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Ask the Mental Health Expert Archives 2001-2004

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Binge Eating

Q. I am a 43-year-old woman. I have an eating binge problem. My father was an alcoholic, and I feel like I'm a "food-aholic". Just as an alcoholic can't stop drinking until the alcohol is gone or the alcoholic passes out, I can't stop eating until the food is gone or I'm sick. What can I do? It's harder than alcohol because one has to eat to live.

A. First of all, you are not alone. In community surveys, as many as 4% of the general population may report problems with binge-eating. In samples drawn from weight-control programs, around 30% of individuals report this problem. Women seem to be about 1.5 times more likely than men to meet criteria for Binge-Eating Disorder (BED). (This, by the way, is not yet an official psychiatric diagnosis in DSM-IV, but it is likely to become one with the next edition).

It is important to distinguish BED from another disorder called bulimia nervosa (BN). In bulimia, the person not only binges--he or she also uses various methods to get rid of the food, such as self-induced vomiting, use of laxatives, or intense exercise. These behaviors can sometimes create serious medical problems. In your case, I think the first thing to do is to get a good professional evaluation. This will help you figure out what the precise problem is--BED? BN? etc.

Sometimes, underlying problems with depression or anxiety can fuel an eating disorder. Sometimes, it's the individual's low sense of self-esteem. And sometimes, eating disorders develop in the context of intense peer and cultural pressures. A mental health evaluation with someone experienced in eating disorders will help you sort these issues out, and find ways of changing your eating patterns. Medication may also be helpful for some patients with either BED or BN. You may also want to check out the Eating Disorders Association website (http://www.uq.edu.au/~zzedainc/), and take a look at the book, Bulimia Nervosa and Binge Eating: A Guide to Recovery, by Peter J. Cooper . (This is not a substitute for seeking professional evaluation).

I hope you are able to get some help soon.

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September 2001

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