What are the Causes of BED /COE?

Many factors likely contribute to the development of BED and COE. Researchers are looking into the impact of chronic dieting, sexual abuse, depression, and obsessive- compulsive disorder have on the development of these disorders.

There is great social pressure in developed countries to be thin and physically fit beyond what is necessary for maintaining good health. The ideal body size of extreme thinness and/or well-defined “ripped” muscles is unattainable for the vast majority of people. Chronically fighting the body’s natural weight by underrating (dieting) has been shown to result in rebound overeating and binge- eating. Some people rebel against society’s ideal body shape by overeating and under exercising. Others become so discouraged about their inability to lose weight that they give up efforts to normalize eating behavior.

Eating is a soothing behavior that leads to a sense of calmness and relaxation. When food is introduced as a way to calm down or as a reward for good behavior, one learns to self-soothe with food regardless of physical need. Overeating becomes a learned response to all manner of physical and psychological stresses, whether they be positive or negative stresses. The habit of overeating becomes so automatic that one is often not consciously aware of the behavior.

Binge eating perpetuates the overeating behavior by increasing the stomach’s capacity. This, in turn, decreases the signals to the body for satiety and encourages further binge eating.

Medical and Psychological Consequences of BED/COE

Chronic binge-eating or overeating can lead to obesity. Obesity is associated with an increased risk of developing diabetes, high cholesterol, and high blood pressure. Chronic overeating and rapid eating can cause digestive problems, sleepiness, and lethargy.

People with BED or COE feel tremendous guilt about their eating behavior and shame about their body size. They tend to isolate themselves which furthers the feelings of inadequacy and the obsession with food and weight. Isolation also makes it easier to binge eat or over eat. They may have limited enjoyment and fulfillment in their lives.

The discrimination experienced by the obese is real. They suffer psychologically and financially as a result. Even obtaining good medical care may be difficult due to prejudice among physicians and other health-care providers.

Treatment Options

Most hospital-based and residential eating disorder programs treat BED along with anorexia nervosa and bulimia. Programs range from one week intensive therapy to several weeks of treatment followed by on-going out-patient treatment. Out-patient treatment is the most common treatment for COE.

Nutrition therapy and psychotherapy are combined to normalize eating/exercise behaviors and resolve underlying psychological issues. Medical monitoring for health problems associated with obesity and overeating is also incorporated. Treatment involves reconnecting one’s eating to physical signals of hunger and satiety, learning healthier stress management and coping behaviors, increasing self- esteem and empowerment, reconciling unresolved family issues and traumatic events, and improving body image/acceptance. Antidepressant medication may also be included.

Self-help groups are another resource for people with BED or COE. Overeaters anonymous are available in most cities around the country and are usually advertised in the classified section of the local newspaper. Support groups are also available on the Internet.