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Individuals suffering from compulsive overeating are obsessed with food and typically eat when they are not hungry. They devote excessive amounts of time and thought to food and secretly plan to eat or fantasize about doing so. Compulsive overeaters engage in frequent episodes of uncontrolled eating, or binge eating. The term binge eating means eating an abundance of food while feeling that one's sense of control has been lost. People who engage in binge eating may feel frenzied, consuming between 5,000 and 15,000 calories in one binge. As a result, some will cancel their plans for the next day because they "feel fat". Bingeing in this way is generally followed by feelings of guilt and depression.
Unlike individuals with bulimia nervosa, compulsive overeaters do not attempt to compensate for their bingeing with purging behaviors, such as fasting, laxative use, or vomiting. When compulsive overeaters overeat primarily through bingeing and experience feelings of guilt after their binges, they can be said to have binge eating disorder (BED).
In addition to binge eating, compulsive overeaters my also engage in grazing behavior, during which they return to pick at food throughout the day. These actions result in an excessive overall number of calories consumed, even if the quantities eaten at any one time may be small.
Left untreated, compulsive overeating can lead to serious medical conditions. For example, compulsive overeating usually results in weight gain and obesity, although it is not the only cause thereof. In addition, compulsive overeating could potentially lead to high cholesterol, diabetes, heart disease, hypertension, sleep apnea, and major depression. Additional long-term side effects of the condition include kidney disease, arthritis, bone deterioration, and stroke. In severe cases, compulsive overeating can result in death.
Other negative effects may include the amount of money that is wasted on food and the feelings of low self-esteem that usually accompany bingeing.
There are several signs that a person may be suffering from compulsive overeating. Indicators that manifest themselves physically include eating alone, consuming food quickly, and gaining weight rapidly. Other signs include significantly decreased mobility due to weight gain, and the withdrawal from activities due to binge eating. Emotional indicators include feelings of guilt or a loss of control, as well as depression and mood swings. Mentally, a preoccupation with body weight may indicate compulsive overeating.
During binges, compulsive overeaters may consume between 5,000 and 15,000 food calories daily, resulting in a temporary release from psychological stress through an addictive high not unlike that experienced through drug abuse. Researchers have speculated that there is an abnormality of endorphin metabolism in the brain of binge eaters that triggers the addictive process. In keeping with this idea, other theories explain addictive behaviors as primarily involving an anomaly in the reward centers of the brain.
For the compulsive overeater, ingesting trigger foods causes the release of the neurotransmitters serotonin and dopamine. This could be another indicator that neurobiological factors contribute to the addictive process. Conversely, abstaining from addictive food and food eating processes causes withdrawal symptoms in those with eating disorders. The resulting decreased levels of serotonin in the individual may trigger higher levels of depression and anxiety.
Eventually, compulsive overeaters continuously think about what the next meal will be. Food is in the preeminent positions of their minds; when deprived of it, the person may engage in actions similar to those of cocaine addicts, including an uncontrollable search for the substance, and in extreme cases, stealing or lying.
Compulsive overeating is treatable with nutritional assistance and medication. Psychotherapy may also be required, but recent research has proven this to be useful only as a complementary resource, with short-term effectiveness in middle to severe cases.
The antidepressant fluoxetine is the only medication approved by the Food and Drug Administration (FDA) for the treatment of an eating disorder, specifically bulimia nervosa. This medication has been prescribed for the treatment of BED. Off-label medications, such as other selective serotonin reuptake inhibitors (SSRIs), have shown some efficacy, as have several atypical agents, such as mianserin, trazodone and bupropion. Anti-obesity medications have also proven very effective. Studies suggest that anti-obesity drugs, or moderate appetite suppressants, may be key to controlling BED.
Many eating disorders are thought to be behavioral patterns that stem from emotional struggles; for the individual to develop lasting improvement and a healthy relationship with food, these affective obstacles need to be resolved. Individuals can overcome compulsive overeating through treatment, which should include talk therapy and medical and nutritional counseling. In addition, several twelve step programs exist to help members recover from compulsive overeating and food addiction.