Based on CDC-uncovered statistics, obesity torments 116 million people every day in the U.S. alone (“Obesity,” 2016). Obesity is not a standalone disease because it tends to tack itself onto other life-threatening diseases (e.g. diabetes, heart disease, arthritis) and wreak further havoc. The comorbid nature of obesity has led to those other diseases being stigmatized as the result of “poor lifestyle choices” (Barrett Ozols, 2005). Continued disregard for many other factors prevents illnesses such as binge eating disorder (BED) from being recognized as a serious endemic within the country.
The DSM-5 guidelines state that BED is an eating disorder
“…defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. Someone with binge eating disorder may eat too quickly, even when he or she is not hungry. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior. This disorder is associated with marked distress and occurs, on average, at least once a week over three months.” (“Eating and Feeding Disorders,” 2013)
While the DSM provides an outline of the disorder, not everyone is affected by the same characteristics and with the same intensities; in fact, some people may display or experience all of these characteristics, but others may only experience few. Consider Chevese’s situation:
“My mother’s alcoholism and my parents’ eventual divorce took their toll on me. I spent my teenage years engaging in risky behavior and binging on food, alcohol, and, to some extent, drugs…my mental health problems were not being addressed, so I continued to binge eat and drink. I was kicked out of apartments when I could not pay the rent, and I ruined friendships and relationships through my excessive partying and subsequent withdraws from jobs and societal contact. I was in the depth of despair and depression with no money and even less sense of self. I moved back to Pennsylvania to live with my grandparents and ate my way through the next year.” (Alliance for Eating Disorders Awareness, 2013)
In contrast, here is Jane’s story:
“It was 1964, I was 23 and working at my first newspaper job in Minneapolis, 1,250 miles from my New York home. My love life was in disarray, my work was boring, my boss was a misogynist. And I, having been raised to associate love and happiness with food, turned to eating for solace…of course, I began to gain weight and, of course, I periodically went on various diets to try to lose what I’d gained, only to relapse and regain all I’d lost and then some…because I didn’t purge (never even heard of it then), I got fatter and fatter until I had gained a third more than my normal body weight, even though I was physically active…and one night in the midst of a binge I became suicidal. I had lost control of my eating; it was controlling me, and I couldn’t go on living that way.” (New York Times, 2007)
Both Chevese and Jane share the fact that they struggle with BED, but they perceive the effects differently in their daily lives. As the most common eating disorder in the U.S., BED affects 3.5% of women, 2% of men, and 1.6% of adolescents (Swanson et al. 2011), yet the severity of the disorder is often undermined and underdiagnosed.
For some time, BED was not considered a “real” mental disorder, and those with this “issue” were “just overeaters” with “moral problems” (Goode, 2000). People have denied BED for years by reframing the condition as ordinary and self-blameworthy, while those living with anorexia and/or bulimia were viewed as “fulfilling the standards of diet culture” (Rothman Morris 2004). Though both extremes of eating disorders are detrimental to physiological and psychological health, news articles are less likely to blame individuals for being (or trying to be) too thin than they are to blame them for being too fat (Fitzpatrick, 2000). People with BED were hiding behind the veil of obesity, and could not even get help without enduring ridicule or shame.
Given the vast spectrum of BED, we should be primarily concerned with ensuring that people with BED have equal opportunities to access resources, treatment, and support for recovery. Thanks to recently reformulated DSM-5 standards for BED, many individuals living with the illness can receive the treatment needed that can finally be covered through their health insurances. Recent advancements in anti-obesity pharmacotherapy have provided the BED population with an opportunity to achieve short-term remission from binge eating and for weight loss, though weight losses are not substantial and long-term benefits are still unknown (Reas et al. 2008). Regardless of the unknown, BED is undoubtedly recognized as an eating disorder, and more prescriptions for specific medications, such as orlistat and topiramate, are filled out by physicians for BED individuals to reduce the physical and mental strains of obesity.
While obesity can be an adverse effect of binge eating disorder, we must not make assumptions about someone’s lifestyle based on their physical appearance. The next person you look at may be fighting an invisible battle with food, and you would never know. People with binge eating disorder are not “just overeaters;” they are people with interests, jobs, and loved ones. They are your ordinary people, but they are also riddled with the scorn of society and its flawed ideals of body image and beauty.
Alliance for Eating Disorders Awareness. (2013). “Chevese’s story: My battle and recovery from binge eating disorder.” Retrieved from http://www.allianceforeatingdisorders.com/portal/chevese-story
American Psychiatric Association. (2013). Feeding and Eating Disorders. Retrieved from http://dx.doi.org/10.1176/appi.books.9780890425596.dsm10
Barrett Ozols, J. (2005). Generation XL. Newsweek, January 6. Retrieved from http://www.newsweek.com/id/47977
Brody, J.E. (2007). “Out of control: A true story of binge eating.” The New York Times, February 20. Retrieved from http://www.nytimes.com/2007/02/20/health/20brod.html
Centers for Disease Control and Prevention. (2016). Obesity. Retrieved from http://www.cdc.gov/obesity/data/adult.html
Fitzpatrick, M. (2000). The Tyranny of Health: Doctors and the Regulation of Lifestyle. New York: Routledge.
Goode, E. (2000). “Watching volunteers, experts seek clues to eating disorders.” The New York Times, October 24.
Reas, D. L. and Grilo, C. M. (2008). Review and Meta-analysis of Pharmacotherapy for Binge-eating Disorder. Obesity, 16: 2024–2038. doi:10.1038/oby.2008.333
Rothman Morris, B. (2004). “Older women, too, struggle with a dangerous secret.” The New York Times, July 4.
Swanson, S.A., Crow, S.J., Le Grange, D., Swendsen, J., Merikangas, K.R. (2011). Prevalence and correlates of eating disorders in adolescents. Results from the National Comorbidity Survey, replication adolescent supplement. Archives of General Psychiatry; 68(7), 714-723. doi:10.1001/archgenpsychiatry.2011.22