I witnessed firsthand the struggles of binge eating disorder with one of my sisters starting in the 1970s.

Although no such diagnosis existed at the time, I can recognize it now. Beginning in her teens and continuing into adulthood she exhibited all the classic signs and symptoms. Unfortunately, doctors, dietitians and even our own family thought it was just a lack of willpower. This kind of guilt trip only worsened the disorder. My sister binged even more and became morbidly obese.

About 3.5 percent of women, 2 percent of men and 1.6 percent of adolescents in the United States reportedly struggle with binge eating disorder—but experts believe the numbers are even higher than that. In fact, since defined as its own disorder in 2013, binge eating disorder (BED) has become the most common of all eating disorders.

But it’s not hopeless—there are many methods available to help take control of it.

First, as with many addictions, the disorder needs to be identified. With BED people are not always aware of the problem and there are no specific tests to diagnose it. However, identifying behaviors and testing for hormone imbalances can help unlock the mystery.

The first step in identifiying binge eating is knowing the common behaviors.

Here’s what it looks like:

BED episodes can include periods of out-of-control eating. The first, and most easily identifiable, behavior is eating too fast and continuing to eat even after feeling full. Many will also eat in secret out of regret or embarrassment. Different from other eating disorders, adults with BED do not try to undo their actions by regurgitating their food or over exercising. They might also be diagnosed as overweight or obese, which is also more common among BED patients than those with other eating disorders.

But such behaviors only hint at the possibility of BED. Diagnosing and learning to control it require a thorough understanding of each individual’s unique condition.

Working closely with BED patients, I’ve found that most have some history of trauma and many exhibit other co-occurring disorders—such as depression, anxiety and sleep apnea. For BED to be diagnosed, it is imperative that patients undergo comprehensive medical and psychological assessments.

Genetic testing can also help identify individuals who are predisposed to BED and other eating disorders. Such studies are ongoing, and the data is preliminary, but the work is promising and may soon provide a standard for identifying high-risk individuals through their genetic makeups.

One of the most effective measures is through hormonal testing. Chemical and hormonal balances in the brain and throughout the body play significant roles. For example, the adrenal hormone cortisol provides our bodies with energy when we’re stressed, so if our bodies don’t produce enough cortisol, then the lack of energy BED patients experience in times of stress can trigger binge eating events.

In addition to cortisol, other hormones should be checked to ensure their proper balance—including thyroid hormones, sex hormones and insulin. Those who suspect they have BED should undergo tests for conditions that are related to it—such as metabolic syndrome, diabetes, hypothyroidism (especially in women), sleep apnea and cardiovascular disease. The results of these tests and assessments create a pool of knowledge about the disorder that can be used to effectively combat it.

Once we know there’s a problem, several avenues can help control compulsive eating, including these three effective tools:

1. Group support.

As with all complex psychological disorders, recovery requires both individual and group support. I use the word recovery deliberately because we are learning that BED shares many traits with substance use disorders such as with alcohol and opioids. We can even see many of the same areas of the brain being activated when it is viewed with a functional MRI.

2. Cognitive behavioral therapy.

Cognitive behavioral therapy —or CBT—encompasses a variety of treatment modalities designed to address the psychological motivations behind the disorder. Understanding cognitive influences, such as certain situations that trigger binge eating episodes, can help address the underlying causes of the disorder. Working with a therapist who specializes in BED offers a better chance at successful recovery. In some cases, cognitive behavioral therapy may also include appropriate pharmacotherapy, particularly for patients who exhibit hormonal imbalances.

3. Mindfulness.

Mindfulness, a subcategory of CBT, is a significant factor in making recovery last. As with cognitive behavioral therapy, it’s key to work with someone who’s trained in mindfulness to help with implementing guided meditations and new thought processes during recovery.

If a hormone imbalance is a driving factor of the condition, the patient should recognize the imbalance and the importance of taking prescribed medications to help. Patients should also be mindful of situations that can trigger binge eating episodes and avoid them or seek strength from support groups.

Fortunately, this story has a happy ending. After many decades of suffering, my sister finally got the treatment she needed. She is now living a healthier, happier and productive life that is free from debilitating self-criticism and self-guilt.

Recognizing and understanding our disorders is the crucial first step to controlling and overcoming them. The good news is that no one is alone. Millions of people are affected, and each person can control their condition with the right tools and support.

 

Relephant:

My Body—A Poem about Eating Disorders.

6 Ways to Become the Champion of Your Eating Disorder.

Author: Dr. Mark Calarco

Image: Flickr/Curtis Perry

Apprentice Editor: Cori Carlo; Editor: Emily Bartran