Combating Binge Eating

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Hardly a night passes when I don't stare down a chocolate chip cookie, until, in a flash, I break. Before I know it, I scarf down the entire thing. When done, I forget about it and get on with my life.

As nutty as my routine sounds, it's just that: a little nutty. But according to some psychiatrists, there's a cadre of men and women, maybe as much as 4% of the population, whose problem is far more serious. They suffer from a controversial and little-recognized syndrome called compulsive binge eating disorder. Sufferers don't merely give in to a couple of cookies. They inhale an entire package or down a whole pizza when a slice or two would do. The episodes are short, intense and replayed over and over.

Think this describes you? Probably not. I'm the first to criticize the idea of turning every normal human habit into a full-fledged pathological problem (does each child who throws a tantrum deserve the diagnosis Attention Deficit Disorder?). But a group of experts insists that binge eating disorder isn't a harmless variation of what we all do, but a distinct, troublesome syndrome. Though we don't need another eating disorder to worry about, I'm inclined to agree. "Binge eaters are totally preoccupied. When they're not binging, they're worried about binging," says James Hudson, professor of psychology at Harvard Medical School. "It completely interferes with their life."

Most binge-eating experts see the disorder as a form of bulimia nervosa, in which people eat compulsively and then purge, usually by vomiting. Binge-eaters will complete the eating part, but not bother purging. Beside the sheer quantity of food consumed, there are other signs of a sincere problem. Bingers tend to indulge in the evening or at night, not around normal meal times. Episodes last under an hour, during which 1,500 calories or more are consumed. Afterwards, besides feeling unbearably stuffed, bingers are ashamed and guilt-ridden. More women than men are afflicted, but not disproportionately so, as with other eating disorders. About 60% of binge eaters are women versus 40% men, compared to anorexia nervosa where 90% are women. But most important, binge eaters tend to suffer from underlying psychological problems, like low self-esteem, generalized anxiety or depression.

The condition can be treated, so if you still think this describes you, speak to a doctor. Just last month, researchers at the University of Cincinnati found that binge eaters who took the antidepressant Celexa for six weeks decreased the number of binge episodes they experienced. Only 40 patients were studied, so the results are still preliminary. Other antidepressant drugs, like Prozac and Zoloft have already been shown effective in cases of binge eating's relative, bulimia. Most likely they work because antidepressants normalize levels of serotonin, a brain chemical that doctors think may be involved in controlling appetite. Practitioners also report success with cognitive behavior therapy, alone or in combination with medication. The therapy focuses on abnormal attitudes toward food and the psychological underpinnings fueling the binge-eating episodes.

The fact that treatments work should leave no doubt in anyone's mind that binge eating is a real medical condition. So, the next time you surrender to a cookie or two or even five, be grateful that the rest of the pack remains on the table.