Comfort eating: the new mental illness

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London - When life gets stressful, do you find yourself reaching for the biscuit tin, or for a large bag of crisps? Or maybe you’ll treat yourself to a big bowl of ice cream after a bad day at work. But then that one biscuit leads to another – and another. Do you ever find you just can’t stop?

You are far from unique. Experts say that for a significant number of people, a treat can repeatedly turn into a full-blown food binge.

Indeed, so common is this behaviour that it has now been officially classified as a new type of eating disorder: binge-eating disorder.

The diagnosis has recently been added to the influential US Diagnostic and Statistical Manual of Mental Disorders (DSM) – the psychiatrists’ “bible”.

This will give binge-eating disorder the same psychiatric importance as anorexia and bulimia.

So what characterises this new disorder and will the diagnosis really make a difference to sufferers?

“People suffering from binge-eating disorder tend to be overweight and, in addition to this, have phases when they regularly binge eat – but without the purging behaviour associated with bulimia,” explains Christopher Fairburn, professor of psychiatry at Oxford University and a leading authority on binge eating.

Those affected often suffer from depression, and the binges are almost always done in secret.

People who are extremely self-critical may be particularly prone.

Sufferers have a long-standing tendency to turn to food in response to emotional issues, says Fairburn.

“When binge eating, people can’t stop eating once they’ve started – and many can’t resist starting in the first place,” he says.

 

It’s not the same as being greedy

Binge-eating disorder causes great distress – and prompts a huge amount of self-loathing afterwards.

“This is different from greed, which is about letting your hair down, going for it and enjoying it,” Fairburn explains.

Self-loathing is certainly an emotion that 23-year-old Hayley Bennett recognises only too well from her own eating problems.

These date back to when she was 8 years old and was called “fat” by another child at school.

The taunt led to a preoccupation about her weight, and she became introverted and miserable. Food became both her comfort and her “enemy”.

“At the age of eight, I was a bit chubby but unaware of it,” she says.

“Maybe I’d just have lost that weight naturally in time, but as it was, I became obsessed with my body – and with food. I thought about it all the time, but I never ate from hunger.”

Hayley says that starting a binge – which she always did in secret – would bring a sense of relief and satisfaction, but afterwards she would find herself filled with self-hatred.

“I did have some hurtful comments from others about my weight, but it was mostly that I was so hard on myself; so self-critical. I felt I could never live up to having the perfect, slim body that I wanted.

“Like me, my parents thought that if I lost weight I would be healthier and happier. Like me, they had no idea I had an eating disorder.

“My mom and my teachers tried to help me by encouraging me to eat healthily. In retrospect, though, saying that I couldn’t have a dessert when other children were having them just made me want one all the more.”

By the age of 11, Hayley was already sneaking food.

“I couldn’t just have one KitKat, I’d have to have a pack of six,” says Hayley, a graduate who lives with her parents.

Her worst binge was a large family bag of Doritos and two of the biggest blocks of Dairy Milk chocolate, one after the other.

Hayley’s binge food of choice was almost always chocolate – and there are good biological reasons why it’s fatty and sugary foods that binge eaters choose, say doctors.

Fat and sugar trigger the release of endorphins and dopamine – the body’s feel-good chemicals, inducing a natural high. But when this recedes, guilt and depression set in.

“You feel like you’ve sabotaged yourself again,” says Hayley. “You just feel so disgusted with yourself, and out of control.”

Perhaps not surprisingly, those who suffer from binge-eating disorder are usually overweight (although they can also lose weight, even significant amounts).

The weight gain is because they overeat generally, not because of the binge episodes, says Fairburn, who is director of the Centre for Research on Eating Disorders at Oxford.

This excess weight means they are also at risk of other serious health risks associated with obesity, including type 2 diabetes, high cholesterol, heart and gall bladder disease.

 

Why dieting won’t help

Most sufferers think – like Hayley – that they just need support with dieting and may consult a GP or join a dieting programme.

Experts stress, however, that it’s vital the underlying psychiatric problems are tackled first.

“I knew that what I was doing was not normal or right, but it never occurred to me I might have an eating disorder,” says Hayley. “I thought I had a weight problem.”

Fairburn says a great deal of research has gone into how to help people lose weight and to discover why some people overeat.

“Some researchers believe it’s a genetically determined problem, while others think it is more the product of our food-rich environment,” he says. “In fact, it is likely to be the result of both. Moreover, obese people do not all behave in the same way.”

Hayley agrees: “I feel many health professionals don’t understand that you can be overweight and have an eating disorder.

“I also think people in general see a fat person and think you’re lazy and greedy, and that you’ve got into this situation because you just love food. I didn’t love food, although I was obsessed with it.”

Treatment that encourages a person who is already obsessed with food to focus on it still further could do more harm than good, says Julia Buckroyd, emeritus professor of counselling at the University of Hertfordshire.

In many cases, dysfunctional eating patterns were developed in childhood.

Buckroyd says that a number of recent studies have highlighted the fact that obesity and overeating are attempts to “control an overwhelming internal anxiety state”.

“Typically, many people who are significantly obese are emotional eaters,” she says.

“Human behaviour – however bizarre or destructive it may be – does have meaning.

“These people are trying to make themselves feel better, even if, of course, they’re not doing this in actual fact.

“They need help to find ways of coping other than food.”

 

Binge eaters are not always fat

Another complication is the fact that people with eating disorders do not always fit neatly into the established diagnostic categories.

Binge eating is common to those with binge-eating disorder and bulimia, for instance – and it occurs in some people who’ve tried and failed to keep to a strict diet.

It is therefore interesting that people with binge-eating disorder can, and do, lose weight periodically – and often dramatically.

Hayley herself has successfully lost weight three times on very low-calorie diets, losing 12-20kg in about three months – only to find it creeping back on again.

“Although binge-eating disorder sufferers have a tendency to be overweight, it is also common for them to have periods of successful dieting which may last for months at a time, and periods of overeating when they also binge,” says Fairburn.

“As a result, their body weight may change markedly from month to month and year to year.”

But how important is it, in fact, to have a diagnostic label for patients with binge-eating disorder?

“I’d say the disorder is right on the edges of what one would want to call a mental illness,” admits Fairburn.

“People with binge-eating disorder undoubtedly have a problem, but whether you would want to call it a mental illness is questionable.

“If raising it to a diagnosable condition helps them get the help and recognition they need for their problems, then yes, I’d say it’s a good thing, and its inclusion in the DSM (US Diagnostic and Statistical Manual of Mental Disorders) is helpful.

“This should, in the future, help GPs to recognise it as a separate disorder and enable the patients to get the correct help.”

He adds that this ought to help prevent people being prescribed antidepressants unnecessarily. “Antidepressants have a valuable role to play in treating many conditions, but they will not tackle the root causes of binge-eating disorder,” he says.

(Before bulimia became a recognised illness, sufferers were often prescribed antidepressants, but this changed once the condition became understood.)

Men who are affected might find it doubly hard to get the correct diagnosis and treatment, as many health professionals associate eating disorders with women, says Sam Thomas, of the charity, Men Get Eating Disorders Too, in Britain.

In fact, binge-eating disorder affects men and women equally, whereas with anorexia and bulimia it is mostly women who are affected.

“Many men don’t realise they have an eating disorder,” says Thomas. “They’ll know that they have issues with food, but it often won’t occur to them to think that they could be suffering from an eating disorder and need help.”

 

People binge when upset

IT was Keith Addison’s wife, Suzanne, who first realised her husband had a problem. The 34-year-old father-of-three had begun bingeing when he was 14, around the time his parents split up. He was bingeing daily – saving up his pocket money and bus fares to blow on food to eat at home.

“I wasn’t very popular at school and used to get bullied, so this was my treat for getting through the day,” he explains.

On a bad day, he would eat a sponge cake, a tin of custard, two dozen packets of crisps, two packets of biscuits, a block of cheese, a packet of instant mashed potato, a packet of stuffing with gravy, and a 24-pack of chicken nuggets. His mother never saw it because she got home late.

With hindsight, Keith says the problems relate to the changes in his family life after his parents split. Instead of sitting down to meals together, he’d eat alone while his mother was at work.

 

Keith’s bingeing was compounded by depression.

 

Suzanne has taken practical steps to help Keith control his weight – including doing all the family shopping – and he’s lost 29kg.

His weight had reached 140kg, but today he weighs 111kg and he’s recently started seeing a psychologist to help him understand what makes him binge eat.

For Hayley, finding someone to talk through her problems also marked a turning point. At 19, she sought help from a student counsellor and was offered cognitive behavioural therapy. This helped her take her first steps towards recovery – part of which has involved sharing her eating experiences in a blog.

Today, she is about to start a new job and feels her future is looking brighter than for many years. – Daily Mail

 

FACT FILE

* Binge eating has officially been classified a new type of eating disorder.

* Those affected are often depressed and extremely self-critical.

* Those with binge-eating disorder are often overweight, but…

* They can and do lose weight periodically – and dramatically.

* The disorder affects men and women equally (unlike anorexia and bulimia).

 

*Christopher Fairburn’s book, Overcoming Binge Eating, has a self-help programme based on cognitive behavioural therapy. It sets out key strategies, including monitoring eating patterns, weighing yourself every week and establishing a habit of eating three proper meals a day. Other sufferers may need a personally-tailored programme devised by a psychologist.

“The important thing is to empower people to gain lasting control over their eating and take charge of their health,” says Fairburn.

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