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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