THE BOY eats in secret. He just got his driver's license, and he sits in a car in the pizzeria parking lot, polishing off an entire pie before he drives home. It happens a few times a week: He feels out of control, eats immense amounts of food, and afterward feels bloated and ashamed.
In junior high school, he was able to control his weight, but he's overweight now and afraid of being exposed. This boy, who I worked with, is not alone. There are many more like him.
It's not clear how many children and teens have binge eating disorder, but about 3 percent of adults struggle with binge eating. And up to a quarter of obese people suffer from the problem, which, ironically, gets worse when people diet.
Binge eating is more common in people who suffer from addictions to alcohol and drugs, or who have anxiety or depression. Also, the premenstrual time of women's cycles is a particularly vulnerable time for bingeing, according to a Michigan State University study.
Bingeing is defined as eating much more than normal in two hours, past the point of fullness.
FEELINGS, NOT POUNDS
Distress can both trigger and follow binges, so it makes sense to address emotions. Cognitive-behavioral therapy by a psychiatrist, psychologist or social worker is the most effective treatment, according to the American Journal of Psychiatry.
Medications, such as the anti-seizure drug Topamax and anti-obesity drug Meridia, may be helpful for some people.
Losing weight is not a cure for binge eating disorder, as the problem is driven by emotions rather than pounds. Research shows that while gastric bypass surgery may help people lose weight, it doesn't cure binge-eating disorder. I've met people who have quickly lost more than 100 pounds after gastric bypass surgery, only to gain it all back. They had untreated eating disorders.
SELF-HELP FOR BINGES
Not everyone is ready to go out and admit they need help. People who are just beginning to deal with their problems may feel more comfortable reading about emotional eating. I recommend reading "The Four-Day Win," by psychologist Martha Beck.
Also, researchers say an Internet-based program developed by psychologists and psychiatrists can help teens.
The 16-week program, called StudentBodies2--Binge Eating Disorder, emphasized weight maintenance, not weight loss. Yet the high-school student volunteers actually lost some weight, and kept it off for at least nine months.
Cognitive-behavioral therapy is considered the most effective treatment for binge eating. You can find referrals for psychologists, psychiatrists and social workers at the nonprofit National Eating Disorders Association: nationaleat ingdisorders.org or 800/931-2237.
