Signs and Symptoms of Compulsive Eating

Also referred to as “food addiction” and “binge-eating disorder” (BED), compulsive overeating is characterised by an obsessive-compulsive relationship to food. This condition is not only manifested by abnormal (amount of) food intake, but also by the intake and craving for foods that are, in themselves, harmful to the individual. People suffering from this disorder engage in frequent episodes of uncontrolled eating, or binge eating, during which they may feel out of control, often consuming food in frenzy, past the point of being comfortably full. The binge is usually followed by feelings of guilt, shame, and depression. In order to feel better about themselves, binge eaters will surrender to cravings with another binge, which they hope will numb out the bad feelings; thus, the cycle repeats itself.

Compulsive eating is less well-known than the eating disorders of anorexia nervosa or bulimia, and it can be differentiated from bulimia, which also involves binge eating, by the fact that binge eaters do not attempt to compensate for their bingeing with vomiting, fasting, or laxative use. People with this disorder also engage in grazing, during which they return to consume small amounts of food throughout the day. While each incident of grazing may not involve a lot of food, it adds up over the course of the day. Altogether, compulsive overeaters may eat between 5000 and 15,000 calories per day, resulting in a temporary release from psychological stress through an addictive high not unlike that experienced through drug abuse. (All About Life Challenges, 2012; Wikipedia, 2012).

Signs and symptoms of compulsive eating and/or food addiction

People caught up in this disease exhibit a wide array of symptoms. If you are supporting a compulsive eater through a treatment and recovery process, or even just trying to get them into treatment, it is important for you to know that many of the signs are not observable by you or anyone else; they are occurring either in secret (because the food addict needs it to be that way), or else they are happening as feelings or sensations inside the addict. The person:

1. Is obsessed with thoughts about food
2. “Comfort eats” in order to relieve stress or worry
3. Eats much more rapidly than normal (so that they can eat more)
4. Eats alone or hides food in order to eat in secret due to shame and embarrassment
5. Eats very little in public, but maintains a high body weight
6. Feels guilty due to overeating, and/or eats more than intended to when began
7. Feels sluggish or lethargic from overeating
8. Binge eats or eats uncontrollably even when not physically hungry
9. Eats everything on the plate, even when full
10. Goes on a food binge after dieting or trying to cut back
11. Eats until feeling sick
12. Feels anxious while eating, which results in more eating
13. Does not like to feel hunger
14. Gets depressed or has mood swings
15. May be aware that eating patterns are abnormal
16. Is preoccupied with body weight
17. Over time, has felt the need to eat more and more to get the desired emotional state
18. Has experienced withdrawal when cutting down/out certain foods (not including caffeine)
19. Experiences rapid weight gain or seemingly sudden obesity
20. Has a history of weight fluctuations
21. Has difficulty moving around due to weight gain
22. Sometimes consumes certain foods so often or in such large quantities that spends time dealing with negative emotions instead of working, spending time with family or friends, or engaging in other important or enjoyed activities
23. Has withdrawn from activities because of embarrassment about weight
24. Has a history of many unsuccessful diets
25. Has low self-esteem and (therefore) feels the need to eat greater and greater amounts
26. Sees food as something to be avoided, harmful (All About Life Challenges, 2012).

(Wikipedia, 2012; Gearhardt, A.N., Corbin, W.R., and Brownell, K.D., 2009).

Food addiction: the underlying biochemistry

For many years, overeating and obesity were frequently diagnosed as eating disorders and thus treated as emotional disorders that could be overcome merely by “talk therapy” (counselling). Recently, however, researchers have been able to establish that some food substances trigger cravings with an underlying biochemistry similar to the cravings that an alcoholic has for alcohol. Those trigger foods are typically refined carbohydrates, sugar and artificial sweeteners, fatty foods, and processed foods. They affect the same addictive brain pathways that alcohol and drugs influence. Here are some of the latest scientific findings confirming that food can be addictive:

1. Sugar stimulates the brain’s reward centers through the neurotransmitter dopamine precisely like other addictive drugs.
2. High-sugar and high-fat foods work just like heroin, opium, or morphine in the brain, according to brain imagining scans.
3. Such scans also show that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine (e.g., sugar).
4. Foods high in fat and sweets stimulate the release of the body’s own opioids (chemicals like morphine) in the brain.
5. Drugs used to block the brain’s receptors for heroin and morphine also reduce the consumption of and preference for sweet, high-fat foods in both normal weight and obese binge eaters.
6. People (and rats) develop a tolerance to sugar, needing more and more of it to satisfy themselves, just like addicts do for drugs such as alcohol or heroin.
7. Obese people, just like drug addicts or alcoholics, continue to ingest large amounts of their substance (unhealthy foods for the food addict) despite debilitating health, occupational, personal, and relational consequences.
8. Animals and humans experience “withdrawal” when suddenly cut off from sugar, just like addicts do when detoxifying from drugs.
9. Just as with drugs, after an initial period of enjoying the foods, the compulsive eater no longer consumes them to get high, but to feel normal (Hyman, M., 2011).

These findings have been demonstrated by food addicts who participated in 30 to 90-day residential treatment programs, only to resume eating “a small amount” of their trigger foods. In most cases, the program participants were soon back to full-fledged compulsive eating. This phenomenon has been likened to the alcoholic being told to have a small glass of wine. Probably, the alcoholic needs to abstain forever from the wine, and so does the food addict from the trigger food (Obesity and Food Addiction Summit, 2009).

According to Kay Shepherd, a pioneer in the treatment of food addiction, it is also like alcoholism in that it is a chronic, progressive, fatal disease:

• Chronic, because the condition never goes away;
• Progressive, because it gets worse over time (the compulsive overeater needs larger and larger amounts of the trigger foods to release the feel-good chemicals);
• Fatal, because of the many complications related to the addiction, including obesity, Type II diabetes, heart disease, hypertension, sleep apnoea, depression, kidney disease, arthritis, bone deterioration, and stroke (Obesity and Food Addiction Summit, 2009).

Asleep at the plate: the experiences of binge eaters

If this talk about becoming addicted to food – a substance we need in order to survive – has you worried, have a heart for the compulsive eater. One of the problems binge eaters frequently experience is night time eating. In their total preoccupation with food, those with BED have been known to leave their bed in the wee hours of the morning, wandering into the kitchen in a trance-like state to have another binge.

Sometimes binge eaters do not know until the next morning (when they see the food wrappings and empty containers) whether what they experienced was a dream or a sad reality. They feel their most vulnerable to binges when they are alone, and most report that, once a binge has begun, it is virtually impossible to stop it, or even slow down the event. Because of the huge volatility this disease creates with blood sugar levels (wild spikes followed by massive let-downs), BED-affected individuals’ brains are adversely affected, and they often suffer severe fatigue (Natenshon, A., 2006).

Useful resources

Below are useful links to further information on compulsive eating/ Binge Eating Disorder.

1. What is food addiction?
2. Paper: Obesity in Australia: a need for urgent action
3. Dr Mark Hyman: Food Addiction
4. Binge Eating Disorder: Symptoms and remedies
5. All About Life Challenges: Food addiction Symptoms
6. Binge eating disorder to be recognized in the DSM-V

This article is an extract of the upcoming Mental Health Social Support Specialty “Aiding Addicts”. For more information on MHSS, visit www.mhss.net.au.

References:

• All about life challenges. (2012). Food addiction. All about life challenges. Retrieved on 30 April, 2012, from: http://www.allaboutlifechallenges.org/food-addiction-symptoms-faq.htm
• American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (fourth edition, text revision. Washington D.C.: American Psychiatric Association.
• American Psychiatric Association. (2000). Quick reference to the diagnostic criteria from DSMIV-TR. Washington, D.C.: American Psychiatric Association.
• Drug and Alcohol Rehab Asia. (2012a). Alcoholism explained. Drug and Alcohol Rehab Asia. Retrieved on 7 May, 2012 from: http://alcoholrehab.com/alcohol-rehab/alcoholism-explained/
• Drug and Alcohol Rehab Asia. (2012b) What to expect in advanced recovery. Drug and Alcohol Rehab Asia. Retrieved on 21 May, 2012 from: http://alcoholrehab.com/alcohol-rehab/what-toexpect-in-advanced-recovery/
• Gearhardt, A.N., Corbin, W.R., and Brownell, K.D. (2009). Primary validation of the Yale Food Addiction Scale. Appetite. 52 (2): 430-436.
• Hyman, M. (2011). Food addiction: Could it explain why 70 per cent of America is fat? Dr Hyman.com. Retrieved on 7 May, 2012, from: http://drhyman.com/blog/conditions/food-addiction-could-it-explain-why-70-percent-of-america-is-fat/
• Natenshon, A. (2006). Binge eating disorder (compulsive overeating): Symptoms and remedies. The experience of the binge eater. Empowered parents.com. Retrieved on 30 April, 2012, from: http://www.empoweredparents.com/1eatingdisorders/binge.htm
• Obesity and Food Addiction Summit. (2009). Food addiction: what is food addiction? Obesity and Food Addiction Summit. Island Wood, Bainbridge Island, Washington. Retrieved on 7 May, 2012, from: http://www.foodaddictionsummit.org/foodaddiction.htm
• Wikipedia. (2012). Compulsive overeating. Wikimedia Foundation, Inc. Retrieved on 30 April, 2012, from: http://en.wikipedia.org/wiki/Compulsive_overeating