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Overcoming Binge Eating – Chapter 4

In this chapter of the book Dr Christopher G. Fairburn deals with the psychological and social problems associate with binge eating.

Again, just for the record, I am neither bulimic nor anorexic but as I read this chapter, I found that could relate to issues like the diet-binge cycle, the effects of this cycle (and being highly concerned about my appearance) on my moods and relationships, plus the character traits common among those with binge eating problems.

Binge eating may be an isolated behaviour, but in most cases it is associated with other problems – some may a consequence of binge eating, others may promote the binge eating and some may result AND encourage binge eating which causes a vicious cycle that is difficult to break. An example of this kind of behaviour is dieting (most people who binge also diet) as it neither be classified as either a cause or effect of binge eating.

Dieting often precedes binge eating, but it also a response to binge eating. It is most obvious in bulimia nervosa and anorexia nervosa, where the dieting is generally extreme to the point of fasting. In binge eating disorder, dieting tends to be less extreme and intermittent, not continuous, and these people alternate between phases of successful dieting and periods of overeating which may continue for years if left untreated. (Because dieting is one of the main factors that contribute to bingeing, treatment is geared at reducing the tendency to diet.)

Dr Fairburn goes on to tell us that there are 3 types of dieting: avoiding eating (fasting between binges), restricting the overall amount eaten (calorie restriction) and avoiding certain types of food (those perceived as “forbidden” or “bad”). There is also mention of dieting in other guises, practiced by those who influence their weight or shape by changing their eating habits and justifying it by attributing it to things like food allergies or being vegetarian. What he says is that if you practice any form of dietary restriction to influence your weight or shape, you are “dieting”.

When strict dieting is practiced, failure is inevitable and this may be extremely demoralizing which in turn leads to binge eating. This vicious cycle operates among those who adopt strict dietary rules, not all those who binge.

Measures for controlling shape or weight are covered next – self induced vomiting, laxative and diuretic misuse and over-exercising.

It was interesting to read that most people are ignorant of the fact that self induced vomiting only purges a maximum of 50% of the calories consumed in a binge. Even the use of “markers” (such eating tomatoes at the start of a binge to ensure that all food has been purged when they reappear) is entirely inaccurate as food in the stomach gets churned around and it’s never a case of “first in, last out”.

Other misconceptions revolve around the use of laxatives and diuretics (water pills) – neither of these eliminate any excess calories, but they do make people feel “cleaner” and less bloated, so that’s probably the main reason for people using them.

Over-exercising is common among those with binge eating problems, particularly bulimics and anorexics. They feel compelled and driven to exercise to the point where don’t eat anything until they feel they have burned up enough calories to justify the intake of food.

All these measures may encourage further binge eating and perpetuate the cycle.

Most people who binge are highly concerned about their appearance and weight. Many tie their self esteem into their appearance and are terrified of weight gain. Some may weigh themselves up to 15-20 times per day and measure themselves continuously. Shame over how they look can interfere with their day-to-day life and many may withdraw from society and isolate themselves. This obviously has many detrimental effects on their mental health (depression is common), moods and their relationships. These people may become completely preoccupied with food, extremely anxious and unable to focus on anything else which can lead to them finding it difficult perform everyday activities such as reading, conversing or even watching tv. Some binge eaters, although overweight, are still very concerned about their appearance and may develop feelings of disgust and self loathing. Some refuse to look at their bodies or allow anyone else to see them. Binge eating problems can affect every aspect of life.

There are certain character traits that are common among those with binge eating problems: low self-esteem, perfectionism, all-or-nothing thinking and impulsivity.

Chapter 5 will cover the physical problems associated with binge eating.

Information about previous chapters can be found here:

  1. What is a Binge?
  2. Binge Eating, Eating Disorders and Obesity
  3. Who Binges?

Overcoming Binge Eating – Chapter 2

I haven’t had much time to read in the past week, but yesterday I finally got around to Chapter 2 of this book by Dr Christopher G. Fairburn. I didn’t find it too riveting (I’m waiting for the “solutions” part of the book), but it was mildly interesting nonetheless.

In this chapter, Dr Fairburn states although the awareness of eating problems and disorders is growing, the meanings of terms such as “disorders”, “bulimia”, “slimmers disease”, etc. has become blurred. He goes on to say that not all binge eating is classified as a problem and that if it is, it may or may not be 1 of 4 eating disorders:

Bing Eating is a problem if the quality of life is impaired. The 4 classifications of disorders related to this problem are: Bulimia Nervosa, Binge Eating Disorder, Anorexia Nervosa and then Other Binge Eating Problems.

So, what that means is a person who binges may not necessarily have an eating disorder, depending on whether or not it can be classified as a “problem”.

Bulimia and anorexia are closely related – both disorders are the result of problem binging, relative to the person’s normal food intake and both involve an excessive concern about shape and/or body weight that goes beyond just feeling fat or unhappy with the physical appearance. In the case of bulimia, the person must regularly use a method to control weight, such as self-induced vomiting or laxatives. Most people with bulimia have chaotic eating habits and, like anorexics, may fast or eat very little in between binges. In the case of anorexia, the person must be significantly underweight and they do not regularly use extreme weight control measures although they may exercise excessively. About 30% of anorexics binge, with the size of the binges being relatively small (it may just be a few cookies), but they still lose control. Anorexia may develop into bulimia.

Binge eating disorder is similar to bulimia, except for the fact that the person does not take extreme weight control measures. Not all people with binge eating disorder are overweight.

  • Bulimia Nervosa = binge problem, excessive concern about body weight/shape, extreme weight control measures
  • Anorexia Nervosa = significantly underweight, binge problem, excessive concern about body weight/shape,
  • Binge Eating Disorder = binge problem, excessive concern about body weight/shape

According to Dr Fairburn, classification and descriptions of various eating problems and disorders is an ongoing process and there seem to be discrepancies amongst professionals as to how to accurately identify and diagnose them. I’m not entirely sure where exactly I fit into all this as he doesn’t go into any detail about “Other Binge Eating Problems” but bulimia and anorexia definitely don’t apply to me.

Chapter 3 will explore who binges, the issue of detection and the rate of increase.