Binge Eating

Various studies indicate that a significant portion of bariatric patients suffer from Binge Eating Disorder (BED) or have episodes of Binge Eating (BE) or Night Eating Syndrome (NES). The statistics vary, but a summary from three studies reported in the International Journal of Eating Disorders follows on the next page:

Binge Eating Incidence in Bariatric Surgery Patients

Binge eating functions “to reduce unpleasant emotional states in individuals who lack more adaptive emotion regulation skills. Negative emotions may be triggered in a variety of ways, such as through comparison of one’s body with images found in fashion magazines, by unpleasant interactions with others, or by other undesirable circumstances. Once negative emotion has been triggered, the individual fears that it will escalate, and searches for a means of reducing it. By distracting attention from the negative affect, binge eating temporarily relieves this distress, and thus is negatively reinforced.”2

1 Although postoperative vomiting usually does not represent purge behavior, it may represent failed attempts to binge.
2 Kristeller, J. L., Baer, R. A., & Wolever R. Q. (2006). Mindfulness-based approaches to eating disorders. In Baer, R. (Ed.) Mindfulness-and acceptance-based interventions: Conceptualization, application, and empirical support. San Diego, CA: Elsevier.

Research has shown Mindful Eating practices reduced binge eating episodes in morbidly obese study participants (BMI: 40), with a clinical BED diagnosis at baseline, from slightly over 4 binge eating episodes per week to about 1.5 episodes per week. Moreover, only 20% of the participants still met the criteria for BED at follow-up. Remaining binges decreased substantially in magnitude. Scores on the Binge Eating Scale fell from the “Severe” range to a level just higher than having “Little or No Problem” with binge eating (scores lower than 14). Measures of depression and anxiety also decreased from clinical to sub-clinical levels.3 A recently completed Randomized Clinical Trial (RCT), with a larger sample size, found reductions in participants’ binge eating episodes, as well as significantly improved scores on the Disinhibition and Hunger Drive scales of the Stunkard and Messick (1985) Eating Inventory – indicating greater internalization of behavioral change. This study is still in preparation with published results expected prior to the end of 2007.

Pinaquy et al. found that difficulty in identifying and describing emotions was a predictor of “emotional eating” in those suffering from BEDiv. Mindful Eating classes include multiple opportunities for exploring emotions through journaling and self-awareness activities.

i Adami, G.F., Gandolfo, P., Bauer, B., & Scopinaro, N. (1995) Binge eating in massively obese patients undergoing bariatric surgery. International Journal of Eating Disorders, Vol. 17, No. 1, 45-50.
ii Kalarchian, M., Wilson, G.T., Brolin, R.E., & Bradley, L. (1996) Binge eating in bariatric surgery patients. Correspondence to: Melissa A. Kalarchian, Psychology Department, Busch Campus, Rutgers University, New Brunswick, NJ 08903. Copyright 1998 by John Wiley & Sons, Inc.
iii Powers, P., Perez, A., Boyd, F. & Rosemurgy, A. (1999) Eating pathology before and after bariatric surgery: A prospective study. International Journal of Eating Disorders, Vol. 25, Issue 3, 293-300.
iv Pinaquy, S., Chabrol, H., Simon, C., Louvet, J. P., & Barbe, P. (2003) Emotional eating, alexithymia, and binge-eating disorder in obese women. Obesity research, 11, 195-201.