Binge Eating Disorder and Diabetes (Part 2)

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I’d like to start off by thanking those people who posted comments and questions about binge eating disorder (BED) on my previous blog entry ("Binge Eating Disorder and Diabetes [Part 1]") over the last week. Some of you have shared that you have BED, while others are perhaps questioning the possibility. Arming yourself with facts about BED can help you and your health-care team determine whether you have this disorder and, if so, how to get the right treatment.

So, what causes BED? Well, as with many conditions, there’s probably no one single cause, but here are some likely culprits:

  • Psychological factors: The study I mentioned last week revealed that people with BED are more likely to have psychological issues, such as a history of depression, substance abuse, or emotional problems. In fact, it’s speculated that at least half of those with BED have depression or a history of depression.
  • Frequent dieting: While not a factor for everyone, researchers think that people who have frequently gone on (and off) diets or who have followed overly restrictive eating plans are more prone to having BED, along with other eating disorders, such as bulimia.
  • Lack of adequate coping skills: People with BED often feel a lack of control in their lives, and may be unable to handle certain emotions, such as anger, stress, or boredom. One way of dealing with emotions is to overeat. Impulsive behavior may be seen in someone with BED, as well.
  • Genetics and biological makeup: It’s possible that brain chemistry and metabolism can influence eating behaviors. And there may be a tendency for eating disorders to run in the family.

While the exact cause or causes of BED are a little murky, what we do know is that someone with BED is more likely to be overweight or obese, which in turn raises the risk for heart disease, Type 2 diabetes, high blood pressure, gallbladder disease, sleep apnea, and possibly certain types of cancer. Interestingly, a few studies have found that BED may be more common in people who already have Type 2 diabetes (ranging anywhere from 2.5% to 26%) than in to people who don’t. People with Type 2 diabetes and BED tend to be younger, have a higher body-mass index (BMI), and have more depression than in those without BED. And BED is more common in women with diabetes than in men with diabetes.

If you think you may have BED (or any kind of eating disorder), it’s important to seek medical help. Aside from the possible health consequences, you may end up missing more days from work or school, avoiding friends and social activities, and having difficulty enjoying life overall.

Treatment of BED focuses on treating the eating disorder first and losing weight, if needed, second. Concurrent psychological issues, such as depression or anxiety, must be addressed as well. There are several possible forms of treatment, including cognitive behavioral therapy that centers on problem-solving skills and learning healthy habits; psychotherapy; and medication (including use of antidepressants, appetite suppressants, and antiseizure drugs). Weight loss may not be recommended until the BED is treated, unless it’s medically supervised. Very-low-calorie diets can actually trigger BED.

To wrap up, if you think you may have BED, talk to your health-care provider. He or she should be able to refer you to a mental health care provider and/or an appropriate eating disorder treatment program.

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