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Binge Eating Disorder Linked to Social Anxiety

The Vicious Cycle of Binge Eating and Social Isolation

The connection between negative body image and anxiety around social interactions is extremely common, and often has its origins in the pre-teens.  The usual pattern follows a predictable path:  Adolescent is bullied about their appearance, size, or weight which ultimately causes the victim to seek solace in the safety of their home.  When other kids are out attending dances or football games, someone with a negative body image sits in their bedroom, saving the world from having to even look at them.

Self-disgust over perceived flaws become unreasonably magnified, causing anxiety, which in time can lead to a desire to quell these negative emotions.  Many times the individual being teased about their weight or appearance buys into the cruel criticism about their looks, and begins to believe they are so unappealing to look at that they might as well save others from having to look at them.  This results in a social phobia or social anxiety, where intense fear becomes associated with being in a social setting where one can be judged.

To manage this anxiety, some young people resort to substance abuse—drugs and/or alcohol to ease the emotional pain caused by the bullying and self-disgust.  For some, the substance abused is food.  The repetitive cycle that emerges is very similar to a substance addiction, with many of the same characteristics present.

What is Binge Eating Disorder?

Binge eating disorder (BED) is exactly what its name implies:  Recurrent episodes (versus occasional overeating) of eating large amounts of food in a subconsciously attempt to numb negative emotions, such as a deep sense of worthlessness, shame, and self-loathing related to a negative body image.  The consuming of excessive amounts of food has become a BED when the following criteria are present, as defined by the Diagnostic Statistical Manual (DSM-5):

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
    • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  2. The binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.
  3. Marked distress regarding binge eating is present.
  4. The binge eating occurs, on average, at least once a week for 3 months.

The binge eating is not associated with the recurrent use of inappropriate    compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

BED is the most common of all the eating disorders, with about 3.5% of women, 2% of men, and 1.6% of teens suffering from it.  It can lead to various debilitating health risks, such as diabetes, high blood pressure, sleep apnea, heart disease, and gallbladder disease.  Just as devastating, living with a BED can severely curtail one’s ability to function socially, at school, or at work.

A study out of Yale University in 2012 examined the link between social anxiety and the eating disorder psychopathology in BED.  By studying 113 participants with BED who were administered a battery of tests and participated in various clinical interviews they were able to conclude that there was higher levels of social anxiety were associated with binge eating frequency in patients with BED.

What does BED Look Like?

There are certain characteristics common among those who suffer from BED.  Like a drug or alcohol addiction, people suffering from a BED obsess about their next binge episode, planning for it and going to great lengths to hide it from others.  Also, like with a drug addiction, there is an inability to cease using the food in a self-abusive manner, even though the negative consequences are beginning to cause them great distress, such as weight gain and social isolation.

Signs that a loved one may have a BED include:

  • Finding empty food wrappers hidden under beds, in closets, drawers, etc.
  • Secretive food behaviors, like stealing, hiding or hoarding food, and insisting on eating alone
  • Unusual eating patterns develop, such as not eating at the usual mealtimes, eating all day long, skipping meals, developing food rituals, engaging in fasting or repetitive dieting

In addition to the tendency to avoid social situations where they feel they will be ridiculed and teased, other co-occurring mental conditions may be present, such as depression.  The vicious cycle of shame and self-disgust over their negative body image leads to the use of food as a form of temporary comfort, which then leads to self-loathing and depression after they have binged—just entrenching the problem further.

Casa Serena can Help

At Casa Serena, we understand that one of the first steps in treating an individual with BED is to identify the source of the emotional pain that has led to the disorder.  Cognitive behavioral therapy (CBT) is considered the most effective treatment modality for identifying the triggers and thought patterns, and replacing them with healthy thought and behavioral responses.  The compassionate staff at Casa Serena helps to navigate those with a BED towards the healthy, productive life that they deserve.  Contact us today at (925) 682-8252.

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/22152497

http://www.eatingdisorderhope.com/treatment-for-eating-disorders/co-occurring-dual-diagnosis/anxiety/body-image-and-social-anxiety

https://www.nationaleatingdisorders.org/binge-eating-disorder

Calling Binge Eating what it is…a Real Disorder

Understanding the Very Real Dangers of BED

When people hear the terms ‘anorexia’ or ‘bulimia,’ most understand these words to represent complex mental health disorders that result in disordered eating.  For decades now, public awareness of the serious emotional issues that underlie anorexia and bulimia have helped people understand the validity of these dangerous psychiatric conditions.  However, upon hearing the term ‘binge eating disorder,’ many may wrongly associate it with simply a lack of self-control or a character flaw rather than as a bona fide disorder.

On the contrary, binge eating disorder, or BED, was recently added to the revised Diagnostic and Statistical Manual (DSM 5), recognizing it as a valid, diagnosable illness.  By adding BED to the DSM it gives health professionals specific diagnostic criteria that will aid clinicians in identifying and assessing the disorder, leading to effective treatment decisions for those struggling with BED.

What is Binge Eating Disorder?

Because the word “binge” has been used loosely to describe compulsive behaviors such as binge-watching a TV series, or “binging out” on ice cream after a break-up, there is a tendency to dismiss a binge eating disorder as just a reckless overindulgence in food that has resulted in weight gain; just as binge-watching on Netflix results in lost productivity.  It is a misnomer though, as BED usually has co-occurring mental health conditions that drive the disordered eating, which can result in dire health and psychological outcomes.  These comorbid mental health conditions include:

  • Anxiety
  • Bi-polar disorder
  • Depression
  • Substance abuse

Binge eating disorders affect about 2.8 million adults, according to a 2007 national survey by Biological Psychiatry.  Of those who suffer from BED, 5.2% will die from health complications that resulted from the disorder.  Shockingly, BED is more prevalent in adults in the U.S. than both anorexia and bulimia combined.

Those who suffer from BED use food to manage emotions they do not want to experience.  These unwanted emotions include anger, boredom, guilt, stress, sadness, or a sense of being out of control.  Someone with a BED will attempt to offset these emotions with the pleasure they anticipate they’ll feel by consuming vast quantities of comfort food on a recurrent basis.

BED is also accompanied by a fixation on body image, leading to compensatory behaviors after over-indulging in the food, such as vomiting (although purging is not a common trait in BED), using diuretics or laxatives, or over-exercise.  Despite the serious psychological and sociological issues that underlie BED, the disorder is often misdiagnosed as simply an issue with weight.

Diagnostic Criteria for BED

The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder as such:

 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
  • Eating much more rapidly than normal
  • The binge eating episodes are associated with three (or more) of the following:
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward
  • Marked distress regarding binge eating is present
  • The binge eating occurs, on average, at least once a week for 3 months
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

 Signs and Symptoms of BED

Although there are a multitude of variations of BED, there are certain signs and symptoms that someone may be suffering from this serious disorder.   By being aware of these signs, the chance for successful treatment of the disorder is made possible.  Some behaviors are displayed that may be predispositions for developing an eventual BED, but not necessarily.  Regardless, awareness is key in helping a loved one with a mental health condition such as BED.

Emotional characteristics of BED

  • Depression, social isolation, and moodiness
  • Feelings of anger, shame, anxiety and worthlessness preceding the binge
  • Negative or distorted body image
  • Rigid thinking
  • Perfectionist tendencies
  • Need to be in control
  • Conflict avoidance

Behavioral characteristics of BED

  • Eating secretly, hiding, stealing, or hoarding food
  • Disappearance of large amounts of food, empty wrappers or containers indicating large quantities of food consumed
  • Periods of impulsive or continuous eating beyond the point of feeling full, but does not purge. Eating fast, or eating large amounts of food when not hungry
  • Creating rituals allowing for binge sessions
  • Extreme rigidity with food, with periodic dieting/fasting

Effects of BED

A binge eating disorder can put someone at risk for developing several serious health conditions, including heart disease, type 2 diabetes, or high blood pressure, mostly due to obesity or radical weight fluctuations.  Because of the comorbid psychiatric conditions, a BED can also lead to a substance abuse disorder, which in itself can lead to death.

In addition to the physical effects, a BED can cause the sufferer to become disengaged from their normal responsibilities, eventually becoming unable to keep up with their obligations.  A BED can also affect relationships, due to the secretive behaviors and shame that may cause the sufferer to withdraw from loved ones.

Because BED is often a misunderstood condition, it is important to seek help from a provider who is an expert in the field of treating eating disorders.  At Casa Serena, our specialized professionals use evidence-based treatment methods in a caring and supportive environment to effectively treat BED.   Allow our compassionate staff to restore you or your loved one to good health and renewed quality of life.  Call us today (925) 682-8252!

Sources for this page:

http://www.bingeeatingdisorder.com/what-is-BED.aspx

http://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-myths-facts

https://www.nationaleatingdisorders.org/binge-eating-disorder

http://www.huffingtonpost.com/kenneth-l-weiner-md-faed-ceds/binge-eating-disorder_b_3346760.html

http://www.ncbi.nlm.nih.gov/pubmed/16815322