Compulsive Overeating




What is it?
Effects of compulsive overeating
What causes compulsive overeating?
Treatment of compulsive overeating
References

What is it?

Compulsive overeating is an encompassing term that does not have a distinct diagnostic definition. Some researchers conflate the terms compulsive overeating and binge eating (e.g. Lyons, 1998). The term is used to describe a range of eating styles that are experienced as driven, obsessive or out of control. People who describe themselves as having compulsive overeating may also feel obsessed by food (or certain types of food), particularly those that are restricted or "off limits." People who eat compulsively may spend a lot of time thinking about food or planning in advance what they are going to eat; and may plan to eat alone or in secret. Some people may feel as if they are "addicted to food" but food does not possess physiologically addictive molecular components in the way alcohol, nicotine and other drugs do. Nevertheless, compulsive eating may serve similar psychosocial functions as drugs, such as emotional numbing, comfort or reward, or avoidance of social anxiety. Episodes of compulsive eating tend to be followed by feelings of guilt or regret; or by resolutions to avoid overeating in future.

People who describe their eating as compulsive may have tried numerous diets which helped to achieve short term success in controlling their eating patterns; but some may also have found that dieting may have made the problems worse in the longer term as dieting tends to exacerbate preoccupation with food, eating and negative body image.

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Effects of compulsive overeating

The effects of compulsive eating are similar to those of binge eating disorder. Compulsive eating can lead to overweight or obesity although this is not always the case. Conversely, not all people with obesity have compulsive overeating. Being overweight may contribute to the development of type 2 diabetes, hypertension, cardiac problems, osteoarthritis, mobility problems and visual impairment (Wonderlich, et.al, 2009). It can have a profoundly negative effect on a person's self esteem and can impair social relations.

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What causes compulsive overeating?

For some people the roots of compulsive overeating may stem to childhood or adolescence. People with compulsive eating may have grown up in an environment where food was used for comfort, reward or distraction, or simply where unhealthy eating habits existed. Parental eating habits may have been compulsive or overly strict. Alternatively, having a parent who was preoccupied with dieting or weight control may play a role. Some people who have compulsive eating can recall their own history of yo-yo dieting and weight gain going back to teen years, and research shows that chronic dieting and preoccupation with weight loss are contributory factors in the maintenance of compulsive overeating (Fairburn, 1995). There is a link between adverse childhood experiences such as abuse or bullying and binge eating disorder (Streigel-Moore, et.al., 2002). There may be a link between polycystic ovary syndrom (PCOS) and compulsive overeating. Chronic, ongoing psychological and relational stress may also be contributory factors, where eating may serve to modulate or distract from adverse emotional states.

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Treatment of compulsive overeating

Recommended treatments for compulsive overeating are similar to those for bulimia and binge eating disorder. Guided self-help (e.g. Bailer, et.al., 2002), cognitive behaviour therapy (CBT) (Fairburn, et.al., 1995), and interpersonal psychotherapy (e.g. Agras, et.al., 2000) seem to produce equivalent results in the long run in terms of reducing episodes of compulsive eating. Cognitive behaviour therapy may involve up to 20 sessions of group of individual structured behavioural and psychological work. Homework is required in between these sessions and the therapy requires the individual to take a proactive role in the process of change. The aims of CBT are to improve awareness of triggers for overeating and learn how to avert or diffuse them; improve regularity of eating and eliminate eating between meals and snacks; broaden systems for psychological self-evaluation and address other problematic issues such as dichotomous thinking, mood intolerance, perfectionism, relational difficulties and low self-esteem.

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References

Agras, W. S., Walsh, B. T., Fairburn, C. G., Wilson, G. T., & Kraemer, H. C. (2000). A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Archives of General Psychiatry, 57, 459-466.

Bailer, U., de Zwaan, M., Leisch, F., Strnad, A., Lennkh-Wolfsberg, C., El-Giamal, N., Hornik, K. and Kasper, S. (2004). Guided self-help versus cognitive-behavioral therapy in the treatment of bulimia nervosa. International Journal of Eating Disorders , 35 , 522-537.

Fairburn, C.G. (1995). Overcoming Binge Eating. London: Guilford.

Fairburn, C. G., Norman, P. A., Welch, S. L., O'Connor, M. E., Doll, H. A., & Peveler, R. C. (1995). A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Archives of General Psychiatry, 52, 304-312.

Lyons, M.A. (1998). The phenomenon of compulsive overeating in a selected group of professional women. Journal of Advanced Nursing,27 :6, , 1158 - 1164.

Striegel-Moore, R.H. Dohm, F., Pike, K.M., Wilfley, D.E., and Fairburn, C.G. (2002). Abuse, bullying, and discrimination as risk factors for binge eating disorder. American Journal of Psychiatry, 159, 1902-1907.

Wonderlich, S.A., Gordon, K.H., Mitchell, J.E., Crosby, R.D. and Engel, S.G. (2009). The validity and clinical utility of binge eating disorder. International Journal of Eating Disorders, 42:8, , 687-705.

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