Compulsive overeating

Compulsive overeating (or food addiction) is a compulsive behavior characterized by excessive food consumption. Professionals address this activity either with behaviour therapy or a food-addiction model.

Description
An individual suffering from compulsive overeating engages in frequent episodes of uncontrolled eating, or binge eating, during which they may feel frenzied or out of control, often consuming food past the point of being full. The slang term binge eating means eating when not hungry. The clinical term means that and much more. A person who engages in binge eating may eat between 5000-15,000 calories in one binge. This explains the fact that 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, compulsive overeaters do not attempt to compensate for their bingeing with purging behaviors such as fasting, laxative use, or vomiting, although they can have the same feelings of guilt. Compulsive overeaters will typically eat when they are not hungry, and quickly spiral out of control at some point during a food consumption episode. Their obsession is demonstrated by the fact that they devote excessive amounts of time and thought to food, and secretly plan or fantasize about eating. Compulsive overeating usually leads to weight gain and obesity, but is not the only cause of obesity. While compulsive overeaters tend to be overweight or obese, binge eating is not limited to overweight people. In addition to binge eating, compulsive overeaters can also engage in grazing behavior, during which they return to pick at food throughout the day. These actions result in a large overall number of calories consumed even if the quantities eaten at any one time may be small. When a compulsive eater overeats primarily through bingeing, they can be said to have binge eating disorder.

Left untreated, compulsive overeating can lead to serious medical conditions including 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. Other negative effects may include the amount of money that is wasted on food and feelings of low self-esteem that usually accompany bingeing.

Signs and symptoms

 * Feeling of loss of control
 * Eating much more rapidly
 * Eating alone
 * Feelings of guilt
 * Preoccupation with body weight
 * Depression or mood swings
 * Rapid weight gain
 * Significantly decreased mobility due to weight gain
 * Withdrawal from activities because of binge eating
 * History of many different unsuccessful diets

Addiction
During binges, compulsive overeaters may consume from 5,000 to 15,000 food calories daily, resulting in a temporary release from psychological stress through an addictive high not unlike that experienced through drug abuse. In bulimics, this high may be intensified by the act of purging. Researchers have speculated there is an abnormality of endorphin metabolism in the brain of binge eaters that triggers the addictive process. This is in line with other theories of addiction that attribute it not to avoidance of withdrawal symptoms, but to a primary problem in the reward centers of the brain. For the compulsive overeater, the ingestion of trigger foods causes release of the neurotransmitters serotonin and dopamine. This could be another sign of neurobiological factors contributing to the addictive process. Abstinence from addictive food and food eating processes causes withdrawal symptoms in those with eating disorders. There may be higher levels of depression and anxiety due to the decreased levels of serotonin in the individual.

Some food addicts are more interested in what food is served at social gatherings than in the actual gathering. After a while they are always thinking about what the next meal will be; food is at the forefront of the person's mind, and when deprived of it, the person can engage in actions similar to those of cocaine addicts, uncontrollable search for the substance and in extreme cases stealing from others or lying.

Management
Compulsive overeating is treatable with nutritional assistance and medication. Psychotherapy may also be required, but recent research has proven this to be only useful as a complementary resource, with short term effectiveness in middle-severe cases.

The antidepressant fluoxetine is the only medication approved by the Food and Drug Administration (2012) for the treatment of an eating disorder, that being bulimia nervosa. This medication has been prescribed for the treatment of Binge Eating Disorder. Off-label medications such as other SSRIs and several atypical agents such as mianserin, trazodone and bupropion have shown some efficacy. Anti-obesity drugs have also proven very effective, although some of the drugs used in the study cited were removed from the market, for example sibutramine. Sibutramine is a reuptake inhibitor of norepinephrine, serotonin and, to a lesser extent, dopamine, that is thought to cause weight loss by increasing satiety. It was removed from the worldwide market in 2010 due to increased risk of cardiac events. This study suggests that anti-obesity drugs, or moderate appetite suppressants, may be key to controlling BED.

Many eating disorders are thought to be behavioral patterns stemming from emotional struggles that need to be resolved in order for the sufferer to develop lasting improvement and a healthy relationship with food. Compulsive overeating (along with anorexia and bulimia nervosa) is a serious problem and can result in death in severe cases. However, with treatment, which should include talk therapy and medical and nutritional counseling, it can be overcome. Several Twelve Step programs designed to help members recover from compulsive overeating and food addiction exist today.