FARGO - What does it look like to start a diet? Maybe it means eating salads every day for lunch, throwing away the chips in the pantry or occasionally choosing not to eat the brownies sitting in the break room. A diet can seem like a healthy and harmless way to simply lose a few pounds, and for many individuals it can be.
However, sometimes what seems like an innocent form of healthy eating can develop into unhealthy methods of losing weight. Food can become scary and eating an enemy.
This week is National Eating Disorder Awareness Week, a time aimed at eliminating misconceptions about eating disorders; such as the notion that anorexia and bulimia are the most common types.
Eating disorders are commonly associated with restrictive eating and methods such as fasting, skipping meals, smoking, vomiting or taking laxatives. In fact, a 2013 National Eating Disorder Association (NEDA) survey found that half of teenage girls and approximately one-third of teenage boys use these damaging approaches to weight control.
However, eating disorders aren't always identified with eating less food. Surprising enough, the most common eating disorder is binge eating disorder (BED).
The NEDA study identified BED as three times more common than anorexia and bulimia combined. Three out of 10 individuals looking for weight loss treatments show signs of BED and roughly 40 percent of the people affected are males. Still, this disorder wasn't categorized as its own diagnosable eating disorder until May 2013.
What is BED?
"Binge eating is a common eating disorder where people eat a very large amount of food but at the same time they feel very out of control. They feel powerless to stuff, and they feel distressed because of their eating," says Dr. Kelly Kadlec, a licensed psychologist at The Sanford Eating Disorder and Weight Management Center in Fargo. "They can't stop even if they want to, and they become very upset about it."
Signs and symptoms
BED symptoms are not to be confused with overeating.
"Overeating can be large amounts of food, too, but people who are simply just overeating usually feel like 'Oh, I should stop eating but maybe I don't want to, or they are able to stop,'" Kadlec says. "They might be a little upset, but they are not getting depressed and really distressed (over food)."
According to Kadlec, BED can be identified through a few warning signs and symptoms.
"It has to happen at least once a week for the past three months where you are having this out-of-control eating," Kadlec says. "You eat until you are really uncomfortably full. You eat a large amount of food even though you aren't physically hungry. (People with BED) typically eat very rapidly and a lot of times they are doing this in secret. They are hiding food and they are very embarrassed by their eating."
There are multiple dangerous psychological and physical effects of BED that people need to consider as well. Mental health disorders, such as depression, can potentially occur alongside BED. The eating habits BED causes can be the source of medical complications such as weight gain, gastrointestinal problems, high blood pressure and problems with cholesterol. "Typically (those with BED) binge on foods that are not like fruits and vegetables," Kadlec says. "The foods are usually things such as carbs, sweets and pastries. It's a lot of high-calorie foods people usually binge on."
The hidden disorder
BED may be the most common eating disorder, yet individuals suffering often go untreated. In fact, just 3 percent of people who meet the criteria receive a diagnosis. Feelings associated with BED can lead to common perceptions that cause this disease to go undiagnosed. Kadlec believes this is partially because BED is incredibly secretive to the individual who has it.
"Usually people are very embarrassed and ashamed of their eating so they don't reach out," Kadlec says. "I think there's a lot of stigma around binge eating where people think the patient doesn't have self control, which is not true."
While anorexia and bulimia can often be identified by physical changes like hair loss, decreased energy and discoloration of the skin, BED doesn't necessarily display itself physically.
"People with binge eating (disorders) can be overweight or a normal weight and one might not notice anything in particular," Kadlec says.
The lack of knowledge and understanding about BED could be another reason why it frequently goes untreated.
"I think a lot of providers don't know how to diagnose binge eating," Kadlec says. "Other providers who are not trained don't know what to look for."
Kadlec says although BED previously fell within categories of other eating disorders, now it has its own diagnosis. This recognition is critical because some insurance companies won't cover eating disorder treatment without its own formal diagnosis.
Proper understanding of anorexia and bulimia has brought more awareness and help to individuals who have it. With binge eating disorder awareness growing since its formal recognition in 2013, professionals are hoping this is the first step toward accurately treating the disorder and fighting misunderstandings surrounding it.
What to do next
For people who believe they may be struggling with an eating disorder such as BED, Kadlec recommends the following:
- Talk to your doctor. "Look for a provider or a clinic that has expertise in eating disorders," Kadlec says. "By asking a primary care provider for a referral, you can also find someone that they may know that treats eating disorders."
- Utilize online resources. Websites such as Nationaleatingdisorders.org and Bedaonline.com contain helpful details to learn more about BED. "There is a lot of information on these sites about binge eating, how to find help and questions you can ask a provider," Kadlec says
- Confide in people you trust. "Start that conversation with a professional and seek help from there," Kadlec says. Often a simple phone call - even with a trusted family member, friend or colleague - may help.