Magazine article The Journal of Employee Assistance

Compulsive Overeating and Yo-Yo Dieting: Like Alcoholism, Binge Eating Is an Addictive Disorder and Should Be Recognized and Addressed as Such by Employee Assistance Professionals

Magazine article The Journal of Employee Assistance

Compulsive Overeating and Yo-Yo Dieting: Like Alcoholism, Binge Eating Is an Addictive Disorder and Should Be Recognized and Addressed as Such by Employee Assistance Professionals

Article excerpt

Turn on your television, walk into any bookstore, or look at the magazine headlines in the supermarket and you'll see and hear plenty about America's obesity crisis. Surveys indicate that roughly two-thirds of Americans are overweight (i.e., their body mass index is higher than 25), and more than half of these people are obese or morbidly obese (meaning their BMI is higher than 30). (1) The obesity problem continues to grow (no pun intended) because many people live sedentary lifestyles and/or use food to help cope with unpleasant feelings.

Many obese people do not like the way they look or feel, so they continually search for a new diet and/or weight reduction program, only to conclude that "it's just not the right diet for me." The fact is that diets typically help to reduce weight, although some work more quickly than others. But many dieters are unable to stay on their course of recovery and relapse repeatedly, only to look for the next answer. The diet industry fosters this never-ending search for "the perfect diet."

Most Americans, however, are less forgiving. They see obesity as a self-control issue and are critical of those who struggle with their waistlines. Although many health care professionals express concern about obesity, few view it as an addictive disorder with physical, psychological, and spiritual components.

This grim picture has parallels to the way we viewed alcoholism 40 to 50 years ago. In fact, the obese individual's behavior is similar in many ways to that of the alcoholic (e.g., changing from vodka to beer). Additionally, obesity is linked strongly with other addictive disorders--reports of sober Alcoholics Anonymous members who have gained large amounts of weight are not unusual.

CONTRIBUTORS TO OBESITY

Many people who are obese suffer from compulsive overeating or yo-yo dieting, though not all obese individuals are compulsive overeaters. (2) Compulsive overeating is characterized by recurrent episodes of eating an excessive amount of food within a discrete period of time, with a sense of a lack of control over eating during each episode. The episodes are associated with at least three of the following characteristics:

* Eating much more rapidly than normal;

* Eating until feeling uncomfortably full;

* Eating large amounts of food when not physically hungry;

* Eating alone because of embarrassment over how much one is eating; or

* Feeling disgusted, depressed, or very guilty after overeating.

The professional term that encompasses compulsive overeating is binge eating disorder (BED). According to the National Institute of Mental Health (NIMH), between 2 percent and 5 percent of Americans experience binge eating disorder in any six-month period. (3) Although BED appears in the Diagnostic and Statistical Manual of Mental Disorders (Vol. IV), it does not have specific diagnostic criteria or an accompanying numerical indicator. As a result, compulsive overeating treatment is not covered by health insurance plans.

Yo-yo dieting (also known as weight cycling) is a repetitive loss and gain of significant amounts of body weight. It is characterized by being overweight, losing a substantial amount of weight, regaining most or all of it, then beginning the process once again. Yo-yo dieters experience this "roller coaster" cycle at least twice a year.

Both compulsive overeating and yo-yo dieting usually result in increased rates of physical and mental problems, including (but not limited to) heart disease, diabetes (type II), cancer, hypertension, high cholesterol, depression, and sleep apnea. Both illnesses are also chronic and progressive.

UNIQUE CHARACTERISTICS OF BED

Compulsive overeating is characterized by several factors that make it especially difficult to treat. The first factor is the lack of recognition that BED is an addictive disorder. When you compare the behaviors, actions, attitudes, deflections, manipulations, defenses, and (ultimately) self-destructive outcomes of binge eaters with those of clients suffering from other addictive disorders, you soon recognize that BED is guiding overeaters' perceptions, judgments, and daily living decisions. …

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