Binge Eating Disorder: Social and Psychological Issues

Binge Eating Disorder

What is It?

Binge Eating Disorder, is a blanket term used to describe the act of consuming unusually copious amounts of food, and is often simultaneously associated with some psychological trigger.  Binge Eating Disorder is not currently included in the DSM (Diagnostic and Statistical Manual of Mental Disorders) however, it is scheduled to be added to the new DSM V, and was included in DSM IV as an area for further study (dsm5.org).  According to www.dsm5.org, binge eating is comprised of the following:

“A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1. eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

2. a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:

1. eating much more rapidly than normal

2. eating until feeling uncomfortably full

3. eating large amounts of food when not feeling physically hungry

4. eating alone because of feeling embarrassed by how much one is eating

5. feeling disgusted with oneself, depressed, or very guilty afterwards

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least once a week for three months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.” (dsm5.org)

The act of binge eating is generally associated with obesity and weight management issues, though; binge eating also encompasses negative social ideas regarding an individual’s ability to control their own actions.  This lack of control, seen negatively in other deviant acts such as substance abuse and gambling, is coupled with the deviance of being obese or overweight and can cause many social and psychological issues in individuals that are struggling with Binge Eating Disorder (BED).  According to a diagnosis overview from New York University, “It is thought that 4% of US population has binge eating disorder. Women are slightly at more risk than men. The illness peaks at 40-50 years old” (psych.med.NYU.edu). 

An Example of Binging

http://www.youtube.com/watch?v=v9e-wRrLGX4

A (Very) Brief History

                According to much of the literature, the act of binge eating is nothing new, the formal disorder however, is a relatively recent invention.  According to an article entitle “A Fear of Food: A History of Eating Disorders” posted on randomhistory.com, “it was not until the early 1990s that binge eating was recognized as distinct from bulimia nervosa. The reason for this probably has to do with the reluctance to associate obesity, per se, with an eating disorder (Gordon 2000)” (randomhistory.com).  Additionally, NYU states that Binge-Eating Disorder is associated with Bulimia Nervosa, furthering the connection between the two disorders.  BED is interesting because while most of the negative harm to the body is physical and related to obesity and weight gain, much of the treatment options revolve around the psychiatric treatment of the patients, illustrating the complexity of the diagnosis.

Relation to Other Disorders

                As with adult ADHD, Binge Eating Disorder was once a part of a narrower field of eating disorders which has been expanded on to include more diagnoses.  In “The Emergence of Hyperactive Adults as Abnormal”, Conrad and Potter state, “Adult ADHD offers a clear example of how a medicalized category can expand to include a wider range of troubles within its definition” (Conrad and Potter, 143).  Similarly, Binge Eating Disorder was born out of Bulimia Nervosa, and its rise coincides with a broader look by society into issues of obesity and health. 

                One can also view binge eating as a form of self-injury, and as with self-injurers, Binge Eating Disorder is often associated with other psychological stresses or triggers such as depression (psych.med.nyu.edu).  In “Self-Injurers: A ‘Lonely Crowd’”, Adler and Adler state, “According to Best and Luckenbill (1982), loners who are deviants are socialized by conventional society, not by fellow deviants, and yet they choose deviance.  They Choose deviance not because they want to contradict their socialization, but because they face situations where conventional courses of action are unattractive or unsatisfactory” (Adler and Adler, 131).  For Example, look at this woman’s feeling toward her own binge eating:

 http://www.youtube.com/watch?v=wWFf8eQFxWU

                Over-indulgence in food, can also be related to over-indulgence in other substances such as alcohol or drugs.  Specific to this course, Peralta published an article entitled “Hey, Don’t Blame Me…Blame the Booze” focusing on gender-appropriate roles of alcohol abuse, showing that binge-drinking contributes to the violation of gender-appropriate behavior.   However, there is also a gendered component to binge eating as NYU asserts that women are more at risk than men for engaging in binge eating (psych.med.nyu.edu). This is significant because it shows that binge-eating also violates gender norms, the norms of being the ideal woman. In American society and culture, women are more likely to be judged negatively or positively based on physical body characteristics, which can suffer under Binge Eating Disorder. 

Underlying Social Constructions: A HEAVY gender bias

 
One need only Google image search "Binge Eating" to find a heavy gender bias. 8 of the first 10 images depict either a sad woman surrounded by food, or a woman ecstatic to be surrounded by food, illustrating the association between binge eating and unstable emotions. Additionally, much of the literature connects Binge Eating Disorder with a variety of other psychologically deviant issues such as depression, and an inability to handle life's stresses. The following images are some of the first image returns when you Google "Binge Eating", they are numbers 1, 6, and 7 of the first 10.

The first Google image search return of "Binge Eating"

the depressed female binge-eater

she loves burgers

A study published in Appetite, a journal dedicated to nutrition, entitled "Stress-induced laboratory eating behavior in obese women with binge eating disorder" states, "The stress-induced eating behavior of BED patients is characterized by a stronger motivation to eat (indicated by a fast initial eating rate) as well as by a lack of satiety perception" (Schulz, Laessle).  Women are the focus of this study, concentrating on the obese participant's lack of ability to cope with stress.  Amazingly, when using Academic Search Complete 3 of the first 5 search results of "Binge Eating" return articles or studies dealing specifically with female binge-eaters, and tie the act of binge eating to other psychological issues.

Of course, there is the more obvious deviant illustration, the association between Binge Eating Disorder and obesity.  This is an interesting connection because the history of Binge Eating Disorder seems to indicate it was born out of the Bulimia Nervosa diagnosis, traditionally associated with the severely underweight.  Nevertheless, the association between Binge Eating and obesity persists, arguably due to the multi-billion dollar industry of nutritional supplements aimed at weight loss, and prescription medication aimed at health improvement. 

Who REALLY Benefits from this Diagnosis?

myhealthiestlife.com

From a health and physical fitness point of view, the obvious winner in the battle against obesity is the dietary supplement industry.  According to consumerreports.org, the industry grossed 26.7 billion dollars in supplement sales in 2009. 

An important factor in legitimizing a diagnosis or a medical condition is the role the medical community plays in furthering the reality of diagnosis, the fear of bad health, and fostering a need for patients to purchase prescription medication.  According to a press release by sfgate.com, a report by Global Industry Analysts predicts "Anti-Obesity" drug profits to reach 10.3 billion dollars by the year 2017 (sfgate.com). 

Still, there are more beneficiaries of this diagnosis, as psychiatric treatment is often labeled under treatment options for this disorder.  According to NYU, treatments include Cognitive Behavioral Therapy, Interpersonal Psychotherapy, and Medications. 

Social Reasons for the Existence of this Diagnosis?

The social reasons for the diagnosis of Binge Eating Disorder are varied, but mainly revolve around society's ideas of what is healthy, responsible, and emotionally stable.  The research I have seen shows a heavy gender bias toward females, despite NYU stating that women are only "slightly" more likely than men to deal with binge eating episodes (psych.med.nyu.edu).  As with most things in life, there is a flip side to the negativity of binge-eating. 

Though the DSM defines Binge-Eating Disorder as being characterized by a number of certain conditions, the overarching pillar of the disorder is consuming copious amounts of food, often in a less than healthy fashion associated with psychological loss of control, or an emotional trigger.  However, others argue that doing essentially the same thing, minus the stereotypical obese-woman dealing with stress, is actually a healthier way of eating. 

amazon.com

Let me explain, "The Warrior Diet" coined by Ori Hofmekler, is a system of eating aimed at weight management in which a person "underfeeds" for a period of up to twenty (yes 20) hours, only to "overfeed" for a period of 4 hours.  This "overfeed" takes place in the form of one giant meal.  As Hofmekler reasons, "The 'Undereating Phase' during the day maximizes the Sympathetic Nervous System's (SNS) fight or flight reaction to stress, thereby promoting alertness, generation of energy, fat burning and the capacity to endure stress" (warriordiet.com).  After literally starving yourself for 20 hours, the dieter then over-eats (binges) because, "The 'Overeating Phase' at night maximizes the Parasympathetic Nervous System's (PNS) recuperation effect on the body, thereby promoting calming down, relaxation, digestion and the utilization of nutrients for repair and growth. This feeding cycle stimulates the production of cellular factors such as Cyclic AMP or GMP, which stimulate hormone synthesis and fat burning during the day, as well as protein synthesis and growth during the night, respectively" (warriordiet.com)

And there you have it, once again the social legitimacy of an act considered deviant, is once again nothing more than a social construction pitting the perceptions of the powerful (wealthy) against the perceptions of the weak (poor).  Does it make any sense, that when this woman binges, it is unhealthy, deviant, and life threatening;

BAD!

 (weightlosssurgerychannel.com)

But when this guy does it, and writes a book about it, and more importantly looks like he's healthy, then systematic binge-eating is healthy, mindful, and sexy.

GOOD! (as in Good God this is stupid)

 

warriordiet.com

The short answer is no.  Though as with most diagnoses, there are circumstances I am sure when this diagnosis is warranted, and that its recipients benefit from the treatment they receive. However, I find it interesting that the social constructions surrounding the disorder are so gender-biased, that this diagnosis happened to arise around the time the United States began critically looking into obesity, and that alternative systems of binge-eating are promoted as healthy options.  These factors add further complexity to the diagnosis, and to the socialization of medicine and health more broadly. 

- Steve

Word Count: 1,500 (1,802)

Works Cited

"A Fear of Food: A History of Eating Disorders". randomhistory.com. 2011.

Adler and Adler. "Self-Injurers: A 'Lonely Crow'". Readings in Deviant Behavior. pp. 129-132.

      Pearson Education Inc. 2010.

Conrad and Potter. "The Emergence of Hyperactive Adults as Abnormal". Readings in Deviant

      Behavior. pp. 138-144. Pearson Education Inc. 2010.

"Global Anti-Obesity Drugs Market to Reach US$10.3 Billion by 2017, According to New Report by

      Global Industry Analysts, Inc." sfgate.com/press releases. November 17, 2011.

"K 05 Binge Eating Disorder: Proposed Revision". DSM5.org. 2012.

McCoy, Krisha. "Binge Eating Disorder". NYU Langone Medical Center. psych.med.nyu.edu.

        2012.

Peralta, Robert. "Hey Don't Blame Me...Blame the Booze". Readings in Deviant Behavior. pp. 217-

        222. Pearson Education Inc. 2010.

Schulz, S. S., & Laessle, R. G. (2012). Stress-induced laboratory eating behavior in obese

women with binge eating disorder. Appetite, 58(2), 457-461.

doi:10.1016/j.appet.2011.12.007

"What's behind our dietary supplements coverage".  consumerreports.org.  January 2011.