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The following is an excerpt of an actual message I received from a patient. Of course, certain details have been omitted to preserve confidentiality:

Dear Doctor,

I am having trouble and am scared to death. I cannot go back – I cannot. I am having trouble, I do well for three or four days, then I am binging again. Tonight I was physically hungry and I had a granola bar and a glass of milk that started me on another. I had another glass of milk and then another granola bar, a sugar-free chocolate pudding and then all hell broke loose. I had to run to the bank and I was half thinking WHY????? AM I EATING LIKE THIS????? and then I drove to Wendy’s… and had a hamburger and large fry on the way home and 3 Heath bars after I got home, WHY????

I feel fantastic with my exercise. I feel fantastic when I stick to my food plan… healthy and not sluggish.

I am scared to death and feeling like I am slipping off a cliff.

…a frightened patient

Binge Eating Disorder (BED) is a very common problem among dieters. In some studies up to 40% of patients may meet the definition that includes recurrent episodes of eating a large quantity of food and feeling a lack of control during the episode. Patients with BED usually report eating more rapidly than normal, eating until uncomfortably full, eating large amounts when not physically hungry, eating alone because of embarrassment about how much is eaten and feeling disgusted, depressed or guilty after over-eating. This disorder does not occur with anorexia or bulimia and must be accompanied by marked distress during binge eating, on average, at least two days
a week for six months.

In 1959 Dr. Albert Stunkard described this disorder in a 37-year-old high school teacher
named Hyman Cohen. At the time he was referred as a “compulsive eater” he was 5 ft. 9 in. tall and 272 pounds (BMI 40.5). He sought help to lose weight so he could qualify for the position as principal at the school where he taught. He worked with Dr. Stunkard to help him lose weight “like hiring a policeman to check on me” and named this disorder because his eating reminded him of alcoholic binges.

Treatment of Binge Eating Disorder

Cognitive-behavioral therapy has had the best track record in dealing with binge eating disorder. In a sound therapeutic relationship patients are educated about how their thoughts maintain their eating pattern and how they can change both their thoughts and their behaviors.
Patients weigh in regularly, keep food records, and records of the emotional and physical effects of their eating. The goal of early treatment is to reduce binges and promote healthy eating and alternatives to binge eating. In certain cases, medications may assist patients with binge eating disorder. Patients should always discuss their
concerns with their doctor.

This article was originally published in a broadcast of the Health-e-Thoughts Newsletter (distributed by betterMD.net on December 6, 2000)

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