Compulsive Overeating

Compulsive overeating, also known as binge eating, is a disorder accompanied with marked distress and at least three of the following: (1) eating very rapidly, (2) eating until uncomfortably full, (3) eating when not hungry, (4) eating alone, and (5) having feelings of disgust or guilt following overconsumption. This disorder is usually not accompanied by recurrent purging, excessive exercise, or fasting.

Compulsive overeating can also be secondary diagnosis as part of anorexia nervosa or bulimia nervosa. Compensatory behaviors such as purging and excessive exercise help differentiate between anorexia from bulimia.

Men, in general, make up 40 percent of the population of binge eaters. However, obese males who compulsively overeat attempt fewer diets, medications, and weight-loss supplements before seeking weight-loss treatment. These findings suggest less pronounced body dissatisfaction and fewer help-seeking behaviors by males compared to females.

Compulsive overeating is a serious medical condition with short-term and long-term consequences. In the short term, there are numerous reports of esophageal and gastric rupture due to overconsumption. These ruptures are life threatening. The long-term results can include obesity. The effects of obesity include hypertension, hyperlipidemia, coronary artery disease, diabetes, respiratory disease and congestive heart failure, liver disease, edema, gallstones, osteoarthritis, and an increased risk for certain cancers. These cancers include endometrial, breast, kidney, colorectal, pancreatic, and esophageal.

In addition to medical concerns, compulsive overeating is a nutritional issue. Most binges are high in foods with little or no nutritional value, usually consisting of meal high in fat and sugar with no complex carbohydrates or fiber.

Compulsive overeaters also suffer psychologically. Fifty percent of all compulsive eaters suffer from depression. The lower levels of serotonin that are found in binge eaters could mediate this. Drugs that maintain serotonin levels such as sertraline and prozac have been effective in treating compulsive overeating.

Behaviors associated with this disorder include a change in dietary habits, difficulty with social eating, and social and repetitive body checking. The majority of the participants would routinely pinch areas of their body to check for fatness and avoid wearing clothing that increases body awareness. Behaviors such as these point to the social implications of compulsive overeating and may be included with other symptoms of psychiatric disorders.

These behaviors plays a large role in compulsive overeating, allowing healthcare practitioners to use behavioral therapy, such as cognitive behavior therapy (CBT) and group therapy in treating this disorder. Seamore evaluated the effectiveness of group therapy for women with compulsive overeating. He found that with 6 months of group therapy, all participants demonstrated changes in dichotomous thinking, eating behavior awareness, and detachment from food. These dietary changes all led to a reduction in binge eating.

CBT acts to diffuse the fears and anxiety associated with compulsive overeating. By changing thought patterns and creating tools to address self-deprecating thoughts and fears, CBT has been shown to be an effective therapy. Recently, CBT has been combined with selective serotonin reuptake inhibitor (SSRI) treatment and has shown increased effective when compared to either treatment alone.