Psychopathology of recurrent and uncontrolled binge eating behaviors: causes and therapy

Recurrent binge eating behaviors are repetitive, persistent and uncontrolled actions aimed at emotional regulation. These are dysfunctional eating behaviors that often tend to worsen the emotional discomfort experienced. Because of the proven shame the binge eating behavior is carried out in solitude and is commonly followed by guilt. If the uncontrolled eating behavior occur at night, the quality and/or the continuity of nighttime sleep is compromised with drowsiness and diurnal dizziness.

Nervous Bulimia is an eating disorder characterized by recurrent binge eating behaviors accompanied by the feeling of losing control over how much and what you are eating. People affected by this disorder are overly concerned about body shape and weight: they generally use self-induced vomiting to maintain a normal weight.

Other possible weight compensating conducts are exercises or use of laxatives, diuretics and enteroclisms. In some people the amount of food ingested during the binge eating behavior is minimal. Other people referred only binge eating behaviors or just episodes of self-induced vomiting. These forms are generally termed atypical forms of bulimia falling within the category of eating disorders not otherwise specified.

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Other psychopathological disorders characterized by recurrent binge eating behaviors are the Bing Eating Disorder (BED) and Night Eating Syndrome (NES). Both have been related to the presence of obesity since, unlike bulimia nervosa, in these disorders, the binge eating behaviors are not followed by weight compensating conducts. BED is commonly characterized by a more severe and early onset obesity with a more serious and early onset eating disorder.

The combination of personalized food programs and psychological treatments, however, can lead to a remission of the disorder. NES, on the other hand, is commonly associated with stress, sleep and mood disturbances with alterations in the neuroendocrine system. This disorder can be treated with psychiatric drugs that increase serotoninergic function (Stunkard & Allison, 2003). To investigate these disorders’s causes and the difficulty in weight loss, a research has evaluated the effects of stress on sleep quality, excess hunger, desire for certain foods and less motivation to exercise. The association of these factors could contribute to weight gain and obesity, not only by increasing the frequency of the binge eating behaviors but also by reducing the effectiveness of weight-loss interventions. In fact, lifestyle modification and proper psychological stress management can play a significant role in achieving a satisfactory weight loss for overweight or obese people (Geiker et al., 2017).

There are several treatment options for eating disorder characterized by recurrent binge eating behaviors. According to recent clinical trials, cognitive behavioral therapy and interpersonal psychotherapy would be the most effective interventions (Grilo, 2017).

References:

Geiker NRW et al. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight lossinterventions and vice versa? (2017). Obes Rev. [Epub ahead of print].

Grilo CM. Psychological and Behavioral Treatments for Binge-Eating Disorder (2017). J Clin Psychiatry. 78 Suppl 1:20-24.

Stunkard AJ & Allison CK. Two forms of disordered eating in obesity: binge eating and night eating (2003). International Journal of Obesity 27, 1–12.

Tiziana Corteccioni

About Tiziana Corteccioni

Tiziana Corteccioni
MD, Specialist in Psychiatry, Psychotherapist.


Psychiatrist and Psychotherapist, Cognitive behavioral therapist.

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