Can’t Stop Binge Eating

The word binge brings a distinct image to mind: A woman stuffing all sorts of foods—from cream puffs to chips to pizza—into her mouth at a frenzied pace. For some, this is pretty close to reality.

Take now-recovered binger Kristin Gerstley, 27, of Houston. Her typical binge: hitting multiple drive-throughs—McDonald’s for a Quarter Pounder and fries, Taco Bell for nachos, and more. “As I got the bags, I’d pretend to check off the items on a fake list I’d created,” she says. “I didn’t want anyone to think I was ordering all that food just for myself.” After paying, Gerstley would drive to a secluded area of the restaurant’s parking lot and (before she even knew it) eat it all.

Gerstley’s overeating may sound extreme, but it’s more common than you think. Earlier this year, ground-breaking research out of Harvard University–affiliated McLean Psychiatric Hospital showed that Binge Eating Disorder, or BED, is America’s most common eating disorder. According to James I. Hudson, MD, ScD, a psychiatry professor at Harvard’s McLean Hospital and lead author of the study, bingeing is “extraordinarily underrecognized, both by health professionals and by the public at large.”

If BED is more common than anorexia and bulimia combined, we wondered how many more women are struggling with lower-level bingeing—the kind that has you downing a box of cookies without thinking because you’re hungry from dieting or inhaling a bag of chips when you’re angry.

What we found: Almost all of us have binged. In a Health.com poll, 82 percent of respondents said they’d gone on a binge where they felt they couldn’t stop eating, and more than half reported uncontrollable urges to eat until physically sick.

What’s going on? Are we all treading into eating-disorder territory? Or just having high-caloric lapses in judgment? Here, what you need to know about the bingeing epidemic.

Anatomy of a binge
You eat a whole basket of chips with salsa while waiting for a friend at a restaurant. You nibble on a donut, only to find you’ve eaten three before even finishing the morning paper. Are these binges? Yes. While the clinical level of bingeing identified in the Harvard study is defined as uncontrolled eating at least twice a week for at least six months, most experts call any uncontrolled eating “bingeing.” The key words: “Loss of control,” Harvard’s Hudson says.

The number of American women with the clinical bingeing disorder hovers around 5 million, while the number of women who mini-binge at a more moderate level may be about three times as high, estimates Roger Gould, MD, associate clinical professor of psychiatry at the University of California, Los Angeles, and author of Shrink Yourself: The Ultimate Program to End Emotional Eating. And frequency, Gould believes, isn’t that important. “When people are binge eaters, they’re binge eaters—whether they do it once a month or once a week.”

For sure, dietary lapses come in all shapes and sizes. Kathy Hardesty’s last binge was chocolate-induced. The 57-year-old from Pismo Beach, California, received a one-pound box of chocolates as a gift, and ate the whole thing within 24 hours. Brenda Messer, 45, does the occasional binge boomerang between sweet and salty. “Before you know it, forget about the bag of chips and the Ben & Jerry’s—they’re both gone.” The 1,000-plus women who answered a Health.com poll binged on everything from tacos to Twinkies, mashed potatoes to marshmallows.

Whatever the food, the binge impetus is almost always emotional, experts say. Any negative thought, from insecurity to anger, emptiness to self-doubt, can kick-start overeating. But why is turning to food such a common coping mechanism? “Food helps change our conscious experience. We go into a bubble,” Gould says. “Everything feels all right, and nothing can get to us.”

Kathy Hardesty binged be- cause of loneliness and money worries, she says. Brenda Messer was under family and job stress. Both ate to get away from their troubles and did feel better—for a while.

This escapism is actually a form of denial, Gould says. “Food becomes a medication, a tranquilizer. Often, an addictive cycle of eating for emotional relief is born: “I feel bad. I can escape it by going on a binge.” Then you wake up from that and crash because the other part of you clicks in, the part that thinks, “I shouldn’t have done that.” And it doesn’t matter if you’re escaping by raiding the fridge, hitting three fast-food drive-throughs, or finishing off a pint of Rocky Road. The end result, Gould says, is typically a wash of guilt, which can prompt the entire cycle to repeat.

Shame, in fact, is another defining characteristic of binge eating. “Binge eaters feel they’ve let themselves and others down,” Hudson says.

This is reinforced by society, which tends to regard binge eaters as people who have “let themselves go” or “indulge in ‘pigging out,’” he says. Bingeing can be physically devastating, too. Overeating, as we all know, can lead to obesity and a host of associated diseases including hypertension, high cholesterol, diabetes, joint problems, and certain types of cancer.

Your brain on a binge
Just how do we get from eating for fuel to this dangerous eating to feel good? It all starts at birth, says L.A.-based nutritionist Jonny Bowden, PhD, author of The 150 Healthiest Foods on Earth. “A baby cries, and he’s fed,” he says. “So in the very first instance of learning, food is associated with survival, with having our needs met, with satisfaction.”

Over time, that once-simple hardwiring can become jumbled as parents use food to pacify youngsters or teens discover food as a cure for boredom. “You are overlaying the pathway with more emotional tones. There are very short steps from that to ‘I had a fight with my boyfriend. I’d better eat everything in sight,’” Bowden says.

He also believes there’s a biological reason we tend to crave high-carbohydrate, high-fat items (whether it’s two Twinkies or even a whole box)—the neurotransmitter serotonin.

Associated with satiety and feeling good, serotonin is delivered in the form of tryptophan, an amino acid. To reach the brain, tryptophan needs insulin. The theory, Bowden says, “is that high-carb foods produce insulin, ushering tryptophan to the brain and producing higher serotonin levels. The result, he explains, is like “instant Prozac.” No wonder chocolate and Cheetos seem to call out louder than salmon and brown rice.

Add to that the evolutionary response to stress, which prompts our bodies to produce cortisol. Originally designed to help us, say, escape a herd of prehistoric animals, cortisol signals the brain to refuel with (what else?) high-carb, high-fat food. Today, though, that stress signal can be a traffic jam, a spousal spat, a deadline at work. “Our bodies no longer distinguish between running away from a woolly mammoth and getting the kid to soccer practice on time,” Bowden says.

All of these factors help trigger that feel-better binge. But there’s more. All of this is taking place in what Hudson calls today’s “toxic environment”—a society that caters to sedentary lifestyles; easily available, high-calorie snack foods; the wealth to afford such foods; and ever-mushrooming portion sizes.

There’s also a genetic component. In a study published last year in the Archives of General Psychiatry, family members of obese individuals with BED were twice as likely to suffer from the illness as were family members of obese relatives with no history of binge eating.

The dieting factor
There’s yet another piece to the binge puzzle—dieting. With an estimated 40 to 50 percent of American women trying to lose weight at any given time, feeling deprived becomes another common trigger. In fact, in a food-diary study done by Gayle Timmerman, PhD, RN, associate professor at the University of Texas at Austin School of Nursing, women who binged had consumed about 750 calories less the day before they binged.

“The women may have felt deprived, which perhaps contributed to their loss of control the next day,” she says. A follow-up study in 2003 found that feelings of deprivation and preoccupation with food were not related to actual calorie intake, but to chronic, unsuccessful dieting behavior, which may sabotage effective weight management.

Such was the case for Joyce Huh, 20, from Cupertino, California, who says she’s “usually pretty good about keeping tabs on my eating habits in the daytime” (i.e., a tuna sandwich on wheat bread and water for lunch, a large salad with minimal vin-aigrette and a piece of pita bread for dinner). But, Huh says of a recent binge, “At 10 p.m., I was starving and couldn’t take it anymore. I had a bingefest with all the health-food snacks I could find. I figured these snacks would help monitor my ‘portion control,’ but that wasn’t the case. Fat-free popcorn, hunks of dark chocolate, cheese and crackers, cinnamon graham crackers: I ate it all! And felt disgusted with myself afterward.”

Archana Vijayan, 31, believes repeated dieting is what ultimately led her to seek solace in sweet and salty foods. When weight crept on postcollege, she began dabbling in numerous weight-loss plans. The pounds would drop—and then return with a vengeance. With each new diet, Vijayan says, she adopted new, unhealthy eating habits, including bingeing.

Dieters’ attempts to limit carbs can also set them up for bingeing, says Cynthia M. Bulik, PhD, director of the University of North Carolina at Chapel Hill Eating Disorders Program. “If you haven’t eaten for a while or have been eating low-carb, you may not have enough serotonin in your brain to feel full, or the fullness signals aren’t being read correctly by the brain, so you keep eating past the brain’s stop sign,” she says.

That may be compounded by the fact that we tend to be speedy eaters when we’re very hungry. “Our rate of eating is faster at the beginning of any meal. And when we’re food-deprived, we eat even faster,” Bulik explains. “If you’re famished and food is put in front of you, it feels like torture to unfold the napkin properly, have premeal chit-chat, and attend to all of the etiquette issues when what you really want to do is grab a roll and pop it in your mouth pronto.”

Putting the brakes on emotional eating
It’s easy to avoid a dieting-related binge, experts say: Make sure you have several small meals throughout the day so you don’t feel so deprived that you speed-eat the chips and salsa before dinner. And don’t restrict satiety-inducing carbs to the point where you never feel satisfied.

Dealing with the emotional issues that fuel bingeing, however, isn’t quite as simple as timing meals or managing carbs. For many, the feelings that trigger the cravings and overeating are almost unconscious. That’s why mindfulness has become the number-one way to gain control. How to start? Nutritionist Bowden says you need to get in touch with the feeling that triggers the binge.

Instead of numbing whatever it is—loneliness, frustration, anxiety—with food, ask yourself, “What am I really feeling?” Then ask, “If I eat this food, or go on this binge, what will it cost me?” Most cravings pass within 15 minutes, he says, so if you can fight the urge to eat while exploring the underlying trigger, you’ll be working on your issues while keeping the overeating at bay.

Eating sans distractions may also help you savor food instead of inhaling it. “Make a deal with yourself that you can eat what you want, but you must sit at the table,” Bowden says.

Eating mindfully, rather than trolling through the kitchen or zoning out in front of the tele-vision, actually helps you pay attention to what you really need. In fact, a recent University of Rhode Island study found that if a woman places her fork down between bites of pasta, then purposefully chews 15 to 20 times, she realizes that she’s fuller faster—and she ultimately consumes about 70 calories less per meal. Stress-reduction techniques such as yoga or walking also may help reduce the negative feelings that trigger emotional eating.

Other treatments for serious binge eating are still being researched. A number of studies have tested medications, particularly those that target serotonin receptors in the brain. These may help some people, but not all. What does seem to work well is cognitive behavioral therapy, which teaches individuals how to monitor their eating and change unhealthy eating habits, particularly in sticky stress-induced situations.

Ultimately, getting your out-of-control eating in hand is hard work, but it can be done. Take control of your life today.

Have a great day and God bless!