Binge Eating

It starts off with my thinking about the food that I deny myself when I am dieting. This soon changes into a strong desire to eat. First of all it is a relief and a comfort to eat, and I feel quite high. But then I can't stop, and I binge. I eat and eat frantically until I am absolutely full. Afterwards I feel so guilty and angry with myself.

This book has been written for anyone who has a problem controlling their eating, whatever their age, whatever their gender, whatever their weight. It is about eating in an uncontrolled way. It is about binge eating.

The term binge used to mean one thing to most people: drinking to excess. Today the word more often means eating to excess. For many people a binge is something perfectly innocuous—a dietary slip or lapse, a simple overindulgence. For others, though, it signifies partial or complete loss of control over eating. This is a major problem for a large number of people, and not just those in the Western world.

Yet despite the fact that binge eating is undeniably widespread, most people know comparatively little about the problem. Are binges always large? Are they always followed by purging? Is binge eating a lifelong problem, or can it be overcome? Is binge eating a sign that something else is wrong? What sort of person is prone to binge and why? How do we distinguish—in ourselves or in those we care about—between a true binge and simple overeating? And, most important of all, how can people learn to overcome binge eating?

None of these questions can be answered without a full understanding of what a binge is, and that is the subject of this opening chapter.

WHAT DOES BINGE MEAN?

The meaning of the word binge has changed over the years. It has been in common use since the mid-nineteenth century when binge meant principally "a heavy drinking bout, hence a spree," according to the Oxford English Dictionary. While that remains one of its meanings, nowadays dictionaries often define a binge in terms of overeating, and the term indulgence may be used. Merriam Webster's Collegiate Dictionary, Eleventh Edition, for example, says that one meaning of the word binge is "an unrestrained and often excessive indulgence."

This so-called "indulgence" is actually a common phenomenon reported by both men and women. For some it is an occasional indiscretion, as mentioned earlier; it has no effect on their lives. For others, though—such as the woman whose description opened this chapter—it is a genuine problem, something that has a profound impact on many aspects of their lives. Failure to understand this distinction—between indulgence and binge eating—lies at the heart of much of the confusion about the behavior.

Recognizing the need to clarify the meaning of the term binge eating, researchers have investigated the experiences of those who binge eat. While no two personal accounts are identical, it turns out that the episodes of eating that people view as binges have two core features in common: The amount eaten is viewed as excessive—although it might not seem so to the outsider—and, crucially, there is a sense of loss of control at the time. It is important to be aware that technical definitions of a binge generally specify an additional feature, namely, that the amount eaten was definitely larger than most people would eat under similar circumstances. This size requirement is somewhat contentious, as we will discuss later in this chapter, but it is widely employed.

THE CHARACTERISTICS OF A BINGE

I randomly grab whatever food I can and push it into my mouth, sometimes not even chewing it. But I then start feeling guilty and frightened as my stomach begins to ache and my temperature rises. It is only when I feel really ill that I stop eating.

Personal descriptions of binge eating can be tremendously revealing. What emerges is an account that you might recognize if you binge or someone you know binges.

Feelings. The first moments of a binge can be pleasurable. The taste and texture of the food may seem intensely enjoyable. Such feelings seldom last long, however. Soon they are replaced by feelings of disgust as the person consumes more and more food. Some people feel revulsion over what they are doing but nevertheless continue to eat.

Speed of Eating. Typically people eat rapidly during a binge. Many people stuff food into their mouth almost mechanically, barely chewing it. Some also drink copiously to help wash the food down, which contributes to their feeling full and bloated. Drinking a lot also helps people bring up the food later on.

Agitation. Some people pace up and down or wander around during their binges. They may exhibit an air of desperation. They feel the craving for food as a powerful force that drives them to eat. This is why the term "compulsive eating" is sometimes used. Obtaining food may take on extreme importance; people may take food belonging to others, shoplift from stores, or eat discarded food. Most view such behavior as shameful, disgusting, and degrading.

I begin by having a bowl of cereal. I eat it really quickly and then immediately have two or three more bowls. By then I know that my control is blown and that I am going to go all the way and binge. I still feel very tense, and I desperately search for food. These days this means running around college looking for food people have thrown out. I know that this is really disgusting. I stuff the food down quickly. Sometimes I go into town, stopping at stores along the way. I buy only a little from each store so as not to arouse suspicion. I stop when I have run out of money or, more usually, because I am so full that I physically cannot eat any more.

A Feeling of Altered Consciousness. People often describe feeling as if they are in a trance during a binge. If you have experienced this trance-like state, you know that your...