What is compulsive overeating?
It is estimated that 4 million American adults are compulsive overeaters.
The behavior is nearly twice as common in women as in men, and it typically begins before the age of twenty years. The primary sign of compulsive overeating is regularly eating large quantities of food uncontrollably without physical hunger. Other food-related behaviors include eating rapidly, eating to the point of physical discomfort, eating alone and secretly, hiding food to eat later, hiding the evidence of eating, stealing other people’s food, and eating food that has been discarded or is about to be discarded.
Compulsive overeaters have a preoccupation with food, spending inordinate amounts of time on meal planning, food shopping, and cooking and eating. They make furtive trips to convenience stores, fast- food restaurants, and late-night grocery stores. They recognize that their eating habits are not normal and feel powerless to stop eating voluntarily. They turn to food for comfort and yet use it as a reward. Their rapid weight gain brings them feelings of guilt, shame, disgust, and self-loathing. They cannot separate their identify from their weight; in weighing themselves, for example, how they feel about themselves is dictated by the number on the scale. They believe that they will be better persons once they are thin, so they try various diets with a sense of desperation. Although weight may be lost initially, it is often regained, plus more.
Researchers have not conclusively determined the underlying causes of compulsive overeating. Studies have investigated genetic predispositions to food addiction, in which a person’s metabolism of foods, such as sugar, wheat, and fats, affects the same areas of the brain affected by other addictive substances, such as cocaine. Other brain studies have examined compulsive overeating as a biochemically based impulse disorder somewhat similar to kleptomania, hypersexuality, compulsive shopping, and gambling addiction. A connection to dopamine in the brain has been shown, as well as hypersensitivity to the pleasurable properties of foods.
Some medical professionals consider compulsive overeating to be a means of self-medicating for clinical depression. In some cases, the resulting rapid weight gain may be a protective mechanism to cope with physical or sexual abuse. The behavior also may serve to numb painful emotions of rejection, abandonment, and low self-esteem. One study showed that compulsive overeaters produce more cortisol in response to stress than do normal eaters; cortisol is known to stimulate the drive to eat, leading to obesity. Chronic stress has an apparent connection to the preference for high-energy foods that contain large amounts of sugar and fat.
The unbalanced diet of the compulsive overeater, who typically chooses sweets and starches, has adverse health consequences, such as high serum cholesterol level, high blood pressure, and increased risks for heart attack, stroke, kidney failure, and diabetes. This diet also may result in lethargy, moodiness, irritability, and depression.
In some cases, self-harming may be used to dissociate from emotional pain by substituting physical pain that releases endorphins. Compulsive overeaters who self-harm usually hold themselves to unreasonably high standards, have difficulty expressing their emotions, and are repulsed by their own bodies. The extreme and rapid weight gain contributes to varicose veins, blood clots in the legs, sciatica, arthritis, and bone deterioration. It may also cause shortness of breath and sleep apnea.
Like alcoholism, compulsive overeating is considered to be a disease in that it involves treatment and recovery and cannot be overcome by willpower alone. However, it is also a behavior that may be managed with behavior modification therapy. A typical initial exercise is to keep a food diary, a written record of the kind and quantity of food eaten, the time and place of eating, and the emotional context. This diary is then analyzed to identify habits, underlying emotions, and foods that trigger uncontrollable eating. The next step usually is to consult a nutritionist to devise a healthy food plan with adequate calories for energy, necessary nutrients, and fiber for improved digestion. A third step is to identify and practice healthy activities–emotional coping mechanisms–that substitute for food; these activities may include exercise, meditation, and spending time with friends.
Persons can seek support from professional counseling or from a twelve-step program such as Overeaters Anonymous. In some cases, drug therapy with antidepressants may be appropriate.
Academy for Eating Disorders. http://www.aedweb.org.
National Eating Disorders Association. http://www.nationaleatingdisorders.org.
Ross, Carolyn Coker. The Binge Eating and Compulsive Overeating Workbook: An Integrated Approach to Overcoming Disordered Eating. Oakland, Calif.: New Harbinger, 2009. With distinct sections on healing the body, mind, and spirit, this book offers a whole-body plan for regaining physical and emotional health.
Sheppard, Kay. Food Addiction: The Body Knows. Rev. ed. Deerfield Beach, Fla.: Health Communications, 1993. Written by a certified eating-disorder specialist, this book addresses the addictive influences of the metabolism of flour and sugar, as well as the psychological need for support and self-healing.