Compulsive overeating

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Compulsive overeating (or food addiction) is a compulsive behavior characterized by excessive food consumption. Professionals address this disorder by means of behavior therapy.[1]

Description[edit]

Individuals suffering from compulsive overeating are obsessed with food and typically eat when they are not hungry. They devote excessive amounts of time and thought to food, and secretly plan to eat or fantasize about doing so. Compulsive overeaters engage in frequent episodes of uncontrolled eating, or binge eating. The term binge eating means eating an abundance of food while feeling that one's sense of control has been lost.[2] People who engage in binge eating may feel frenzied, and consume 5,000 to 15,000 calories before stopping. Bingeing in this way is generally followed by feelings of guilt and depression;[3] some will cancel their plans for the next day because they "feel fat."[4]

Unlike individuals with bulimia nervosa, compulsive overeaters do not attempt to compensate for their bingeing with purging behaviors, such as fasting, laxative use, or vomiting. When compulsive overeaters overeat through bingeing and experience feelings of guilt after their binges, they can be said to have binge eating disorder (BED).[2]

In addition to binge eating, compulsive overeaters may also engage in grazing behavior, during which they return to pick at food throughout the day.[2] These actions result in an excessive overall number of calories consumed, even if the quantities eaten at any one time may be small.

Potential negative effects[edit]

Left untreated, compulsive overeating can lead to serious medical conditions. For example, compulsive overeating usually results in weight gain and obesity, although it is not the only cause thereof. In addition, compulsive overeating could potentially lead to high cholesterol, diabetes, heart disease, hypertension, sleep apnea, and major depression. Additional long-term side effects of the condition include kidney disease, arthritis, bone deterioration, and stroke. In severe cases, compulsive overeating can result in death.

Other negative effects may include the amount of money that is wasted on food and the feelings of low self-esteem that usually accompany bingeing.

Signs and symptoms[edit]

Besides binge eating behaviors, there are several signs that a person may be suffering from compulsive overeating. Common behaviors of compulsive overeaters include eating alone, consuming food quickly, and gaining weight rapidly. Other signs include significantly decreased mobility and the withdrawal from activities due to weight gain. Emotional indicators can include feelings of guilt, a sense of loss of control, depression and mood swings.[3] A preoccupation with body weight may indicate compulsive overeating.

Food addiction[edit]

Further information: ΔFosB

During binges, compulsive overeaters may consume between 5,000 and 15,000 food calories daily, resulting in a temporary release from psychological stress through an addictive high not unlike that experienced through drug abuse.[3] Compulsive overeaters tend to show brain changes similar to those of drug addicts, a result of excessive consumption of highly processed foods.[5] Researchers have speculated that there is an abnormality of endorphin metabolism in the brain of binge eaters that triggers the addictive process. In keeping with this idea, other theories explain addictive behaviors as primarily involving an anomaly in the reward centers of the brain.

For the compulsive overeater, ingesting trigger foods causes the release of the neurotransmitters serotonin and dopamine.[3] This could be another indicator that neurobiological factors contribute to the addictive process. Conversely, abstaining from addictive food and food eating processes causes withdrawal symptoms in those with eating disorders.[3] The resulting decreased levels of serotonin in the individual may trigger higher levels of depression and anxiety.[6]

Eventually, compulsive overeaters continuously think about what the next meal will be. Food is in the preeminent positions of their minds; when deprived of it, the person may engage in actions similar to those of cocaine addicts, including an uncontrollable search for the substance, and in extreme cases, stealing or lying.[7][8][9]

Management[edit]

See also: Jaw wiring

Compulsive overeating is treatable with nutritional assistance and medication. Psychotherapy may also be required, but recent research has proven this to be useful only as a complementary resource, with short-term effectiveness in middle to severe cases.[10][11]

The antidepressant fluoxetine is the only medication approved by the Food and Drug Administration (FDA) for the treatment of an eating disorder, specifically bulimia nervosa. This medication has been prescribed for the treatment of BED. Off-label medications, such as other selective serotonin reuptake inhibitors (SSRIs), have shown some efficacy, as have several atypical agents, such as mianserin, trazodone and bupropion.[12][13] Anti-obesity medications[14] have also proven very effective. Studies suggest that anti-obesity drugs, or moderate appetite suppressants, may be key to controlling BED.[15]

Many eating disorders are thought to be behavioral patterns that stem from emotional struggles; for the individual to develop lasting improvement and a healthy relationship with food, these affective obstacles need to be resolved.[16] Individuals can overcome compulsive overeating through treatment, which should include talk therapy and medical and nutritional counseling. Such counseling has been recently sanctioned by the American Dental Association in their journal article cover-story for the first time in history in 2012: Given “the continued increase in obesity in the United States and the willingness of dentists to assist in prevention and interventional effort, experts in obesity intervention in conjunction with dental educators should develop models of intervention within the scope of dental practice”.[17] Moreover, Dental appliances such as conventional jaw wiring and orthodontic wiring for controlling compulsive overeating have been shown to be “efficient ways in terms of weight control in properly selected obese patients and usually no serious complications could be encountered through the treatment course.[18] Finally, several twelve step programs exist to help members recover from compulsive overeating and food addiction.[3]

Food selection[edit]

If foods consumed are not meeting dietary needs such as protein, lipids or vitamins, there will be a drive to keep eating until adequate nutrition is found. Shopping in supermarkets, it may be confusing to assemble meals with full nutritional substance, since, for instance, many processed foods appeal to an appetite for sweetness. The remedy with whole foods has been described as follows:[19]

Kicking sugar and white flour and substituting whole grains, vegetables, and natural fruits, in season, is the core of any sensible natural regime. Changing the quality of your carbohydrates can change the quality of your health and life. If you eat natural food of good quality, quantity tends to take care of itself. Nobody is going to eat a half dozen sugar beets or a whole case of sugar cane.

See also[edit]

References[edit]

  1. ^ Ho, Karen S. I.; Nichaman, Milton Z.; Taylor, Wendell C.; Lee, Eun Sul; Foreyt, John P. (1995). "Binge eating disorder, retention, and dropout in an adult obesity program". International Journal of Eating Disorders 18 (3): 291–4. doi:10.1002/1098-108X(199511)18:3<291::AID-EAT2260180312>3.0.CO;2-Y. PMID 8556026. 
  2. ^ a b c Saunders, Ronna (January 1, 2004). ""Grazing": A High-Risk Behavior". Obesity Surgery 14: 98–102. doi:10.1381/096089204772787374. Retrieved October 27, 2014. 
  3. ^ a b c d e f Goldberg, Joseph (August 21, 2014). "Food Addiction". WebMD. WebMD. Retrieved October 27, 2014. 
  4. ^ Goldsmith, Toby D. (2013-01-30). "Bulimia: Binging and Purging". Psych Central. Retrieved 2014-02-01. 
  5. ^ Nolen-Hoeksema, Susan (2014). (ab)normal Psychology. New York, NY: McGraw-Hill Education. p. 348. ISBN 9781308211503. 
  6. ^ Kriz, Kerri-Lynn Murphy (May 2002). The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge-Eating Disorder and Bulimia Nervosa (PhD Thesis). Virginia Polytechnic Institute and State University. [page needed]
  7. ^ Sheppard, Kay (1993). Food Addiction: The Body Knows. ISBN 978-1-55874-276-5. [page needed]
  8. ^ "Are You a Food Addict?". Food Addicts Anonymous. Retrieved 2014-02-01. 
  9. ^ "Food Addiction - Signs, Symptoms & Treatment". Addictions.com. Retrieved 2014-02-01. 
  10. ^ "Binge-eating disorder Treatment at Mayo Clinic - Diseases and Conditions". Mayo Clinic. 2012-04-03. Retrieved 2014-02-01. 
  11. ^ Johnson, Bankole A.; Ait-Daoud, Nassima; Wang, Xin-Qun; Penberthy, J. Kim; Javors, Martin A.; Seneviratne, Chamindi; Liu, Lei (2013). "Topiramate for the Treatment of Cocaine Addiction". JAMA Psychiatry 70 (12): 1338–46. doi:10.1001/jamapsychiatry.2013.2295. PMID 24132249. Lay summaryScienceDaily (October 25, 2013). 
  12. ^ White, Marney A.; Grilo, Carlos M. (2013). "Bupropion for Overweight Women with Binge-Eating Disorder". The Journal of Clinical Psychiatry 74 (4): 400–6. doi:10.4088/JCP.12m08071. PMC 4021866. PMID 23656848. 
  13. ^ Calandra, Carmela; Russo, Rina Giuseppa; Luca, Maria (2011). "Bupropion Versus Sertraline in the Treatment of Depressive Patients with Binge Eating Disorder: Retrospective Cohort Study". Psychiatric Quarterly 83 (2): 177–85. doi:10.1007/s11126-011-9192-0. PMID 21927936. 
  14. ^ "Obesity Treatment at Mayo Clinic - Diseases and Conditions". Mayo Clinic. 2013-06-07. Retrieved 2014-02-01. 
  15. ^ McElroy, Susan L.; Guerdjikova, Anna I.; Mori, Nicole; O'Melia, Anne M. (May 7, 2012). "Pharmacological management of binge eating disorder: Current and emerging treatment options". Therapeutics and ClinicalRisk Management: 219–41. doi:10.2147/TCRM.S25574. PMC 3363296. PMID 22654518. Retrieved October 31, 2014.
  16. ^ "Factors That May Contribute to Eating Disorders". NEDA. Retrieved October 27, 2014. 
  17. ^ Curran, Alice E.; Caplan, Daniel J.; Lee, Jessica Y.; Paynter, Lauren; Gizlice, Ziya; Champagne, Catherine; Ammerman, Alice; Agans, Robert (November 2010). "Dentists' Attitudes about Their Role in Addressing Obesity in Patients: A national survey". Journal of the American Dental Association 141 (11): 1307–1316. 
  18. ^ K. Al-Dhubhani, Mohammed; M. Al-Tarawneh, Ahmad (November 2014). "The Role of Dentistry in Treatment of Obesity—Review". Saudi Journal of Dental Research. doi:10.1016/j.sjdr.2014.11.005. 
  19. ^ William Dufty (1975) Sugar Blues, page 181

Further reading[edit]

  • Brownlee, Christen (2009). "Food fix: Neurobiology highlights similarities between obesity and drug addiction". Science News 168 (10): 155–6. doi:10.1002/scin.5591681012. INIST:17072118. 
  • "Eating Awareness Training" Molly Gregor, copyright 1983 "...reclaim (your) 'birthright', the right to eat without compulsion, obsession, or suffering. ...what the body wants, as much as it wants, whenever it wants." From the Preface by Thomas Lebherz, M.D.