Unlike the eating disorder of bingeing and purging (bulimia), where the person induces vomiting or ingests large amounts of laxatives in order to get rid of the food, bingeing is a psychological disorder that manifests itself by loss of control in which emotion and thinking patterns cause a person to take on dangerous eating habits, such as overeating. Usually, these habits are a way of coping with depression, stress or anxiety. Food, being the commodity of which the sufferer has lost complete control, becomes more of an enemy than a lifeless object. Binge eating is new to the long list of traditional eating disorders and is said to affect millions of people around the world. Persons suffering with this disorder are not immediately recognized, because they are quite masterful at hiding their actions. For the purpose of this essay, specific clinical issues such as Dialectical Behavior Therapy and treatment programs for binge eating disorder will be analyzed.
What causes binge eating disorder? Although we do not know the exact cause of binge eating disorder, researchers have found that it is a combination of biological, psychological and social and cultural factors.
1. Biological causes of binge eating disorder Binge eating is caused by genetic irregularities in the hypothalamus, (a small piece of tissue in the brain) which controls body weight and appetite. When not working properly it transmits incorrect messages about hunger and fullness. Studies also show that food addiction may also be inherited and that low-levels of serotonin in the brain (a neurotransmitter which helps to communicate messages from one area of the brain to another) also plays a major role in developing binge eating disorder. (Binge Eating Disorder)
2. Psychological causes of binge eating disorder Studies show that there is a co-relation between binge eating and depression as more than half of diagnosed patients with binge eating disorders are being treated for depression or were at sometime in their lives. Feelings of low-self esteem, unhappiness and discontentment with their body image are the key issues of compulsive overeating. Binge eaters usually have trouble in expressing their feelings as well as controlling their urges to overeat. (Binge Eating Disorder)
3. Social and cultural causes of binge eating disorder Advertising plays a major role in subjecting binge eaters to emotional eating due to the fact that the “thin” message is advertised everywhere, i.e, television, magazines, billboards, etc. It is also said that parents have influenced the succession of binge eating among their children “by using food to comfort, dismiss or reward their children” (Binge Eating Disorder, 3) while frequently commenting about their weight and body image. Another major cause of binge eating is sexual abuse during childhood. (Binge Eating Disorder)
How is binge eating disorder diagnosed? Another eating disorder that is similar to binge eating is bulimia nervosa. People with bulimia nervosa will self-induce vomit, over-exercise or use other ways to lose their caloric intake. People with binge eating disorder do not express these symptoms; in fact binge eating causes them to be overweight. Their symptoms include frequent uncontrollable bingeing and feeling upset during or after bingeing. Below is an example of a person suffering from binge eating disorder.

Steve’s Story

“Steve has struggled with weight problems for as long as he can remember. But over the past six months, he’s been bingeing more and more frequently and has packed on another 50 pounds. Steve is really anxious about the weight gain. He hates the way he looks and he’s worried about developing diabetes, which his doctor tells him is a very real risk. But he doesn’t know how to stop his out-of-control eating. Steve tries to eat normally, but as the day goes on, the compulsion to binge gets stronger and stronger. On the way home from work, Steve usually gives in to the urge. First he goes through two different fast food drive-ins, ordering two cheeseburgers, a large order of fries, a chocolate shake, coleslaw, and a bucket of fried chicken. Then he pulls into a secluded parking spot and wolfs everything down in his car. Next, he heads to the grocery store to grab donuts, cookies, and chips. Once he’s home alone, Steve starts in on the snacks. He doesn’t stop until the food is gone or he’s so stuffed that he feels sick. Afterwards, he berates himself for being such a pig, but he knows it won’t be long until he binges again.“ (Binge Eating Disorder, 1)

Normally, the disorder is discovered when patients seek help from their doctor for weight-loss treatment. If binge eating disorder is suspected, the doctor will run many tests and exams such as x-rays and blood work to ensure there is no physical illness. When the results of the tests and exams are negative, the doctor will refer the person to a mental illness specialist, i.e., psychiatrist or psychologist who will interview and assess the person for an eating disorder.
How is binge eating disorder treated? The treatment process for binge eating disorder is a very difficult one mainly because most people try to hide their disorder. There are different types of treatment for binge eating disorder and by following a specific treatment plan, the person will be able to gain control over their eating disorder.
1. Psychotherapy Psychotherapy focuses on changing a persons thinking and behavior in regards to food. It teaches them how to check their eating as well as their moods. Methods for developing problem solving skills, healthy attitudes toward food and weight are also taught. Studies have shown that cognitive behavior therapy, interpersonal therapy and dialectical behavior therapy have been effective in treating binge eating disorder. (Binge Eating Disorder)
2. Cognitive Behavior Therapy “During cognitive behavior therapy the therapist may ask you to keep a food diary or a journal of your thoughts about eating, weight, and food. The therapist will also help you recognize your binge eating triggers and learn how to avoid or combat them. Cognitive-behavioral therapy for binge eating disorder also involves education about nutrition, healthy weight loss, and relaxation techniques.” (Binge Eating Disorder, 6)

Interpersonal Psychotherapy “Interpersonal psychotherapy for binge eating disorder focuses on the relationship problems and interpersonal issues that contribute to compulsive eating. Your therapist will also help you improve your communication skills and develop healthier relationships with family members and friends. As you learn how to relate better to others and get the emotional support you need, the compulsion to binge becomes more infrequent and easier to resist.” (Binge Eating Disorder, 6)
3. Dialectical Behavior Therapy “Therapy combines cognitive-behavioral techniques with mindfulness meditation.” (Binge Eating Disorder, 6) Dialectical Behavioral Therapy helps control emotions by teaching patients to identify what causes their emotions and to stop them from escalating to critical behaviours. Breathing exercises is an excellent way to help with relaxation. To achieve this effect, patients learn to breathe from the diaphragm by stimulating the part of the nervous system responsible for relaxation. Mindful eating is another process patients can help with regulating their emotional responses to food while eating. Patients will be provided with the necessary information and process to help focus on their awareness as well as provide a way to escape the emotional and mental numbness created by binge eating. The following are ways to practice Mindful Eating: a) Begin Mindful Eating by Preparing Yourself for Food – Become Aware of Food “Be aware as you go to the kitchen or to the table that you are preparing to eat. Take an inventory of what has been prepared. You may benefit from saying the names of different foods aloud, if possible. Recognize how much is available of each kind, and how large your plate is.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 1) “Recommendation: Use dishes and silverware that are enjoyable. If you are having some chips, put them in an attractive bowl rather than eating from the bag. Put away the plastic ware and eat from dishes that you enjoy seeing. Pour drinks into glasses or mugs (also, if you're getting coffee at a coffee shop and you're going to drink it there, ask for a mug rather than using the paper cup).” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 1) “Benefit: You will have a better idea of what you want from the food available after taking a full inventory. And identifying everything verbally will force you to be concrete. This can help to reduce anxiety around food. (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 1) b) Mindful Eating Means Eating with Your Eyes “Your eyes will tell you a good deal about the food in front of you. What does it mean to use them with purpose--to eat with your eyes? Take in your food's shape. Is it flat, like a cracker? Roundish and bumpy like cauliflower? Or does it look smooth, shiny, or dull? Examine color. Notice variations in color on the skin of a piece of fruit or in grill marks on a steak. Is the color appealing? Bright? Deep? You may notice spices in or on your food. There could be some oregano in a tomato sauce, or perhaps some pepper dusting a chicken breast.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 2) “Benefit: Chefs go to great lengths to prepare food attractively because they know it can add excitement and satisfaction to the experience. We eat in order to become satisfied and often to pursue pleasure. The more we pay attention to what our eyes tell us, the more satisfaction and pleasure are available.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 2) c) Mindful Eating Means Enjoying the Smell of Foods “Most of us don't take the time to lean over a dish and take in the smells of the food intentionally. And we miss out. When you enter a kitchen in which preparation for a good meal has begun, your sense of smell knows right away. But if you've been preparing the food or if you've been in an adjacent room, you can get "numb" to the good smells. Don't be shy. When etiquette allows, bring your nose close to your food and see if you can pick out what's in it before you take a bite. Breathe in slowly, searching through the scents for a preview of what you're about to eat.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 3) “Benefit: Your sense of smell is tied to your sense of taste. You get to begin your enjoyment of the food's flavor without eating it. Being intentional here will give you a greater willingness to be intentional in later steps. (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 3)” d) Hearing the Sounds of Eating “For most of us, eating does not really involve the sense of hearing. But the sounds of food and eating have a lot to tell us. There is no mistaking the sound of a piece of silverware making contact with a plate, or a beverage being poured over ice. Biting into a carrot makes a different sound than biting into any other food. And passing a spoon through macaroni and cheese or a casserole is recognizable even without seeing it happen. Pay attention to sounds prior to eating. And remember that when you begin to eat, the sounds continue. Tune in to food sounds like the crunch of a tortilla chip. Recognize the sounds of your food being moistened in your mouth. And hear yourself swallow.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 4) “Benefit: Just as music can please us through our sense of hearing, so can eating, in its own way. As you hear what you are eating, you become more aware of your participation, which helps you to know how much you've eaten.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 4)

e) Feeling your Food to Increase Satisfaction “Touch is such an important part of eating that it would be impossible to eat without it.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 5) Sensual Eating, Outside the Mouth “Touch is present in eating in many ways. The sense of touch informs us from the moment we reach for a fork (or, if eating finger food, the moment we reach for the food itself). And the experience can be bad as well as good. For example, if you are trying to cut into food with a fork that digs into your finger, guess what? Your enjoyment will be less. Prior to taking a bite, you will be aware of other touch-based information. You will feel a food's weight--a bite of dark chocolate is heavier than a kernel of popcorn. A spoonful of peanut butter weighs more than a spoonful of rice.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 5) Sensual Eating, Inside the Mouth “Of course, touch tells us about the texture of food once we begin to eat it. Here are some possibilities, with an example of each: Smooth (yogurt), Bumpy (cracker), Creamy (pudding), Grainy (hummus), Gritty (some nuts; also noticeable in pears), Chewy (dried fruit), Crunchy (snack chips), Crumbly (coffee cake, certain kinds of cheese). Temperature also is an important piece of information to the brain. Foods taste different depending on their temperature, and their textures change as well (think of a cold hunk of cheese versus the same cheese heated and melted). Further, touch helps us to push food to the various parts of our mouths for chewing and to orient it so that we can swallow.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 5) “Recommendations: Make sure your food is at the right temperature to allow you to enjoy it--no half-heated food!” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 5) f) Awakening to the Taste of Food “Flavor is perhaps the most powerfully sensual information we get from eating. The variations are endless and intriguing. Our taste buds (actually working with the sense of smell) can bring us great pleasure as well as great disgust. Usually, however, only a small part of our consciousness is aware of the flavor of food we eat. It's just enough to keep us eating. What if we really paid attention to all the data that taste can bring? When you have taken a bite of food, check in to see what flavors are there--both bold and subtle: Salty, Sweet, Bitter, Acidic, Earthy, Bland, Spicy, Sour, Toasted/Roasted, Minty, Woody, Floral, and/or Smoky.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 6) “Recommendation: If it's hard to focus on flavor, closing the eyes can make things easier.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 6) g) Don’t Forget to be Mindful of the Stomach “There's so much going on in the senses registered through the eyes, nose, ears, and mouth that it can seem unnatural to include the stomach as well. But real satisfaction would be impossible without input from the stomach, which tells us when we have completely fulfilled the need to eat. You may recognize a delay between the time you are full and the moment you know you are full. To reduce the effect of this phenomenon, check in with your stomach every three or four bites. Don't start checking in halfway through the meal; you are more likely to forget to check at all. Further, starting early in the meal allows you to compare later feelings of moderate fullness to feelings of having a relatively empty stomach. Take a deep breath as you check to clear your head and help you tune in. Compare your feeling of fullness with the level of satisfaction in eating your last bite. In general, pleasure associated with eating a bite of food lessens as the stomach becomes more full.” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 7)

h) Enjoy the Self as well as Food “When you stop eating when you are comfortably full and begin some other activity, ask yourself how you feel about you. What is your self-opinion? If you are like most, being aware of the body's amazing ability to respond to food sensually is very satisfying. And knowing that you have treated your body well--honored your body--throughout the meal or snack helps in developing a culture of self-care that can extend to other areas of your life (exercising in a healthy way, for example). You may also have a strange psychological reaction to treating yourself well: "I don't deserve this. I'm uncomfortable doing this because it feels good, and I'm not supposed to feel good." And there is a real challenge. It takes a lot of courage to exist outside your comfort zone, whether the "extreme" place is much better than your normal way of being or much worse. Living in a new and better place, and staying there, can be a big adventure. If you have had difficulty working your way through this exercise, don't worry. It will take some practice to eat with real awareness, particularly in a culture that works so hard to take your attention away from what you are eating, how much you are eating, and how satisfying it is (or isn't). Continuing to eat mindfully will make all those distractions very, very boring!” (Mindful, Sensual Eating: How to Develop Food and Eating Awareness, 8) Dialectical Behavior Therapy also teaches the patient to look at emotions in a different way for example “anger”. The patient may say “I’m angry! What’s wrong with me?” (Dialectical Behavior Therapy May Be an Effective Treatment for Binge Eating, 1) The therapist will help the patient change this to “I’m angry. I wonder why?” (Dialectical Behavior Therapy May Be an Effective Treatment for Binge Eating, 1) to ensure that “anger” does not lead to other negative emotions like shame or guilt. In Dialectical Behavior Therapy self-distraction and self-soothing skills are taught for moments in which the person cannot change a stressful situation right away. For self-distraction the therapist teaches the patient to use the following skills: 1) Involve yourself in physical activities as distress tolerance helps you to feel better. When you do physical activity, endorphins are released and you get a good feeling because of the chemicals that are released.
2) Contribute your time to volunteer work or to someone, give something to someone else. 3) Visit an emergency waiting room or a hospital waiting room and compare yourself to people coping the same as you or less well than you. 4) Watch comedies or emotional movies to create the opposite emotion to what you are feeling. 5) Push a bad situation away mentally by leaving it for a while. 6) Count to 10. 7) Squeeze a rubber ball very hard, take a hot shower, listen to loud music, etc. (Distress Tolerance) Self-soothing skills help sooth each of the five senses. To sooth your vision sense, buy a beautiful flower or paint your room a different colour. Be aware of each sight that passes in front of you. To sooth your hearing sense, listen to beautiful or soothing music or to invigorating and exciting music. Be aware of any sounds that come your way, letting them go in one ear and out the other. For your sense of smell, spray on some of your favorite perfume or spray fragrance in the air and light a scented candle. For your sense of taste, enjoy a great meal and have a have a calming drink, like herbal tea or hot chocolate as well treat yourself to your favorite dessert. While eating, focus on its taste. For your sense of touch, experience whatever you are touching; notice if the touch is soothing or not. (Distress Tolerance)
Initial Testing of Dialectical Behavior Therapy for Binge-Eating Disorder The initial testing of Dialectical Behavior Therapy for Binge-Eating Disorder included 18 participants and the results were very encouraging. “Sixteen (89%) had stopped binge eating by the end of the treatment” (Dialectical Behavior Therapy May Be an Effective Treatment for Binge Eating, 1) compared to another group who did not engage in Dialectical Behavior Therapy, only 12% stopped binging. At the end of six months, 56% (of the 89%) of the participants were still abstinent from binge eating not to mention that they did not receive any further help after the 20-week period. Although there was no other treatment program to compare with at the time of this study, it is apparent that Dialectical Behavior Therapy is better than doing nothing. Is it better than any other treatment? Only time will tell. (Dialectical Behavior Therapy May Be an Effective Treatment for Binge Eating) Specific clinical issues such as Dialectical Behavior Therapy and other treatment programs for binge eating disorders were included and analyzed in this report. It is important to understand that bingeing is a serious psychological disorder caused by unhealthy thinking and low self esteem. This leads to life threatening eating habits such as overeating. There have been many treatments outlined for this disorder to help patients learn that food does not have to be the enemy. Those hiding their actions must seek psychological support to help overcome their internal fears in a healthier way. In this manner, relief will come to those millions who are affected by this disorder around the world.
Works Cited/Bibliography
Tiemeyer, Matthew. “Dialectical Behaviour Therapy May be an Effective Treatment for Binge Eating.” About.com a part of The New York Times Company, 2009. Updated: April 26, 2009. < http://eatingdisorders.about.com/od/treatmentstrategies/a/dbtbingeeating.htm.>

Dietz, Lisa. “Dialectical Behaviour Therapy Self Help – Distress Tolerance.” 2003.

Tiemeyer, Matthew. “Mindful, Sensual Eating: How to Develop Food and Eating Awareness.” About.com a part of The New York Times Company, 2009. Updated: March 14, 2009. < http://eatingdisorders.about.com/od/resourcesandreviews/ss/mindfuleating.htm.>

Melinda Smith, M.A., Suzanne Barston, Robert Segal, M.A., and Jeanne Segal, Ph.D. “Binge Eating Disorder, Symptoms, Causes, Treatment, and Help.” Last modified: March 2008.

Mayo Clinic Staff. “Binge Eating Disorder, Guidance on the Path of Healing.” May 2009.