By MICHELLE L. BRANDTGorging oneself with turkey and Christmas cookies may be an annual ritual for some, but for millions of Americans overeating extends well beyond the holidays.
"People have said that Thanksgiving is just for amateurs – real bingeing happens every other day," said Debra Safer, MD, a clinical science research associate at the School of Medicine and staff psychiatrist at Stanford Hospital & Clinics.
Safer is launching a study on binge eating treatment and is now recruiting volunteers.
The National Institutes of Health identifies binge eating as the most common eating disorder, affecting up to 4 million Americans. The chronic disorder is characterized by frequent and compulsive overeating, often in secret and with a great sense of shame; Safer refers to it as a "driven" type of eating. Unlike with bulimia nervosa, sufferers do not attempt to purge after their binges and their bingeing is usually unrelated to body image or a desire for thinness.
"There are many different reasons for binge eating but it often occurs when people don’t meet some sort of standard that they’ve set for themselves," Safer said. "For example, perfectionist thoughts during the day led one of my patients to binge on candy bars when she got home at night."
Recurrent binge eating and obesity are frequently linked. Safer said 50 percent of binge eaters are overweight or obese, and studies show that the prevalence of binge eating increases with the degree of obesity. The weight gain that frequently accompanies binge eating can put sufferers at risk of high blood pressure, diabetes and heart disease.
Along with physical side effects, Safer said people with binge eating disorder also face psychological, family and workplace problems. Studies have shown that overweight people who binge have more social and psychological stress than non-bingeing overweight people.
Current treatments for binge eating include medication, cognitive-behavioral therapy, interpersonal psychotherapy and various forms of group therapy. "It seems curative to have people talk in a focused way," Safer said.
While researchers believe group therapy can prompt participants to stop or reduce their binge eating, Safer added, they don’t know which type of binge eaters would benefit the most from the various therapies.
During Safer’s study, participants will be randomly assigned to one of two therapy groups. One group will focus on the role of self-esteem and self-awareness in binge eating while the other will focus on the role of negative emotions and binge eating. Unlike other types of therapy, the sessions won’t focus on dieting, losing weight or even food itself. "My patients have told me that it’s not about the food," Safer commented.
Study volunteers will receive an individual pre-treatment orientation session followed by 20 weeks of group therapy for approximately six months. Follow-up assessments will take place at three, six and 12 months after treatment completion; participants’ bingeing patterns, self-esteem and emotional states will be closely examined during this time.
Safer is seeking men and women who have binged at least twice a week for six or more months. Eligible study volunteers must be age 18 or older, live within 30 minutes of Stanford and be willing to commit to study requirements.
Researchers cannot accept patients with a history of bipolar disorder or schizophrenia. People currently in a weight-loss program or an eating disorder treatment program or patients on weight-altering medications are also ineligible.
Interested volunteers can call 498-5089 or e-mail firstname.lastname@example.org.
Stanford Report, December 10, 2003