Dr. B. Timothy Walsh (columbia.edu)
Rina Silverman’s refrigerator is almost always kept empty. She keeps it that way to avoid episodes of frantic food consumption, often at night after a full meal, in which she tastes nothing and feels nothing. The nothing she feels and tastes will give way to nauseating fullness, and a bitter backwash of guilt, shame and reproach. The fullness passes but the corrosive shame and self reproach are always there.
The holiday season is beginning, filled with an overabundance of food, family and feelings, common triggers for binge eaters reports the LA Times. Like Rina Silverman, they use food to assuage the guilt, anger, and sadness that consumes them this time of year.
But is binge eating a psychiatric disorder? 1 in 30 Americans, about 7.3 million adults, are at the center of this psychiatric debate.
“It’s a tricky business,” says Columbia University psychiatrist B. Timothy Walsh, who chairs the American Psychiatric Association’s work-group on eating disorders. “It’s easy to oversimplify and criticize the effort to recognize binge eating as a psychiatric disorder and to assume a diagnosis will be overused by some and misused by others. But just because a system can be abused doesn’t mean the system is flawed. We have to try to draw line when we have reasonable confidence we’re describing a group of folks who are struggling with impairment.”
According to Vitals.com, Dr. Bernard T. Walsh received his medical degree at Harvard and completed his residencies at Dartmouth and Hitchcock.
Binge eating (avidityfitness.net)
In 2007 researchers discovered that 3.5% women and 2% of men were binging at some point in their lives. This would make this behavior more common then both anorexia and bulimia combined.
The cut off between normal and pathological is often unclear. But in light of new research and the growing numbers of adults suffering from the disorder, psychiatrists must decide whether binge eating should stand alongside bulimia and anorexia as a separate psychiatric condition, with its own set of symptoms and treatments.
Presently two kinds of talk therapy have shown good results in treating binge eaters; Cognative Behavioral Therapy or a relatively short course of psychotherapy designed to help a patient recognize feelings or situations that set off this behavior and ways to cope with them.
Medications have been largely disappointing; a small group of studies has suggested that the diet drugs sibutramine, or Meridia, and the anticonvulsant drug topiramate, or Topamax, may help curb the desire to binge.
The decision whether or not binge eating should be defined as a psychiatric disorder should be reached early next year, when the American Psychiatric Association updates their diagnostic manual that guides mental health professionals.
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Tags: American Psychiatric Association, anorexia and bulimia, B. Timothy Walsh, Binge Eating, Binging, Cognative Behavioral Therapy, Disorder, Dr. Bernard Walsh, holiday season, Meridia, Psychiatric Condition, Rina Silverman, sibutramine, thanksgiving feast, Topamax, Topiramate
Matt Cook | November 26, 2009 at 12:14 pm
Indeed; binge eating disorder sufferers face an awkward position at present - if it is officially recognised as a psychiatric disorder, then the arguments against seem to be around the risks of over-pathologising a significant amount of the population with possible resultant medication etc (but this argument often appears to be put forward by people outside the profession who might not necessarily understand about diagnostic criteria and protocols etc); but if it is not recognised as such, then those thruely suffering face the possibility of not being taken seriously. Many people around the world will be watching this debate and looking forward to the outcome. From a practical point of view from the sufferer, whether it is recognised as a psychiatric condition or not, the behaviour is extremely distressing and requires help to overcome, help that adresses cognitive & behavioural aspects but also nutritional and emotional.
Thanks for the article.
Matt
John Samuels | November 26, 2009 at 12:50 pm
There is a tendency in psychiatry to over-itemize disorders, to label and prescribe. The comments above are of value, that it seems as if medication prescribed for eating disorders is not necessarily effective. Girls are subject to influence of media images from little which present a “perfect” body type, such as Barbie, Disney Princesses, then in fashion magazines, as well as role models who have achieved remarkable success such as those in High School Musical, and Miley Cyrus, that for the vast majority of girls, is unattainable. This can lead to disatisfaction with one’s body, as well as one’s self esteem, value as a person. Additionally, watching television can produce tension, and when one doesn’t have a positive outlet for that tension, can contribute to anxieties which are part of the basis for eating disorders. Lifestyle changes, in addition to professional therapies, are of value for those with eating disorders. Much less time with TV and movies, can be of help for girls in a number of ways, as well as engaging in pro-social activities, giving to others contributes to self-esteem. Girls who engage in art projects are benefited in two ways, they find a couple of hours of tension-free peace, where they can disappear into a positive world of creativity and express their emotions through art, as well as developing skills by which they can see tangible evidence of their worth. “If I could create that,” something they can look at every day,” then I must have some value.” Professional art therapy can also be of value to some girls with eating disorders. Positive art therapy, that is, producing art work that is happy and postiive, rather than art work which might be considered the “venting” of negative emotions, has been shown to have more value in contributing to positive emotions, in one clinical study, although both have been shown to have value.
Todd29 | December 31, 2009 at 3:26 pm
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