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binge eating disorder Archives - Suzanne Wallach

Is Obesity An Eating Disorder?

Obesity-eating-disorder

Eating disorders are serious mental illnesses that are characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes several different types of eating disorders, all of which are categorized under the Disorder Class: Feeding and Eating Disorders. While obesity and eating disorders are linked, it would be inaccurate to claim they are one and the same. One publication asserts that “obesity is a heterogeneous condition with a complex and incompletely understood etiology, and thus cannot be considered a mental disorder per se.” Hence, most medical experts do not label obesity as an eating disorder, nor is it included in the DSM-5. 

What Is Obesity?

Obesity is essentially an abnormal or excessive fat accumulation that presents a risk to one’s health. Harvard Health explains that the healthy range for body mass index (BMI) is between 18.5 and 24.9, overweight is defined as a BMI of 25 to 29.9, and obesity is defined as a BMI of 30 or higher. Obesity is associated with serious health problems (e.g., diabetes, coronary heart disease, cerebrovascular disease, colorectal cancer, etc.). Although it is not recognized as an eating disorder, obesity accounts for far more morbidity and mortality than all the eating disorders combined because it is much more prevalent. More than 30% of Americans are obese, compared with the 4% of Americans who meet criteria for anorexia nervosa, bulimia nervosa, or binge-eating disorder, according to the American Psychological Association. This issue continues to rise and has reached epidemic proportions, as over the past five years, the obesity rate among adults aged 18 and older in the United States has increased an annualized 1.8%, amounting to 33 people per 100 individuals. An estimated 300,000 deaths per year are due to the obesity epidemic, which makes it the second leading cause of preventable death in the United States. 

There are many factors that can play a role in the development of obesity, such as genetic influences, caloric intake, exercise, stress and more. Obesity is a common comorbidity (i.e., the simultaneous presence of two or more diseases or medical conditions) of certain eating disorders. Those who struggle with obesity, for example, may also struggle with anorexia as a method of controlling one’s food intake in the hopes of weight loss. Research indicates that “there is a significant co-occurrence of eating disorders, particularly binge eating disorder, in individuals with higher BMI.” Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at greater risk of these than individuals with either condition alone. Both obesity and eating disorders require medical intervention.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How To Recover From An Eating Disorder?

Eating-Disorder-Recovery

There are several different types of eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and each is categorized under the Disorder Class: Feeding and Eating Disorders. They are serious mental illnesses that are loosely characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. The pervasive symptoms associated with any type of eating disorder can cause adverse physiological consequences and interfere with one’s ability to adequately function in daily life. Although eating disorders are life-long conditions, with proper treatment and support, a person can learn to effectively manage its symptoms. 

Treatment Process

There are a variety of eating disorder treatment options available. The path of recovery will not be the same for everyone, as everyone is unique with distinct needs. A personalized treatment plan will provide an individual with the highest potential for a successful recovery. Depending on the nuanced needs of the individual, the treatment process could include any combination of the following components:

  • Inpatient treatment: intensive, inpatient treatment can help address severe malnutrition and other physical health complications that have developed from one’s eating disorder, settings may include:
    • Hospitalization
    • Inpatient facility
  • Psychotherapy: there are a variety of therapeutic modalities used to help treat individuals with eating disorders and may be integrated into treatment plans, some of which include, but are not limited to:
    • Cognitive behavioral therapy (CBT): can be used to help an individual break unhealthy behavioral patterns associated with his or her eating disorder by identifying and replacing dysfunctional patterns.
    • Dialectical behavior therapy (DBT): DBT can benefit a person diagnosed with an eating disorder by helping to foster self-management skills, lower stress, reduce anxiety, and learn to control destructive eating behaviors.
    • Interpersonal therapy (IPT): IPT focuses on how a person’s communications and interactions with other people affect one’s own mental health. Through interpersonal therapy an individual will learn to resolve and adjust unhealthy interpersonal problems, resulting in a symptomatic recovery.
  • Medications: there are certain medications that may be used in in treatment plans for eating disorders:
  • Anorexia nervosa: the FDA (US Food and Drug Administration) has yet to approve any medication specifically for the treatment of anorexia nervosa. 
      • Bulimia nervosa: the only medication that is approved by the FDA for the treatment of bulimia nervosa is the SSRI (selective serotonin reuptake inhibitors) known as Prozac (fluoxetine). 
      • Binge-eating disorder: The first medication the FDA approved as treatment from binge eating disorder is called Vyvanse (lisdexamfetamine). Antidepressants such as SSRIs (e.g., Prozac) could be prescribed to reduce the frequency of binge eating episodes. Anticonvulsant medications, such as Topiramate, could be prescribed to reduce the frequency of bingeing episodes. 
  • Nutritional counseling: to facilitate weight restoration and body-weight management.
  • Medical care and/ or medical monitoring: to minimize and mitigate possible medical complications that can arise from eating disorders

The treatment plan for an individual diagnosed with an eating disorder will be directly informed by several contributing factors, such as: the exact diagnosis, how long he or she has been actively engaging in unhealthy eating habits, his or her personal health history, and the presence of any co-morbid disorders. The goal of eating disorder treatment is to help an individual find a healthy and sustainable relationship with food. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Identifies As An Eating Disorder?

What Identifies As An Eating Disorder?

Eating disorders are complex psychological conditions that are characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. The National Institute of Mental Health (NIH) specifically defines eating disorders as “serious medical illnesses marked by severe disturbances to a person’s eating behavior.” There are different types of eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the Disorder Class: Feeding and Eating Disorders. The three most common types of eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. There is no single, identifiable cause as to why someone develops an eating disorder. Research has, however, indicated certain biological, psychological, interpersonal, and social risk factors that have been noted to increase one’s susceptibility for developing an eating disorder.

Three Common Types

Anorexia nervosa is characterized by behaviors including unreasonable and unhealthy habitual food restrictions, over-exercising, abusing diet pills, abusing laxatives, and/ or fasting. An individual struggling with bulimia nervosa experiences frequent episodes of binge eating (eating excessive amounts of food in short periods of time) followed by purging (attempting to rid the body of the food by vomiting, fasting, and/ or excessively exercising). Binge eating disorder is particularly like bulimia nervosa, except an individual with binge eating disorder does not follow up his or her binge eating behaviors by purging. Instead, the individual internalizes the binge eating behaviors which ignite inner turmoil and unwanted emotions (e.g., feeling disgusted, ashamed, guilty, distressed, etc.) because of his or her excessive over-eating. Eating disorders can have debilitating effects and interfere with one’s ability to adequately function in his or her daily life. 

Signs and Symptoms

Every person is unique and will exhibit a distinct set of signs and symptoms as they relate to the presence of an eating disorder. Furthermore, the type of eating disorder an individual struggles with can influence the signs and symptoms experienced. The Mayo Clinic provides a list of examples of behaviors that could be indicative of an eating disorder, some of which include the following: 

  • Obsessively focusing on healthy eating
  • Skipping meals 
  • Withdrawing from social activities
  • Making excuses for not eating
  • Adhering to an overly restrictive diet 
  • Preparing separate meals when eating in a group instead of eating what everyone else is eating
  • Excessive exercise
  • Constantly checking the mirror and/ or pointing out perceived flaws
  • Using laxatives, herbal weight loss products, and/ or dietary supplements
  • Regularly excusing oneself during meals to use the restroom
  • Eating in secret
  • Expressing disgust, shame, and/ or guilt about one’s eating habits

The combination, severity, and duration of symptoms is influenced by the type of eating disorder present as well as the individual. If left untreated, continued malnutrition that occurs with an untreated eating disorder can lead to severe short and long-term consequences. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

 

Are Binge Eating and Borderline Personality Disorder (BPD) Connected?

Are Binge Eating and Borderline Personality Disorder (BPD) Connected?

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. It characterized by a pervasive pattern of instability in interpersonal relationships, self-image issues, and difficulty managing emotions and behaviors, which interfere with one’s ability to function in everyday life. Although there is no single cause of borderline personality disorder, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” Akin to BPD, the exact cause behind why individuals develop eating disorders remains unknown, but research has found that it is likely due to a combination of psychological, biological, and environmental factors. 

 

Binge eating disorder (BED) is listed in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a severe, life-threatening eating disorder. According to National Eating Disorder Association (NEDA), it is characterized by “recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.” Binge eating disorder is currently known to be the most common eating disorder in the United States.

 

Are They Connected?

Yes, binge eating, and borderline personality disorder are connected. More so, research has found an undeniably strong relationship between borderline personality disorder and dysregulated eating behaviors, such as binge eating. The symptoms of BPD often result in reckless and hasty actions, negatively affecting one’s relationships. Some highly regarded professionals in the mental health field suggest that it may be that the symptoms of BPD play an active role in the development of binge eating disorder. For example, common symptoms of BPD such as chronic impulsivity and urges to self-harm could lead to an individual engaging in detrimental eating behaviors, which would subsequently increase one’s susceptibility for developing an eating disorder. Conversely, engaging in dysregulated eating behaviors may cause an individual to experience overwhelming stress, which may trigger BPD in someone with a genetic vulnerability for the disorder. The prevalence of eating disorders is about 6 to 11% in those with borderline personality disorder, which is far greater than individuals with an eating disorder in the general public that amount to an approximate 2 to 4%. Hence, the rate of BPD in people with eating disorders is notably elevated when compared to the general population.

 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.