Compulsive Eating

Compulsive Eating

Compulsive eating describes a behavior that is present with some forms of eating disorders. It is not a diagnosis in its own right, but more of a description of a type of behavior. It is typically used to describe frequent episodes of uncontrollable eating, where a person continues to eat food long after they feel full and sometimes to the point of feeling sick. People who engage in compulsive eating may meet criteria for Binge Eating Disorder (BED). If someone purges after a binge by vomiting, exercising, using laxatives, diuretics, or enemas, they may meet criteria for Bulimia Nervosa. Both of these are eating disorder diagnoses and seeking treatment as soon as possible is important.

The American Psychiatric Association publishes a manual for diagnosing mental health disorders. According to that manual, called the DSM-5, for someone to be diagnosed with Binge Eating Disorder they must meet the following criteria:

  • Recurrent and persistent episodes of binge eating.
  • A binge episode occurs during a period of time (ex. 2 hours) during which the individual consumes an amount of food larger than most people would eat under similar circumstances.
  • Experience a loss of control over eating during the binge episode.
  • A binge includes at least three of the following:
      1. Eating faster than usual
      2. Eating past the point of comfortable fullness
      3. Eating a large quantity of food despite not feeling hungry
      4. Eating by yourself to hide the amount you’re eating to avoid judgment or feeling embarrassed
      5. Feeling shame, sadness, guilt, or anxiety after binge eating
  • Binge eating happens at least once a week for 3 months or more.
  • The binge is not compensated for, i.e there is no purging, overexercising, enema or laxative use.
  • There is significant distress due to binge eating.

Rigid eating practices such as dieting, intermittent fasting, or cutting out food groups have been linked to a higher incidence of BED. People who struggle with negative body image might initially restrict food or diet in order to lose weight. This restriction in calories may then spark a cycle of binge eating behavior as their body spirals out of balance and attempts to protect itself from “famine”. This restrict-binge cycle, along with possible weight change, can be followed by feelings of powerlessness, guilt, shame and failure. Turning to food can become a natural way to cope with these difficult feelings.

People who engage in compulsive eating usually feel out of control and are aware that their eating patterns are abnormal. Many blame themselves and think if they could just control their food intake or lose weight, they would feel better. This might cause them to become even more restrictive with food. Unfortunately, the more we try to control food, the more food starts to control us and it becomes difficult to end the restrict-binge-shame cycle.

Binge Eating Disorder is the most common eating disorder and is seen as a serious mental health condition. Like anorexia and bulimia, compulsive eating can result in mental and medical complications. Fortunately, with proper help, this can be treated and people can heal. It’s recommended to work with a treatment team that specializes in eating disorders including a licensed therapist, registered dietitian, medical doctor, and sometimes a psychiatrist. Inpatient and Intensive Outpatient treatment may be necessary to provide the proper support. Learn more about treatment.

Additional Signs and Symptoms to Look For

  • Fear of not being able to stop eating voluntarily
  • Depression, anxiety, moodiness
  • Self-deprecating thoughts following binges
  • Withdrawing from activities because of embarrassment about weight or eating behaviors
  • Going on many different diets
  • Preoccupation with food
  • Eating little in public or around other people
  • Believing they will be a better person if their body changes
  • Feelings about self are based on weight
  • Social and professional failures attributed to weight
  • Feeling tormented by eating habits
  • Weight is the focus of life

Emotional Eating

Emotional Eating is another term that is frequently used but is not an eating disorder diagnosis. It refers to instances when a person turns to food for comfort rather than hunger. In most cases of emotional eating, the person is under some form of stress. Emotional eating can also refer to times when a person uses food as a reward, after a hard day at work, or when they feel lonely or depressed. Emotional hunger is different than physical hunger. It often comes on all of a sudden and feels like an urgent need for food. Physical hunger tends to grow more gradually. Physical hunger also dissolves when food is eaten; emotional hunger, on the other hand, does not go away after eating. It should be noted that hunger cues may be difficult to detect after long periods of dieting and restriction. It can be challenging to notice subtle hunger cues until they become significant and the person feels famished. Working with a registered dietitian can be helpful in the early stages of recovery for this reason.

It can be important to learn about what purpose this eating behavior serves so the individual can meet their emotional needs more effectively. While eating for comfort can be part of “normal” eating and is an option as a way to cope, it can become a problem when it’s the only coping skill being used. They may benefit from working with a therapist to learn how to be more assertive, set boundaries, heal from trauma, tolerate distress, and other coping skills to address the underlying problem.

If you or someone you know is struggling with compulsive eating, chronic dieting, or emotional eating, it can be helpful to get support from a treatment team. If this is causing distress, it’s enough reason to reach out. Someone does not need to experience all symptoms of an eating disorder before getting help.

 

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Additional Reading:

Treating Eating Disorders
Approaching Someone with an Eating Disorder
Chewing and Spitting Food

References:

Binge Eating Disorder – By Amy Pershing and Chevise Turner
Sick Enough – By Dr. Jennifer Gaudiani
Intuitive Eating 3rd Edition – By Evelyn Triboli and Elyse Resch
NEDA – National Eating Disorder Association

 

Updated by Molly Bahr – 1/2020
Updated by Tabitha Farrar – 2014
Written By: Colleen Thompson – 2001