies or a few slices of pizza, you’ve got a clinical eating disorder? Probably not. Binge Eating Disorder has some very specific characteristics, and involves a persistent, frequent, and very upsetting pattern of overeating that goes well beyond the occasional “I can’t believe I ate the whole thing” situation that we’re all familiar with.

You can see the official diagnostic criteria for Binge Eating Disorder here. One of the main characteristics of a binge eating episode is feeling out of control—like you literally can’t stop eating or control what or how much you eat during that episode, even though you know you’re not hungry and feel very bad about the overeating.

Personally, I’ve always found it a little tricky to tell the difference between being “out of control” and just not knowing how to stop eating something I like to eat. When I was very overweight, “moderation” just wasn’t in my vocabulary. If the food was there and I liked it, most likely I would eat it until it was gone or others started complaining. Not many cookies in the package survived to be eaten another day when I was around. And I felt miserable about not being able to stop myself from overeating. When I first shifted into weight loss mode, I didn’t get much better at stopping before I’d eaten the whole thing, at least not with my favorite foods—I just made sure that I didn’t have super-sized portions of those “trigger foods” within reach. Fortunately, I rarely felt tempted to binge on the leftover steamed broccoli or baked chicken breasts.

At this point, I still don’t feel very confident that I can stop myself from eating more than I want to eat with certain foods, if they’re right in front of me. I made the mistake the other day of falling for one of those promotional deals you see in the impulse buying section at the checkout aisle at the grocery store—buy 2 packs of Peanut M&Ms (one of my favorites) and get two free. I told myself that I could make those 4 packs last at least 4 days. Wrong—they didn’t make it past the first night.

But I don't think that an occasional (or even weekly) problem like this necessarily qualifies as "binge eating" in the clinical sense this diagnosis uses the term. It doesn't cause me all that much distress, because I know that I can almost always decide not to buy the M&Ms in the first place, and keep my house stocked with foods that don’t trigger serious overeating for me--even when I’m feeling the need to do some serious emotional eating. And part of what enables me to do that is believing that I’m not out of control when it comes to eating—I just need to be careful about applying my efforts at the right point in the chain of events that gets the food out of the store and into my mouth. For me, that means trying to make my decisions pretty early in the behavior chain--i.e, before the food is already in the house, and I'm obsessing about eating it. When I do that, I don't really feel out of control or spend a lot of time worrying about my eating. With true binge eating, things really are out of control, as with other forms of compulsive behavior.

It bothers me that the APA description of binge eating focuses so much on what the individual experiences during an episode of binge eating itself, and ignores all the other links in the behavior chain which lead up to the episode, or other emotional and practical problems that may contribute to binge eating, or factors that might help prevent it. But that’s a problem that runs all through the DSM diagnostic system. Most of the listed disorders are simply collections of symptoms, with no or little reference to context, situation, or other personal and social factors that influence a person’s thinking, feeling, or behavior. That may be necessary to facilitate rigorous scientific research and data gathering. But it’s often this background information that points the way to individualized solutions and treatments that work, and that needs research, too.

It will be great if including this new diagnosis of Binge Eating in the DSM prompts more awareness and more research to improve our understanding of this very real problem, and also gets insurance companies to support treatment. But we all need to remember that no person is just a diagnosis, and that no diagnosis provides a complete explanation for why people do what they do. No one binge eats because they fit the diagnostic criteria for "binge eating disorder." We do it for our own reasons, and those can be identified and changed. And we all have strengths and capacities we can draw on, with the right encouragement and support, to understand our problems, learn how to handle them better, and make choices that will help us feel capable and empowered. Sometimes, calling something a "mental disorder" can make it easy to forget those basic facts.

So, if you feel like you qualify for this diagnosis of Binge Eating disorder, don’t let that define you or limit your options. Look for the ways you can exert some control over your thinking, feelings, and choices before you find yourself in the middle of a binge. And get some help if you need it--working with a good therapist and/or support group can make all the difference in the world.

What do you think about this new diagnosis?


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Comments

  • LQUEST4754
    100
    As a person with lifelong difficulties knowing when to stop, I can see a need for a diagnosis. I have reservations that such a diagnosis could also be used against an individual. It is a double edged sword. - 2/18/2010   9:44:06 PM
  • ARTEMISR
    99
    I have awhile back learned that SP is not always a safe and supportive place unfortunately. And honestly we are not all coming from the same place. While most are here to lose weight, not all are even obese, and even among those of us who are or were, 200lbs and 400lbs still makes a difference in our experiences. And it's frustrating when people come on here and have never weighed 200 or more, or who have never struggled with real binge eating, who then feel that it is ok for them to judge and put down those who are or have. This should be a place where people are free from those kinds of judgments. And it is still always sad to see that it isn't.

    As far as why people need a diagnosis, let me share another analogy. I am mildly dyslexic. I was never tested growing up, despite having been put in a special english class in third grade, no one at my school thought "hey, let's actually consider real learning disorders and get these kids tested!" (I'm still kind of angry about this). It wasn't until college that it was discovered. I still don't need any special disability resources, I do not expect special treatment in classes, I manage just fine. But having a label made such a difference in the world. It made things make sense to me. I grew up, despite doing well in school and being very intelligent, often thinking I was actually, contrary to all that, very stupid. I was made fun of by friends for things I can now look back and see "I wasn't stupid, I was dyslexic!" Sometimes having a diagnosis and knowing something is real and what it means, in and of itself can be wonderful. It's not an excuse. I don't do poorly in my university courses and say "well I'm dyslexic so I can't help it". But I understand why still to this day I mixed up p's and b's in my writing and reading, and know it's not because I'm stupid.

    I feel the same way about most every diagnosis, there is a comfort in just understand that it's real, and knowing what it is. Whether the diagnosis is an eating disorder, a mental illness, a learning disability or a physical illness, sometimes people just need to understand why and realize it's a real issue. And in some cases, as with eating disorders and mental illnesses, the realness that comes with a diagnosis can lead then to finding out how to deal with it and get better. - 2/18/2010   9:21:16 PM
  • FOX2566
    98
    Binge eating as described in the prospectve DSM definitely is a compulsive disorder. I am always concerned about 'normal'things being labeled abnormal. But in this case, it is something out of bounds of anything usual. Probably appropriate to add it to the DSM. - 2/18/2010   8:53:23 PM
  • 97
    As you can tell this is a trigger point for me. I want to thank KIRAHALL for clarifying and explaining exactly what it means to use the DSM for diagnosis, how it is used and the purpose. I also appreciate the members who asked for tolerance and support and those who have braved the waters to share their stories, as honestly, this has really thrown me. Not only because of the negativitely and general lack of true understanding from members, its also weaved into the tone and message of the blog, written from a Coach. - 2/18/2010   6:03:02 PM
  • 96
    These issues come up in waves for alcoholism... "I got drunk at frat parties, & now I'm OK, why can't they just stop?"
    So- I'm glad the word is out- whether washing hands, playing on the computer, over eating, too much drinking.... if your life is out of balance, it's ok to go get help. Why sweat it so much folks? What's wrong with people needing help? Sometimes, sometimes, we all need help.
    & if Spark or AA is enough- then that's the amount of help THAT person needed. A life spiraling out of control is scary. - 2/18/2010   5:39:16 PM
  • JOY_IS_LOSING
    95
    Telling people they have a character flaw for being a binge eater is like telling the same thing to an alcoholic. Yes, I may be able to put down that drink or that fork, but I can see where it may be a serious problem for someone else. If someone is on SP, they are obviously trying to make their lives better. Commenting that they have a character flaw simply because you do not understand the problem, is very insensitive and hurtful. Shame on you. - 2/18/2010   4:37:23 PM
  • 94
    In regards to the comment that the DSM is simply a listing of symptoms and does not understand the underlying behavior and motivation I would like to add the following.

    I am a current Masters student in psychology, therefore current on the DSM and diagnositic material.

    The DSM IV works from a 5 axis model to diagnos and understand an individual. The 5 axis focus on different areas, axis 1 the major presenting mental illness, axis 2 any life long illness such as a personality disorder or developmental disorder, axis 3 focuses asks if there are any medical issues adding to the equation, axis 4 asks the biopsychosocial questions about family and support, and axis 5 is the "global assessment of functioning" given on a 100 point scale how the client is overall able to function given the whole picture.

    however, the problem remains you hear "binge eating" and people can easily think of that behaivor and state they have engaged in that. Such as having OCD means I'm really clean (not true!), therefore leaving diagnosing to professionals is important and understanding the HUGE amount of work that goes into researching and putting together the DSM would also be helpful.

    I know that many use the NOS (which is nessecary at times) to describe various illnesses that are not currently described in the DSM IV, so why not have more explanation and understanding about a disorder that people in the profession are seeing and treating?

    And, let's be real, treatment is not cheap and it would be helpful for people struggling to have insurance assist with their treatment cost.

    Well...those are my thoughts. - 2/18/2010   2:37:59 PM
  • 93
    I'm leaning towards the fact binge eating is a symptom not a disease or disorder.

    Or is this a method of calling it a disorder so that insurance would pay for treatment like so many other diseases/disorders (ADD) have done? - 2/18/2010   2:35:52 PM
  • HEALTHSEEKER57
    92
    Perhaps with a label we will see more research into treatment. - 2/18/2010   2:24:44 PM
  • 91
    One more comment regarding a piece you spoke about Coach Dean:

    Quote:
    It bothers me that the APA description of binge eating focuses so much on what the individual experiences during an episode of binge eating itself, and ignores all the other links in the behavior chain which lead up to the episode, or other emotional and practical problems that may contribute to binge eating, or factors that might help prevent it. But that’s a problem that runs all through the DSM diagnostic system. Most of the listed disorders are simply collections of symptoms, with no or little reference to context, situation, or other personal and social factors that influence a person’s thinking, feeling, or behavior. That may be necessary to facilitate rigorous scientific research and data gathering. But it’s often this background information that points the way to individualized solutions and treatments that work, and that needs research, too.
    End Quote:

    What I'm wondering about is how do you think mental illness, personality disorders and other disorders are diagnosed if not by the personal story? How are physical medical diagnosis done if not by the personal story? Your bio reads that you have college psychology degree, yet you question the validity of personal experiences and stories to create a mental illness/disorder diagnosis? That surprsed me as that is the basis of psychology, personal experiences, personal stories. Of all people you understand the DSM, how it is set up, the weakness and the strengths of this tool - it is a tool, not the end all and be all. There are also other tools, diagnosis are made in the framework of a team, it can evolve and change all the while providing the person with tools and support to move through the diagnosis. I fail to understand how that is an issue, that personal experience and story is used to dx (proposed) clinical binge eating - its that way for all, why would you think this would be so different? It is also the basis of diagnosis for physical illness that tests build upon but without the personal experiences, all the tests in the world won't really provide a solid diagnosis. For example, my experience with thyroid disease is that I showed false results on the blood tests and it was through tracking my personal experiences that my doctor was able to finally discover a test that is more true (although it also tends to do a false positive at times) and my medication is adjusted not only to my blood test results, its also adjusted to the experiences that I track, share with my doctor. Someone with a hidden disease will not walk into a hospital and *bang* a diagnosis is made by a magical test. Its the story that the person shares, its the lists of symptoms that are compiled that eventually lead the doctors and nurses to go "perhaps its cancer" or "perhaps its gout." All physical diagnosis is, is the similar vein as the DSM - a list of symptoms that the person experiences and there are times that for physical disease, there are tests. Not always. Look at the issues surrounding fibromyalgia - it is dx through symptoms and stories, there is no blood test to confirm dx. It is very underreported because there is so much skeptism. Very similar to the issues with mental illness. Remember that it wasn't that long ago that schziophrenia was seen as having more than one personality due to the devil living inside and causing havoc. One day in the future we may be able to map the brain and prove that certain changes occur with mental illness, until that time, all we can do is research, grow, evolve and yes, hear the person's stories to determine what is truly going on. Coach Dean, no therapist (etc) works as an island unto self, its takes a team approach and dx do evolve, change as much as the interventions itself. As I mentioned in my other post, if people are interested, do the research and really know what the purpose of the DSM is, how it is really used and how it should be utilized to assist folks to optimum mental and physical health. Last, the negative comments really reflect the continued lack of support and understanding regarding mental illness, personality disorders and other disorders. For me, its very sad that in 2010, we are still reading such negativity and lack of understanding. It is what causes folks like myself to hide - why would anyone come forward, only to be called weak, stupid and lazy? - 2/18/2010   2:20:14 PM
  • 90
    I too was a binge eating. I would always eat until overly full or eat even when I wasn't hungry. My portion control is much better now. I'm glad they finally recognize this as an actual problem because it is. I would like to see more help for people with this problem. - 2/18/2010   2:05:46 PM
  • BOYHOUSE
    89
    I was a binge eater. I regularly had binge episodes of eating that involved huge amounts of food (yes- even apples!!) This was beyond "pigging- out" and lack of willpower.This was about eating to beyond fullness and could not stop until totally stuffed. This was about feeling the complusion start and having no ability to stop it! This was about eating to the point of pain and finding sleep as a comfort. I found the binge eating to be numbing. I was in college at the time and had "will power" and control in my schoolwork. I was fortunate that I was near a major teaching medical center and had 2years of "talking therapy" with a psychiatrist in training- no drugs, no other diagnosis like depression or anxiety or bulimia. I do agree that SP can provide community support but the beauty of therapy (psychiatrist or psychologist or counselor) is the safe, non- judgmental place to discuss your feelings, the safety to explore the thinking prior to the behavior and during the behavior, and the exploration of why it keeps repeating! If you binge eat and feel that you meet the criteria, look for help.

    It is unfortunate to see so many negative comments associated with mental illness as well as comments that people should just have more control and restraint and that would solve the problem. Just reading the judgemental and negative responses, I think some don't quite understand nor relate with the complexity, self loathing ,and lack of control that is associated with binge eating.
    - 2/18/2010   1:55:36 PM
  • 88
    There is much behind the DSM that isn't discussed in this article, so I suggest if people are interest, do more research on how the DSM is set up, why it is set up how it is etc. DSM is constantly changing, what was a mental disorder in the past, is now removed because there is more understanding around the particular issue. I was someone who struggled years with binge, purge and didn't fit into bulemia or anorexia. My therapist and I talked it out, looked things over and named it as an eating disorder not specified. Why was that important? Because recognition is the first step to healing, the 2nd is intervention and when one is locked in that cycle, its very important that the intervention is appropriate and useful. Binging in the sense that it'll be a mental illness would be the extremes, the lack of control, the incrediable drop in self-esteem, the extreme compulsion to eat,eat, eat etc. When I binged, it wasn't for a hour or a few bags of chips. It was for hours upon hours of eating, my entire home filled with empty bags, dirty pots and pans, garbage overflowing, throwing up to make more room and doing it all over again, until literally fell down in utter exhaustion. It was tears, self-shame, hiding, disguist and yes, at times felt suicidal. Its more than buying a few candybars or overeating one night. It happens in a cycle, it take control of your life just as any eating disorder does. It has all the ear marks of OCD (obessive-compulsive disorder). Are people aware that there are different types of binges? That in my case, I'd eat left-over food from the garbage? That I would cook up food in ways that no one would ever normally eat because I didn't care, just give me food, food and more food. It's a hunger that is so deep that its unexplanable. It can last for days. It has nothing to do with biological hunger. It defined me as a person. When I recognized and acknowledged, I found support, understanding and was able to do the work to break through the barriers that stopped me previously from being a healthy person. It opened up doors for me to realize that it wasn't simply me being "weak" - it was a piece of a whole, the foods, the throwing up, the cycle, it all was a drug, as strong a drug as any street drug out there. It allowed me to stop thinking that I was shameful, disguisting and needed to "be strong." It opened up for me to really get down to the core abuse issues that led to that cycle of eating and being. When I'd try to explain to folks what I was dealing with and now, what I dealt with, I simply say "I struggle with bulemia." People don't get when I say "I struggle with binging, purging and starvation." (and no, I didn't quite fit the whole criteria for bulemia). When folks hear binging, they hear a person having too many cookies one night and don't understand that there is so much more to true down-right binging. Such as my bff, for her as Deb_Wilborn said, its a drug. She'll shut her door and eat for hours upon hours until she is utterly exhausted, then falls asleep. We've talked many long years about this. Yet since binging is seen as "emotional eating" and not taken as serious as someone who has anorexia, she's able to continue denying the effect it has upon her. I think that its a positive to have this come out on a more specific level. A member spoke well of the dangers of lay people simply reading articles pulled from the DSM and making diagnosis. Even myself, working in this area over 30yrs, I did not self-dx. Only a trained therapist, pyschologist, or psychiatrist who spends time with the person can diagnosis. Last to those who say its nothing, live in my shoes, my bffs shoes and you'll discover there is a whole other side to "simply binging." - 2/18/2010   1:49:27 PM
  • DEB_WILBORN
    87
    I have episodes of binge eating, but I've never been sure if it is a true disorder or just something that I do to cope with my emotions. I suspect the later, but that's for me. I have no doubt that others may suffer worse. I know that when I think about eating, it's like scoring a fix of a drug. Getting it feels almost as good as eating it - and it gives me a rush. We need to be very careful with looking at ourselves and others and deciding what we have - there's a reason people are trained to deal with disorders and it's because it isn't as simple as putting down the food. - 2/18/2010   1:14:29 PM
  • TRACYMUKLEWICZ
    86
    As a mental health therapist who uses the DSM, I want to clarify something that you addressed in your concerns Dean, and that's that the DSM is truly a list of symptoms. The reason that people don't diagnose themselves based on those lists is because for ethical use, it takes supervised clinical training and years of use before one can become proficient and appropriate at diagnosing with the DSM. A frustration of mine as a therapist is when people do exactly that...read a list of symptoms and decide that they do or do not have a disorder in there. When you speak to someone who is objective, trained, and takes a holistic look at the situation, that can help facilitate a more appropriate diagnosis, or no diagnosis at all. What many people don't realize is that binge eating disorder is already diagnosed currently, but under "Eating Disorder Not Otherwise Specified." I'm suspecting that's why the DSM V may add the diagnosis, to further clarify instead of using the NOS category.

    Unfortunately, our culture is very adept at diagnosis and treatment that often utilizes medication. There are numerous political and social reasons why disorders are classified in the DSM. Some have to do with drug companies and insurance lobbying. Some have to do with more social issues. Until we have the science and neuroimaging to truly diagnose a disorder medically, these gray areas will always exist. Rather than reading the DSM and deciding what you have, take a look at your own personal situation and focus on what you want to change. We all have internal resources to cope with and manage problematic aspects of any of the disorders in that manual, and if you'd prefer to settle into a disorder mindset, you can do that too. I, for one, would rather see people open to change and working towards their goals, rather than seeking a diagnosis and treatment to happen to them.

    I do fully recognize and support that there are physiological impacts alongside several of the mental health diagnoses, and medical doctors (including psychiatrists) can best support some of those issues. Medication is not a cure all, in many cases it alleviates the intensity of symptoms enough to benefit from other strategies. From a therapy standpoint, my experience is that people have more success when they focus on the strengths they have, support, and changes they can make within themselves rather than focusing on diagnosis. - 2/18/2010   1:00:33 PM
  • 85
    I'll have to sit on the fence with this one. I know that anorexia is a mental disorder, but binge eating??? I really can't put binge eating in the same catagory. - 2/18/2010   12:52:14 PM
  • 84
    I had to stop reader other member comments because some of you are just mean. People are here for community and support - so take your "know it all attitude" and stick it where the sun doesn't shine.

    I am 100% a binge eater - whether it is an officially recognized disorder or not. And even if it is - my doctor will still snicker at me when I tell her that there has to be something wrong with me.

    And for the record - my life is full and happy and I still binge eat.
    - 2/18/2010   12:52:06 PM
  • 83
    I agree 100% with MEL_UNRAU. It's surprising so many people are skeptical of it. The diagnosis will probably be slapped on people who don't really need it, but if this will help people who are suffering and do need to be treated for it, that's absolutely fantastic. There's overeating on occasion, buying that pack of twinkies you don't need and there's an unbearable urge to binge--we're not talking about the first thing here. I think compulsive overeating and binge eating are both overlooked eating disorders, and people who suffer from either need just as much help as somebody who suffers from anorexia or bulimia. Yes, it can often be caused by things like depression or anxiety (Is it ever NOT caused by something else???), but then using binging (or other ED behaviors) as a (faulty) coping mechanism becomes a problem in itself and ruins lives and even kill people. Maybe not by starving to death or tearing your esophagus apart with purging, but by killers like a stomach rupture, diabetes and heart disease to name just a few (although many anorexics and bulimics are affected by those too). Even suicide can become an issue if somebody is so miserable & trapped in eating disordered behaviors. Bulimia, anorexia or binge eating, they're all different means to the same end: emotional relief. I'm ALL for the DSM including this, though intelligent and insightful doctors/therapists/psychiatrists must already recognize it.

    Edit: WENDYRS: I just read your comment. You said it perfectly. I think the people who say it's just poor decision making really have no idea and haven't had to deal with it personally, so they don't understand the gravity of it. The way I think of it, it's like you need to do it so badly you feel like you could claw through a brick wall with your bare hands. - 2/18/2010   12:40:34 PM
  • 82
    Wendyrs - you beat me to it. I was just going to post a very similar comment.

    It takes a lot to look for help when suffering from a disorder. It takes a lot for alcoholics, drug addicts, and eating disordered to realize they need help and to search out that help. Kudos to those who have admitted to having the disorder in these comments. Maybe your admission will help others to recognize and seek a compassionate and professional network to help them overcome this disease. - 2/18/2010   12:31:29 PM
  • 81
    Be careful, the insurance companies will probably use it as a preexisting condition to deny you coverage on part of your insurance. As for binge eating itself, it is like alcohol and drugs and that is they are typically results of an underlying problem. Stress is my biggest culprit and do I really want a pill for that. No.......most medication might help one problem, but the side affects will cause more problems in the future. - 2/18/2010   12:27:49 PM
  • 80
    Having had this problem for years and suffered greatly, I am glad that someone is FINALLY recognizing not only the more "glamourous" eating and other compulsive disorders, but this one as well. - 2/18/2010   12:24:21 PM
  • 79
    MM's two for a dollar. Who could pass this deal up. Thinking ok I'll eat a couple which leads to both bags before the days over. The reason I'm heavy is buying junk and eating it till it's gone. Eating disorder or just a desire? I just don't buy those MM's very often. Maybe once a month and one bag not two. I'm worth it to pass on such a bargain! Progress not perfection. - 2/18/2010   12:20:18 PM
  • 78
    I have to weigh in on this (pun intended). To those of you who commented that people should take responsibility for their actions, and that this diagnosis should not be considered a full-fledged disorder, I say that you have not the slightest idea what it is like to live inside this body and mind. Binge eating is every bit as difficult to overcome as anorexia, bulemia, alcoholism, or drug abuse. In fact, it may be more difficult because we MUST eat to live. What compels me to drive to the store, buy junk food, and eat it before I pull in my driveway? Yes, perhaps years of therapy will help undo whatever emotional issue I am stuffing down my throat, but no amount of "just stop and think" makes me curb that behavior. It is frustrating, maddening, and out-of-control behavior that fuels guilty, shameful feelings about myself. Years ago, when anorexia was first diagnosed, people said the same thing: Just EAT something, already! It was later that people realized it wasn't as simple as all that. I tell the nay-sayers that binge eating is JUST as destructive, and JUST as difficult to treat, and is NOT just another way for people to get their insurance to pay for their supposed poor choices. Have some compassion. - 2/18/2010   12:11:50 PM
  • CKNY54
    77
    Simple question: if binge-eating becomes a bonafide mental illness that insurance and pharmaceutical companies can profit from, will we start to see the real-deal weightloss drugs come to market? - 2/18/2010   12:11:33 PM
  • LSIG14
    76
    I believe that a binge eating disorder is very like alcoholism or drug addiction. If you can overcome it on your own, more power to you - but if not, it needs medical intervention and treatment and I am glad that the medical community is recognizing it as being real, not just a lack of will-power. - 2/18/2010   12:01:19 PM
  • 75
    As usual Coach Dean--what you say makes a lot of sense. The DSMs have always struck me as psych "cookbooks". Efforts to make a discipline (that is as much art as science) easier for less gifted clinicians to learn. Also as a way to make psychiatry considered more of a "science"--something that it suffers from because other medical specialties often look down on it. I have had the privilege of working with some really gifted psychiatrists. They needed no 'cookbooks". - 2/18/2010   11:19:23 AM
  • 74
    By the description, I am not so sure that the definition of binge eating doesn't apply. I think it does. Absence of behavior does not equal absence of compulsion. In some cases it does, but not in all cases.

    Is an alcoholic who avoids bars and does not bring booze home not really an alcoholic?

    Of course s/he is still an alcoholic. They've learned how to cope, how to avoid triggers. Put a pack of cigarettes on my desk. See how long they last. Forever, or until I throw them away. No willpower required. No coping mechanisms necessary. My mother the nicotine addict, on the other hand, would have to exert almost superhuman effort to not smoke them, and she would fail.

    The ability to avoid triggers that lead to a compulsion is important to cultivate, but it does not cure the compulsion. - 2/18/2010   11:02:37 AM
  • 73
    I haven't even read the article. I will though here in just a second. No I don't believe binge eating is a official mental dissorder. But I believe a mental disorder like depression or axiety will cause you to binge eat. I do believe its a addiction. But not in it self a official dissorder. Binge eating always stems from something else like a lot of addictions do. - 2/18/2010   11:02:18 AM
  • 72
    Wow... I am actually surprised that there are people in the supportive place of SP that say that this is crap. I am thrilled to my toes that this is finally being recognized as an eating disorder. For people who have never experienced the uncontrollable need to binge, you can not comprehend the complexity of emotion. It is not simply about "making a decision to stop" or a character flaw... or really even an addiction, because that would mean you have some sort of "high" that comes with it. I personally have never experienced anything other than guilt, fear, and self loathing while binging. There are deep and viseral emotions that are tied to binging... much more than "I need to stop eating now". And it isn't always chocolate or pizza or fries or other emotional trigger foods that a true binge eater will eat. I have consumed more than a pound of raisins at a time. Yes, a pound of raisins. I am choosing to not reveal much more than that here, but know that having this as a diagnosis in the DSM is a wonderful thing. That for people like me, seeking treatment will be easier. And not all treatment is drug related. Yes, something being in the DSM means that they can now market drugs toward "curing" it. But, how many commercials do you see on tv for drugs to cure bulimia or anorexia? I never have because drugs cannot cure an eating disorder. But, because it will be in the DSM, insurance companies will start to cover the treatment. And that alone, will make it worth it. - 2/18/2010   10:54:39 AM
  • 71
    While I can understand some of the skepticism, I have had personal experience with this in my family. I've struggled some myself, but not to the point of my mom & sister especially who really do have a real problem. My sister has found real help and support at OA( Overeaters Anonymous). Her husband used to joke & tease her about it a little when they first got together because he'd never heard of anything like that, & thought it was like an excuse. And while this may open the door for misdiagnosis, & fraud, I hope it can really help some people. Some people really struggle, & feel like people will judge then, & think them weak. My own mom has never sought treatment , though I wish she would have . She went on every fad diet imagineable, and even ate nothing but chocolate chip cookies for 2 weeks straight. I was a kid then, but as an adult I can recognize that that isn't normal, and healthy behavior. I really do hope this might possibly better the lives of some people that are having a tough time, & atleast give them some support & direction. - 2/18/2010   10:50:11 AM
  • 70
    As usual, Coach Dean Anderson's writing is lucid and engaging. The problems with the Diagnostic Manual definition of binge-eating has been well canvassed by Dean, and I agree that much of what happens for the binge-eater is so tied to what occurs outside of the so-called binge-eating episode or period.

    But like the abused woman who experiences a brief honeymoon period of non-abuse by her partner, or even in the face of his long-standing promise that he will never lay another hand on her, there are those moments when she knows that he still wants to.

    Similarly, the possibility of binging is always lurking around the corner and even if I have all the resolve in the world and all the plan As and Bs in place, I am only one act away from the binge, and certainly only one thought away from wanting to.

    Ta, Reggie
    - 2/18/2010   10:27:24 AM
  • 69
    I'm skeptical of the DSM in general, but am very glad to see that binge eating disorder finally made the cut. Its hard to get treatment for anything not in the book and I think that being able to classify it will help people with binge eating disorder get the help they need. As the blog mentions, the criteria are based on measurable symptoms of the disorder, not anticedents or comorbitity, but that's the intent of the manual: to paint a picture of what the disorder looks like. I actually really appreciate the focus on the subjective experience of the binger, it seems like a far better way to really capture "out of control" eating than worrying about how many calories and when they are consumed. - 2/18/2010   10:27:14 AM
  • 68
    Yep Binge eatting was me in the past.
    I have gotten over it & I like the way I live now,THANKS!!! - 2/18/2010   10:26:47 AM
  • ZUMBA70
    67
    I also believe this is a form of "addiction". There is a strong history of alcohol addiction in my family. My sister and I truly, truly believe, as we are not addicted to alcohol - our addiction came out as a food addiction. I think places like Sparkpeople are great tools to try to overcome food addictions! - 2/18/2010   10:26:08 AM
  • 66
    I personally think it should be classified as an addiction rather than a disorder. - 2/18/2010   10:19:43 AM
  • 65
    If you read the criteria of binge eating disorder over at the link provided, you would see that it's not just "I ate too much X today." It's much more complicated than that. Just like clinical depression is not "I'm really sad today." It's episodic, periodic, and ongoing. And those (like me) who have never truly been afflicted with binge eating disorder cannot fully understand what it is. - 2/18/2010   10:00:50 AM
  • 64
    I like the idea of adding Binge Eating as a disorder. I agree there is a difference between binge eating and overeating. Indeed, when a person is binge eating, he or she is doing something different than the person who "can't believe she/he at the whole thing". This blog gave a lot of wonderful information and insight. I agree that the factors leading up to the binge eating are important. But in a diagnosis, I believe that only the characteristics of the behavior are included. I think that the factors leading up to the behavior would be something that 1. psychiatrists would want to learn about and 2. are the things discussed in therapy.
    Finally, I really appreciate that you added the last paragraphs - don't let the fact that something is a mental disorder allow you to abandon facts and strategies that we've learned. - 2/18/2010   9:57:29 AM
  • 63
    This article and the comments have been very interesting to me. I realized that I have never binged. I have overindulged, but I have always been in control. Not being in control would be scary. I'm not sure whether binge eating should be a symptom or a diagnosis. I'll leave that to the pros. - 2/18/2010   9:56:53 AM
  • JPUFFETT
    62
    I'm a little hesitant to say that binge eating is a mental disorder. I strongly feel that it may result from symptoms of another disability (i.e. depression), but not sure that eating disorders have enough roots to be claimed a 'mental' disorder on their own. Don't get me wrong -- I do feel as though eating disorders are serious and real (and that people who have them deserve all the help they can get), but I think they are triggered by many things...just not sure they can be diagnosed solely as a mental disorder. - 2/18/2010   9:48:46 AM
  • 61
    Does this mean then that insurance would have to pay for intervention? This would just be another reason for rates to increase for everyone.

    I don't think it should be considered a mental illness....a character flaw, perhaps, but not illness. Or at least some degree of it should be stipulated. - 2/18/2010   9:34:50 AM
  • ALICOTTER
    60
    Finally someone is realizing that not all eating disorders are about starving ones self. That there are emotional reason for eating and weight gain. YES. This is good news. To often people of size are made to feel like they are fat because they don't exercise (Some of us do, more than skinny people) or because they like food to much. Those with anorexia nervosa and bulimia nervosa have long been treated with compassion and understanding, because of the emotional issues connect to their illness. While those on the other side have been treated with ridicual and contempt.

    As I have blog many times, for me it has never been about being hungery, having cravings or liking a food. It has always been about using food to deal with emotions, usually bad ones.

    Like to think I am a recovering stress/emotional eater who used to binge eat. At the times when I binge ate it was never about the food. I got no pleasure from the food. It was all about eating to push the emotions down. I would continue to eat even if I felt full. I did not want to deal with the emotions so I would push them down literally with food. I had triggers. A visit to my mother for example would have me running for food as soon as I left, just to cope with the unhappy emotions.

    As a result even in recovery I have issues with food. I do not want to deal with it, think about it. I look for solutions which will mean I can have something healthy in the least amount of time.

    When not under stress food is not something I think about. I don't get cravings, can't really say I have ever been hungry. food is my drug of choice I use to self medicate when under stress. - 2/18/2010   9:34:06 AM
  • RLMCCUE
    59
    I guess I have reservations about binge eating being added to the DSM as an eating disorder, simply because I don't believe that there are truly effective ways of treating the disorder. I'm no doctor and this is just my personal opinion. I have a close friend who's anorexic and bulimic, and the treatment that she needs is so specialized and specific, it's much more complicated than just treating someone for, say, depression.

    It's hard for me to put my thoughts into words on this one. I truly believe that binge eating is a serious problem, but I also believe it would be hard to diagnose someone who truly has an eating disorder vs. someone like myself, who occasionally binges because of emotional issues, but not often and not the amount of food that someone with a serious problem has.

    I'd be interested in talking to my psychiatrist and therapist about this, just to get their opinions. Thanks for bringing this subject to our attention, I definitely feel like it's something to be pondered and discussed. - 2/18/2010   9:33:55 AM
  • BERNIE22
    58
    I believe it's bologna. Every once in awhile, I have a day where I crave carbs. Usually a weekend day like Saturday. As a mental illness, I don't see how it can be applied other than if it becomes a problem w/someone's life functions. Much too often, the 'experts' like to feel important and want notoriety so they place another 'label' out there. I feel bad enough about myself w/out any more add-ons for diagnosis. Definately need more research in this area. I used to trust the APA as a 'given' in data and know how, however, after getting educated and taking classes like Statistics, I learned that everything can be skewed to the Researchers bias. Everything! Didn't Freud change his mind about women's issues on rape and such because his peers pressured him? So I don't believe everything I read. I believe in the proof of my efforts. If my sugar's high, then I cut back on sugar (permanently) and watch my intake. If my water weight is up there, again, I watch my sodium intake. Am I becoming a little flabby? Okay I need to beef up the exercise or change it to 'trick' my body. I've come to the realization that the remainder of my life is taking care of my 'temple', the God given body I have of which, better than any house or car, needs love and attention. So, my temple is the expert, not someone with a bunch of credentials. - 2/18/2010   9:26:04 AM
  • 57
    I do think this information has some merit. There are times when I feel like I can't stop eating. I feel unsatisfied. I will eat almost to the point of being sick. I sometimes wake up in the middle of the night to eat. Yes just about everything we do is a choice. I do think that there are outside things that can trigger this. I would not or could not begin to judge those who say they have this disorder. I don't think I have it but I do know what it is like to feel (at times) like you can't stop. No matter what you do. Those people who are being judgmental on this don't appear to have a "real" weight problem. I peeked in on their pages and none that I looked at appear to be over 200 lbs. Just think though, how does a person really get to be 300, 500, 700 or more lbs? Let's be real, they have mirrors, they know that they are fat. most of them appear to be sane people. there is something there that is not allowing them to stop. I hope that people who really need some help will get it. - 2/18/2010   9:15:37 AM
  • 56
    I'm not qualified to speak about bulimia or eating disorders, so I won't.

    Like some earlier posters, I'm more concerned about the many labels we create--for ourselves or for others--and then use the labels to hide behind, satisfied to do nothing more than accept the label. A diagnosis should be a call to action, not an excuse to do nothing. I hope that's what'll happens here, but I'm not hopeful. And I agree with Coach Dean's concern about the focus of the proposal focusing on the end rather than on the whole process--a bit surprising, since psychiatry is USUALLY all about process. - 2/18/2010   9:03:34 AM
  • ARTEMISR
    55
    "I have never quite understood which is the difference between emotional eating and binge eating. "

    I will see if I can try to explain. For me, if I'm just emotionally eating, I'm sad, I had a stressful day, I come home- or might even go out! and eat some sort of comfort food. Maybe icecream. Maybe a lot more icrecream than I should eat, or maybe even really want to eat. I might even feel bad about it, and think "I shouldn't be eating this icecream. I shouldn't be eating based on emotional".

    But a binge for one, like others said, doesn't even have to be comfort food, though for myself I do tend to prefer it. But if I have to, I binge on whatever I can. I feel completely out of control, I want to stop but I can't. I feel guilty and awful the whole time. It feels like, just trying to stuff a hole in me or something. If I just keep eating maybe I can fill it, maybe it will go away, maybe I can keep eating to not completely lose it mentally. I will eat beyound feeling full, beyound feeling stuffed. I will not go out and binge. I may go out! I may go to the grocery store and fill a cart with cheesecake, bags of candy, containers of icecreams, cookies et cetera and go home and eat it all. I will not binge in front of someone else though. It's a very private ritual type thing. IOne of the most typical addiction type behaviors I had (in my mind, things I think of as distinguishing other addictions from "casual use" or whatever), was the financial aspect- knowing I had no money I still couldn't stop myself from ordering ford for delivery with my debit card and racking up a bunch of overdraft fees.

    It's hard to describe I think if you haven't experienced it. It's hard to describe the deep sense of complete self-loathing in a binge that is far beyond just feeling like crap or feeling guitly because I ate more tha I should have. - 2/18/2010   9:02:12 AM
  • ALYSCO2003
    54
    I found I had become a binge eater because I was following fad diets that had me omitting many foods or denying appropriate portions. Once I joined SP, I started eating more fat and protein and other items that were quote, unquote "unhealthy for me" and the binging ceased. I know that this is not the same for everyone but it was me. You have to think about it, many of us, for years try all the gimmicks and fads to lose weight before simply eating and eating moderately and portion-correct.

    I don't feel it's a disorder for myself but it was like a mini pandemic. I started something and it spread from my stomach to my body to mind. It took over until I was always eating - ANYTHING at times. I wasted money on things that never made it to my home from the store! It was so depressing.

    I'm so much happier now. - 2/18/2010   8:51:34 AM
  • 53
    I do not have any clue what it is like to drink a beer because I have to, to ignore gnawing emptiness in my stomach because I have to or get up 20 times a night to check the locks because I have to. I do however know what its like to eat for hours each night because I have to. Like other posters have already said it is not a matter of keeping all of the delicious foods out of the house. I have eaten boxes of saltine crackers, giant bowls of grits or oatmeal and loaves of plain bread if that was all that we had. It doesn't matter what it is as long as it fills me up. Believe one thing -this is not a choice. I do not choose the self loathing and physical discomfort or the shame and embarrasment that I feel when my husband and children wonder why we are out of foods the next morning. Why is it so much easier to think that heavy people are lazy? Like an alcoholic once told me when I asked him to *JUST STOP DRINKING*-- " If it was that easy to stop, it wouldn't be a disease'. - 2/18/2010   8:38:49 AM
  • LAURANCE
    52
    Oh, this is painful! Now that I'm getting old (68) the problem is not quite as intense. I'm getting better with age. But it's still there to some extent. And when I was younger, I fit ALL the criteria. It was horrible to be totally out of control, it was a nightmare.

    I have a problem with those comments which say we simply have to "get a grip" and "take responsibility". Being held "responsible" to do something does not mean that I am capable of doing it.

    "Take responsibility"? I could NOT stop. It was not something I was choosing to do. I was not choosing to refuse to "take responsibility". I was not choosing to refuse to "get a grip". I COULD NOT STOP. I had no choice.

    I'm glad for those who do have the power to make a choice to "get a grip" and "take responsibility". Good for you.

    But don't judge those of us who don't have that power.

    Now, I don't know what these DSM johnnies intend to do about people like me. I have no idea if creating this new "disease" will be of any benefit.

    But I do know that uncontrollable bingeing is for real. - 2/18/2010   8:36:30 AM
  • 51
    I've felt like this for years... I'd just feel this need to eat and then I would go and find something to eat (even if I had nothing at home, I'd go out to buy or order over the phone). It was terrible and I really felt like I couldn't stop or control it. Everyone I talked to about this would say that it was an excuse...
    But since I decided to change my lifestyle, this has happened like... twice or three times in about 2 months, so I guess my mind is feeling at ease now and I am really glad. - 2/18/2010   7:54:43 AM

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