● Having difficulty talking about the feelings associated with binging as well as the feelings that may trigger binging ● Having low self-esteem ● Having frequent fluctuations in weight ● Frequent dieting but often without losing weight ● Repeatedly losing and gaining weight ● Loss of sexual desire Healthcare consideration : These symptoms are not readily apparent during a routine physical examination. Affected persons might simply be told to lose weight and are placed on a weight reduction diet. Healthcare professionals must delve deeper into the reasons behind weight gain. A thorough physical and mental health assessment may reveal the existence of serious eating disorders (American Psychiatric Association, 2013; Mayo Clinic, 2018f; WebMD, 2017b). Assessment of persons suspected of having binge-eating disorder should address the following issues. Although these issues are not signs and symptoms, they may provide clues as to how great is the risk for binge-eating disorder or other eating disorders. It is important that nurses and other healthcare professionals have open, honest discussions about the issues surrounding binge-eating disorder and other eating disorders. (American Psychiatric Association, 2013; Mayo Clinic, 2018f; WebMD, 2017b): ● A family history of eating disorders ● A personal history of physical or sexual abuse ● Family eating habits that encourage the intake of large meals or if food is used as a source of comfort or reward ● Overweight or obese family members Possible Causes and Risk Factors of Binge-Eating Disorder Gloria is a 20-year-old college student and a member of a large family. She has three brothers and two sisters. She has frequent contact with extended family members as well, including many aunts, uncles, and cousins as well as grandparents. Food has always played a big part in family gatherings. Large portions are the custom, and food is often used as a means of providing comfort when problems arise or stress occurs. Gloria is moderately overweight, as are most of her family members. She has a history of dieting but seems to quickly gain back whatever weight she loses. It is difficult for Gloria to adhere to a proper weight loss plan because her family makes fun of her when she tries to diet. The stress of family gatherings, her demanding college studies, and her negative feelings about her appearance all contribute to excessive anxiety. Gloria feels that she has little or no control over her life or over her eating habits. Like many of her family members, Gloria frequently overeats. Lately, her overeating has reached unhealthy proportions. Gloria has begun to binge in secret. The exact cause of binge-eating disorder, like other eating disorders, is unknown. However, experts are beginning to identify the issues that lead to its development. These issues are a combination of psychological, biological, and environmental factors (Mayo Clinic, 2018f). Binge-eating disorder tends to run in families. A family history of the disorder makes someone more vulnerable to its development. Although genetics may very well play a role in the development of binge-eating disorder, it is also likely that people with the disease come from families that overeat or place unusual or unnatural emphasis on food. For instance, food may have been used as a reward; a way to provide comfort; or as a means of coping with problems, stress, and anxiety (American Association of Anorexia Nervosa and Associated Disorders, 2019; Gersch et al., 2016; Mayo Clinic, 2018f). Other factors also increase risk and are being investigated as contributing to the development of binge-eating disorder (Mayo Clinic, 2018f; WebMD, 2017b):
Healthcare consideration : Healthcare professionals have an opportunity to take the lead in support of those persons affected by binge-eating disorder. They are often the first to recognize the problem. They must also take the lead in providing objective, nonjudgmental client care. Description of Binge-Eating Disorder Binge-eating disorder, also referred to by some healthcare providers as compulsive overeating, is a newly recognized eating disorder. It is characterized as follows (Gersch et al., 2016; WebMD, 2017b): ● As a serious mental illness ● By uncontrollable eating, in a discrete period, an amount of food that is larger than what most people would eat in a similar period under similar circumstances ● As similar to the binging that occurs in bulimia nervosa but without the accompanying inappropriate behaviors to rid the body of excess calories (purging) ● As a way affected persons use to cope with depression, stress, or anxiety Healthcare consideration : Two out of three people in the United States who have binge-eating disorder are obese (WebMD, 2017b). Binge-eating can contribute to the already significant problem of obesity in the United States. Incidence and Prevalence of Binge-Eating Disorder Here are recent statistics pertaining to binge-eating disorder (National Association of Anorexia Nervosa and Associated Disorders, 2019): ● It is estimated that 2.8% of American adults suffer from binge-eating disorder in their lifetimes. ● About 50% of the risk for binge-eating disorder is genetic. ● Almost 50% of binge-eating disorder clients have a comorbid mood disorder. ● More than 50% of binge-eating disorder clients have comorbid anxiety disorders. ● Almost 1 in 10 binge-eating disorder clients have a comorbid substance abuse disorder, usually alcohol use. ● Binge-eating or loss-of-control eating is as high as 25% in post-bariatric clients. General Signs and Symptoms Leslie works as a nurse practitioner in a busy family practice setting. One of her clients, a 16-year-old adolescent named Marcie, is moderately overweight. Marcie’s parents are concerned about their daughter’s eating habits. They tell Leslie that Marcie often eats to the point that she complains of stomach pains. They also point out that Marcie continues to eat even though she tells them she is full. Leslie decides to meet privately with Marcie. She suspects that Marcie has an eating disorder, most likely binge-eating disorder. Unlike anorexia nervosa or bulimia, there are no obvious physical signs or symptoms (at least initially) of binge-eating disorder, especially if the affected individual is of normal weight or is only slightly overweight. Here are some types of behaviors that are characteristic of binge-eating disorder (American Psychiatric Association, 2013; Mayo Clinic, 2018f; WebMD, 2017b): ● Frequent episodes of eating abnormally large amounts of food ● Feelings of not being able to control what or how much is eaten ● Eating when full or not hungry ● Eating very rapidly ● Eating until uncomfortably full, sometimes to the point of having epigastric and gastric pain ● Often eating alone because of feelings of embarrassment over the amount of food that is being eaten ● Feelings of embarrassment, disgust, depression, or guilt after binging ● Feelings of isolation and loneliness
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Book Code: PYMA2024
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