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Most people who have an eating disorder also have depression (see page 709) or an anxiety disorder (see page 718). About 40 percent have obsessive-compulsive disorder (see page 720). Eating disorders can severely and irreversibly harm the body and can be fatal. They can also cause serious psychological problems. In addition to placing tremendous pressure on a person’s relationships with family and friends, eating disorders can lead to the following health problems:

• Irregular heartbeat or cardiac arrest

• Heart failure

• Kidney damage

• Liver damage

• A weakened immune system

• Permanent loss of bone mass, leading to bone fractures and osteoporosis

• Infertility (from interruption of the menstrual cycle)

• Anemia

• Malnutrition

• Loss of muscle mass

• Depression

• Imbalances of electrolytes (sodium, potassium, and other minerals)

Binge eating also increases the risk of obesity, heart disease, diabetes, and colon cancer. The most common types of eating disorders are binge eating, anorexia, and bulimia.

Binge Eating Disorder

Overeating is common in the United States, where the food supply is abundant and meals are a time to socialize with family and friends. But some people overeat compulsively, frequently consuming huge amounts of food in secret. These people have a binge eating disorder. Binge eating also occurs in another eating disorder called bulimia (see next article), but people with bulimia typically purge their body of food—usually by self-induced vomiting—after they eat. Purging is not a part of binge eating disorder. Binge eating is probably the most common of all the eating disorders. An estimated 2 percent of the adult American population—about 4 million people—may have a binge eating disorder, which affects more women than men.

The causes of binge eating are unclear, although about half of all people with the disorder also struggle with depression (see page 709). Many people who binge eat report feeling angry, bored, unhappy, or anxious right before an episode of bingeing. Doctors think that affected people may have more difficulty controlling their impulses than other people. Inherited tendencies or brain chemical interactions also seem to contribute to the development of binge eating.

Binge eaters face a number of health risks, especially if they are obese. These risks include diabetes, high blood pressure, elevated cholesterol levels, gallbladder problems, heart disease, and some types of cancer.

Symptoms

People with a binge eating disorder are typically overweight, although their weight may fluctuate. They engage in regular episodes of overeating in which they consume unusually large amounts of food in a short period of time. They eat quickly, even after feeling full, until they feel uncomfortable. They tend to prefer junk foods that are high in carbohydrates and fat. Binge eaters usually eat alone because they don’t want anyone to see how much food they are consuming. Afterward, they often feel guilty, depressed, and angry with themselves for having eaten so much food. They may periodically try to diet to lose the excess weight, but either the diet fails or they soon gain the weight back.

Some people are so obsessed with binge eating that they miss work, school, or social events so they can overeat at home alone. They may reach a point at which they avoid social situations completely because they are so ashamed of their overeating. Many binge eaters have depression.

Diagnosis

A doctor can diagnose binge eating by listening to a person’s description of his or her feelings and behavior and eating habits.

Treatment

Binge eaters think that losing weight will help them feel better about themselves, but the treatment for binge eating focuses on the binge eating rather than weight loss. Some psychotherapeutic methods have proven successful in treating this disorder. Cognitive-behavioral therapy can help a person learn to change his or her negative thoughts