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If you're on a diet, be wary of binges

January 17, 2010 12:36 am

SOME PEOPLE'S New Year's resolutions to go on strict diets can trigger scary eating binges.

Binge eating is not just stuffing yourself on holidays. It means uncontrolled overeating to the point of being uncomfortably full at least twice a week. Many people with the disorder feel ashamed and eat in secret. For example, one of my patients broke down and sobbed when I innocently asked her what she had eaten the day before.

About 3 percent of Americans have binge-eating disorder, making it more common than anorexia nervosa and bulimia, according to a Harvard University study. Men and women of all races and classes are affected. Most binge eaters eventually become overweight.

Controversial research suggests that binge eating may be a type of addiction, similar to alcoholism and drug addiction. Like those compulsions, binge eating disorder can be treated with antidepressant medicines and psychological counseling, according to the National Institutes of Health.

Many people with binge eating disorder also suffer from depression, low self-esteem and trouble expressing emotions. Some overeaters have been victims of sexual abuse. As with other addictions, research suggests there may be some inherited tendencies, as well as changes in brain chemistry.

Research shows people who undergo weight-loss surgery are nearly six times more likely than average to have existing eating disorders. And while bariatric surgery may help with weight loss, it does not cure underlying eating disorders, according to German research. So, it's important to get help.

TALK IT OUT

Talk therapy can help considerably, according to psychiatrists at Rutgers University in New Jersey. This month, they published research comparing two types of counseling: interpersonal therapy, which focuses on people's relationships and communication skills; and cognitive-behavioral therapy, which targets dysfunctional thoughts and feelings.

In a two-year study, researchers found that people who got either type of counseling were 20 percent more likely to stop bingeing than folks who tried diet and exercise.

Group therapy is also helpful, according to University of Minnesota Medical School researchers. After 20 weeks of therapy, people in groups led by professional therapists were more likely to have stopped bingeing than people in self-help support groups.

Nearly 52 percent of those in a therapist-led group stopped bingeing, compared to 18 percent in the self-help groups and 10 percent of the people who got no treatment at all.

So, if you lack health insurance to pay for professional therapy, it may be worthwhile to look into a free-of-charge self-help group such as Overeaters Anonymous.

THREE WAYS TO STOP

Here's a three-pronged approach to putting a stop to binge eating:

First, if you feel you may have binge eating disorder, see your health care provider and ask about getting counseling. If you're not sure how to start this conversation, consider visiting the Something Fishy Web Site on eating disorders.

You can take an online questionnaire there and print the results to bring to your physician. The questionnaire is available online at something-fishy.org/isf/questionnaire.php.

It's important to address the psychological side of the problem.

Second, stop dieting and skipping meals. Restricting foods may trigger binges and cause more weight gain. Even if you are overweight, consider first normalizing your eating instead of trying to lose weight at any cost, according to the American Dietetic Association's position paper on eating disorders.

So if you're not already doing it, start eating breakfast. Eat at least three meals a day. Carry small snacks with you so that you don't become ravenous. Remember, being hungry makes you more vulnerable.

If you feel you've lost touch with regular portions, a dietitian who has experience with eating disorders can coach you toward normalcy, using non-diet approaches such as intuitive or mindful eating.

Third, ask your health care provider if you can start an exercise program. Regular exercise has been shown to boost moods and reduce overeating.

You can change your life.

Jennifer Motl welcomes reader questions via her Web site, brighteat ing.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.