Binge eating disorder - DAI

Content

Introduction

Introduction

Binge eating disorder (DAI) is characterized by the presence of recurrent binge eating episodes. Affected people feel the urgent need to consume huge quantities of food in a short amount of time, even if they are not hungry.

The binges are often planned in advance with a particular type of food purchased for the occasion.

People who have this disorder report that at the time of the binge they are unable to have any control over their eating behavior and, in rare circumstances, report having had a "state of lightheadedness" - particularly if the binge occurred during the binge. night - and not being able to remember what they ate.

Usually, binges happen in private because after eating, people feel embarrassed, ashamed, or even hate themselves for their behavior.

Sometimes, binges alternate with periods in which the amount of food you eat is substantially reduced. This can lead to a vicious cycle that is hard to break up, where blood glucose levels rise and fall rapidly and wrong messages reach the brain resulting in cravings for food even if the body doesn't need it.

Who develops the disorder

Anyone can be affected by binge eating disorder (DAI) and it is estimated that the probability of experiencing it at any given time in life is 1 in 30-50 with no significant distinctions between men and women, unlike what happens for other disorders of nutrition, such as anorexia (read the Bufala) or bulimia, which are more common among women than men.

The disorder tends to manifest itself for the first time in young adults but very often up to the age of 30-40 people do not become aware of the problem and do not ask for help.

Ask for help

Eating too much occasionally doesn't mean you have a binge eating disorder. However, if binges become frequent and have an effect on physical and mental health conditions, it is advisable to contact the family doctor who, after a thorough examination, will be able to ascertain (diagnose) the presence, or not, of the disorder and advise to contact to a specialist such as a psychologist or psychiatrist.

During the visit, the family doctor will ask questions about your eating habits and will try to identify if the following behaviors are present:

  • eating faster than normal during binges
  • eating until feeling uncomfortably full
  • eating large quantities of food even without being hungry
  • eat alone, or secretly, because of the embarrassment you feel about the amount of food you eat
  • having feelings of guilt, shame, or disgust after binging

If all of these behaviors are present, there is likely to be binge eating disorder.

Causes of binge eating disorder

To date, the causes of binge eating disorder are not fully known but, as is the case with many other eating disorders, DAI is considered a behavior aimed at coping with feelings of unhappiness and low self-esteem.

Factors that can increase the risk of developing it are:

  • low self-esteem and lack of confidence
  • depression or anxiety
  • feelings of stress, anger, boredom, or loneliness
  • dissatisfaction with your body and pressures to be thin
  • having experienced stressful or traumatic events in the past
  • presence, in the family, of eating disorders that may suggest a genetic predisposition
  • differences in brain control mechanisms or levels of hormones produced, compared to individuals who do not suffer from the disorder

Binge eating disorder can sometimes develop following a strict diet, particularly if you skip meals and completely eliminate certain foods. Using very restrictive or unbalanced diets to lose weight can increase the likelihood of bingeing.

How to treat binge eating disorder

DAI can be cured and most people will be able to get better with the help of dedicated therapies. Among these, the main ones are:

  • therapist-led self-help programs or self-help programs
  • interventions by a specialized group
  • individual psychotherapy, such as cognitive-behavioral therapy
  • drugs belonging to the group of serotonin reuptake inhibitors

If, in addition to psychological factors, there are problems of overweight, it is also advisable to contact a specialist in the sector to develop a weight reduction plan to be undertaken together, or immediately after, to therapies to solve the psychological aspects.

Risks associated with binge eating disorder

Binge eating disorder can be associated with serious psychological problems, including anxiety and depression, which can worsen over time.

Another possible consequence of the disease is weight gain which, in some cases, can lead to obesity and increase the risk of developing associated alterations and diseases such as, for example:

  • high cholesterol levels (hypercholesterolemia) and high blood pressure (hypertension), factors that increase the risk of cerebro-cardiovascular diseases such as stroke and heart attack
  • diabetes, a chronic disease resulting in an increase in blood glucose levels
  • osteoarthritis, disease that causes pain and swelling in the joints
  • some types of cancer, such as breast and bowel cancer

When you realize you have a binge eating disorder, it is therefore important to ask your doctor for help and undertake the specialist treatment path as soon as possible.

Binge eating disorder and bulimia

Although similar to bulimia nervosa, binge eating disorder has some differences.

In fact, in bulimic people, binge eating is followed by attempts to get rid of ingested food, for example by inducing vomiting or taking laxatives.

Individuals with binge eating disorder, on the other hand, do not use these methods to get rid of ingested food, but try to control their weight by alternating periods of binging with periods in which they eat very little.

Therapy

Therapy

Binge eating disorder is generally treatable, and most people can benefit from appropriate help and support. The main therapies are:

Self-help programs

A self-help program is often the first step towards recovery. There are several and it is important to choose the one that is most suitable for the specific case also on the advice of the family doctor. The specialist, psychologist or psychiatrist, can encourage the person with ADI to read self-help books; in these circumstances we speak of guided self-help programs. For some people, the self-help program alone may be enough to overcome the problem.

Psychotherapy

Psychotherapy can help address the psychological problems underlying the disorder.

The three main treatments (therapies) used are:

  • cognitive-behavioral therapy (CBT) for the DAI, an adaptation of CBT that consists in finding new ways of "seeing" situations, feelings and food
  • adapted form of dialectical-behavioral therapy (DBT), a treatment aimed at improving the ability to control and regulate emotions
  • interpersonal therapy (IPT), care focused on relationships with others and the role they play in influencing eating habits

Such treatments can be very effective in helping people with ADI, although it is not known how long their effects last.
Especially in the early stages of therapy it is common to experience periods when the disorder improves (remission) and periods when it gets worse (relapse).

Selective Serotonin Reuptake Inhibitors (SSRIs)

In some cases the doctor may prescribe an antidepressant belonging to the category of SSRIs, alone or in association with a self-help program.

SSRIs increase the levels of a substance, serotonin, in the brain, resulting in an improvement in mood and eating habits. However, the long-term effects of this treatment in people with DAI are not known.

Common side effects (side effects) associated with the use of SSRIs are:

  • feeling agitated, shaking or anxious
  • feeling or being unwell
  • indigestion
  • diarrhea or constipation (constipation)
  • loss of appetite and weight loss
  • dizziness
  • blurred vision
  • insomnia or excessive sleepiness
  • reduced sexual desire

They often improve over time but some may persist.

Weight loss

The therapies described do not act directly on weight, however, weight loss may occur if you are able to control binges and above all, if the treatments are associated with regular exercise.

If you are trying to lose weight, your family doctor or nutrition specialist (dietician / nutritionist) can come up with a balanced diet plan that will help you lose weight healthily. The diet can be combined with other treatments or it can be started after dealing with and resolving psychological problems.

The diet plan includes:

  • keep a food diary in which to report the reasons that push to binge and the type of food that is taken during the binges
  • eat regular, scheduled meals and never skip them
  • eating healthy snacks between main meals to overcome the feeling of hunger
  • do not eliminate any food from the diet, yesi may be encouraged to include certain unhealthy foods in the diet to reduce the need to overeat
  • follow a balanced diet, with the number of calories controlled and recommended by the family doctor or by a specialist (nutritionist, dietician)
  • exercising regularly, most adults should perform moderate physical activity for at least 150 minutes a week

It is important to lose weight in a healthy way. A too strict diet and the absolute prohibition of certain foods can even worsen the DAI.

Bibliography

Bibliography

NHS. Binge eating disorder (English)

Ministry of Health. Eating disorders

In-depth link

In-depth link

De Virgilio G, Coclite D, Neapolitan A, Barbina D, Dalla Ragione L, Spera G, Di Fiandra T (Ed.). Consensus Conference on Eating Disorders (ED) in Adolescents and Young Adults. Rome: Higher Institute of Health, 2013 (ISTISAN reports 13/6)

Ministry of Health. National guidelines for nutritional rehabilitation in eating disorders.Notebooks of the Ministry of Health. 2017, n. 29

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