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WHAT IS BINGE EATING DISORDER? Douglas Haymaker, Ph.D Stephanie Haymaker, Ph.D Binge eating disorder (BED) is the most common eating disorder among adults in the US. According to a national sur- vey, BED affects an estimated 2.8 mil- lion people. It is more common among adults than is anorexia and bulimia combined. So if you are struggling with these symptoms, know you are not alone. The disorder is diagnosed when an individual has recurring episodes of eating significantly more food in a short period of time than most people would eat in similar circumstances, with marked feelings of loss of control. Binges are usually followed by feelings of shame, disgust or embarrassment, and the behavior is often done in secret. This disorder is associated with marked distress, and occurs, on aver- age, at least weekly for three months. More people suffer from this problem than are diagnosed, because of the dif- ficulty people have in sharing their problem with family, friends or even their doctors. BED is often associated with anxiety, depression and/or sub- stance abuse. BED may develop at any stage of the life cycle, but often arises in adoles- cence or early adulthood. While more common in women, the issue affects many men also. BED occurs at a simi- lar rate across ethnic and racial groups. There is evidence that genetic and bio- logical factors may influence one’s chances of developing this disorder. Why people develop this particular problem is the subject of some debate. Binge eaters often (but not always) have difficulty identifying feelings, lim- ited coping strategies, difficulty with assertiveness and low self-esteem. Paradoxically, sufferers present a confidant, competent face to the outside world, and come home to a private struggle. A common belief is that a lack of will power is at the root of this disorder, but that is a misconception. Although people who are diagnosed with BED do not compensate for binges with purging behaviors such as vomiting, severe dieting, or laxative abuse, they may limit certain foods or develop other unhealthy eating patterns. This sets up a cycle for repeating the pat- tern, as our bodies are biologically primed to overeat when somehow deprived. No amount of determina- tion can compete with this biology. A commitment to regular, healthy meals is an important first step in breaking the cycle. Another important step in exploring recovery from BED involves an increas- ing awareness of the feelings that trig- ger the urge to binge. In an over stim- ulating world, it is all too easy to become disconnected from our inner life. Reaching for comfort food may seem to be a simpler solution. What is initially a calming strategy soon becomes a source of additional stress. Binge eating can become automatic. The solution involves learning to iden- tify feelings and look deeper for what is driving unhealthy and unsatisfying behavior. Eating disorders can be a challenge for treatment because of the many ways these symptoms appear. A thorough treatment plan involves a thoughtful approach to each patient’s specific needs. Treatment may involve some combination of psychotherapy, nutri- tional counseling, family and/or group therapy. Medication may be helpful to address the anxiety and depression that may occur with an eating disorder. Getting started is often the hardest part of the process. If these patterns sound familiar, perhaps it is time to take that first step and seek the help that is right for you. Dr. Douglas Haymaker is a licensed clinical psychologist with over 20 years of clinical experience. He is presently a partner at Hay- maker and Haymaker Psychological Services, a private practice setting where your confi- dentiality is assured, in Bridgewater, NJ. He attended college at Brown University and graduate school at the University of Florida in Gainesville, FL. Areas of specialization include relationship issues, coping with transitions such as loss and divorce, and the assessment and treatment of AD/HD, anxiety, depression and PTSD. He also performs psychological, neuropsychological and educational evaluations.