Compulsive Eating & Bulimia Nervosa

April 9th, 2008

If we ate only when we were hungry and then ate only what our bodies needed, then there would be no need for this leaflet. But eating does much more than keep our bodies alive. We eat to be sociable, to be polite, because something tastes good, and sometimes because were bored, lonely, or angry. For most people this is normal behaviour from time to time. Some however find that eating is more than just a whim. They either cant stop thinking about food - what theyre going to eat and when - or they cant stop eating once they start. Instead of fading, this preoccupation with food grows stronger. Eventually, they dont think about much else. Some hide food and eat in private. Some feel fat after eating and start a habit of throwing up.

These are all unhealthy behaviours and theyre what this article is all about - compulsive eating. There are different types of compulsive eaters, different reasons why people become compulsive eaters and different treatment for this problem.

Types of Compulsive Eating

We all get hungry at regular intervals throughout the day, eat when were hungry, and dont think much about food until were hungry again. We eat what we need and stop when were satisfied. We dont plan our days around what well eat or what we wont eat.
If you are a compulsive eater, its different. You may think about food all day long - either about what youre going to eat next, or about what you wont let yourself eat. Compulsive eaters may seem to be very controlled - often theyre on diets - but privately they always feel out of control.

Bingeing and Purging

People who binge and purge have a disorder called bulimia nervosa. Bulimics are considered compulsive eaters who force themselves to get rid of the food afterward. Some people induce vomiting, others use laxatives to force a bout of diarrhoea. However, most people dont realise that once the food makes it to the intestines most of the calories are already absorbed.

An eating binge is defined as an abnormally large amount of food eaten at one sitting. That could include whole cartons of ice cream, packets of biscuits, whole roasted chickens, litres of soda drinks and loaves of bread. In an eating binge, a person can consume more than 10,000 calories in one sitting. Then, the thought of having eaten all those calories scares the person into purging.

Despite this behaviour, most other people never suspect that someone is bingeing and purging. In general, a person who binges and purges isnt thin or emaciated but isnt overweight either. Additionally, people who binge and purge do so privately. In public, they may look like normal eaters. They may even stay away from food altogether. However, the anxiety generated from such a rigid control and deprivation may lead to another eating binge later.

Compulsive Overeating

Sixty to seventy million people are compulsive eaters. Of that number, 85 percent are women. Not all of them binge by eating huge amounts at a sitting. Some people simply eat small amounts of food all day long. Unlike bulimics, these people do not purge afterward. If they overeat and don't fast or diet, they ultimately become overweight.

Sometimes compulsive eating starts with dieting. This can start a cycle of starving and binging. People stick to a rigid diet all day long, particularly when theyre around other people and eat late at night or when theyre alone. Then, they binge on all the food they denied themselves during the days or week past.

Others may have started out as plate-cleaners. They are simply obedient children who learned at an early age to eat every thing on their plates. So, whether or not they ever learned to realize when they were full, they couldnt act on the realization. They had to keep eating, even when their stomachs told them No more! After a while, many plate-cleaners simply eat everything in front of them without asking themselves whether theyre hungry or stuffed.

Finally, some compulsive eaters are comfort eaters. They eat normal amounts of food most of the time, except when theyre stressed. Then they turn to food to make themselves feel better, either by binging or perpetually nibbling.
Most compulsive eaters either wage a constant war with their weight by dieting or they become overweight. Even if theyve managed to maintain a relatively average weight, they know they have an unhealthy relationship with food. People who are overweight also face the pressure from a society that is obsessed with thinness.

How can family and friends help?

It can be upsetting to witness loved ones putting their health and lives in jeopardy. As a member of the family or as a friend, it is natural to want to help. But unwanted pressure or criticism from others usually makes matters worse. If possible, accept their behaviour instead of confronting them with it. Unless its a life-threatening situation, try to let the person make his or her own choices and let the person know that unconditional love and support is consistently there. Once the person has recognised the problem, offer to help with practical matters such as finding medical assistance, self-help groups and other resources that may be needed to do battle with the eating disorder.

Is it possible to get over an eating disorder?

Yes. It can be a long and difficult process. Sufferers may need to have psychotherapy for months or years, and relapses can occur in times of stress. Approximately 50% of people with anorexia who are treated in hospital continue to have symptoms for many years. An eating disorder is difficult to overcome, but with commitment, patience and support it can be done.