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2/19/10 12:35 A

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I thought it was already included in the diagnos bulimi. It will be interesting to see what the line between binge eating and compulsive overeating will be - if it will be.

"Trust God and buy broccoli."

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2/18/10 4:00 P

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I am so glad it is finally getting some attention. I have suffered from it for years and feel like a lot of my problems may have stemmed from it. Maybe younger binge eaters will be helped and spared the pain I went through and all the misdiagnoses I was labeled.

~ Leslie ~

"Pain is temporary; quitting lasts forever."

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2/18/10 11:37 A

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I have learned to control my binges - some of the time. But even then there is a mind set that goes along with bingeing. I don't eat thousands of calories but my brain is still in that mode.

Since it is going to be included, do you think more research will be done? What meds are yall taking for it, if any?


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2/18/10 10:15 A

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As usual, Coach Dean Anderson's writing is lucid and engaging. The problems with the Diagnostic Manual definition has been well canvassed by Dean, and I agree that much of what happens for the binge-eater is so tied to what occurs outside of the so-called binge-eating episode or period.

Like the abused woman who experiences a brief honeymoon period of non-abuse by her partner, or even in the face of his long-standing promise that he will never lay another hand on her, there are those moments when she knows that he still wants to.

The possibility of binging is always lurking around the corner and even if I have all the resolve in the world and all the plan As and Bs in place, I am only one act away from the binge, and certainly only one thought away from wanting to.

Ta, Reggie

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2/18/10 9:27 A

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I'm glad it's finally being included in the DSM. Before, binge eating was relegated to ED-NOS diagnosis, and that wasn't very helpful from a research standpoint...or from the point of view of trying to get an insurance company to pay for treatment.

"Happiness is different from pleasure. Happiness has something to do with struggling and enduring and accomplishing." ~~George Sheehan

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2/18/10 9:23 A

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This is an article explaining that Binge Eating will be added to the new DSM V. The article link is:

Binge Eating to Become an Official Mental Disorder

By: Dean Anderson : 2/17/2010 5:13:29 PM : 56 comments : 4,521 Views

The American Psychiatric Association (APA) has just released a preliminary draft of the revisions planned for it’s Diagnostic and Statistical Manual of Mental Disorders (DSM). This is the manual that medical and mental health professionals use to determine when individuals are suffering from a mental illness, rather than a temporary emotional or situational problem. It’s also used by insurance companies to determine which illnesses and treatments they will cover.

The new Manual (DSM 5) will include binge eating as a distinct eating disorder, alongside anorexia nervosa and bulimia nervosa, which have been included in previous editions of the DSM.

Does this mean that, if you sometimes have trouble stopping after two or three cookies or a few slices of pizza, you’ve got a clinical eating disorder? Probably not. Binge Eating Disorder has some very specific characteristics, and involves a persistent, frequent, and very upsetting pattern of overeating that goes well beyond the occasional “I can’t believe I ate the whole thing” situation that we’re all familiar with.

You can see the official diagnostic criteria for Binge Eating Disorder here. One of the main characteristics of a binge eating episode is feeling out of control—like you literally can’t stop eating or control what or how much you eat during that episode, even though you know you’re not hungry and feel very bad about the overeating.

Personally, I’ve always found it a little tricky to tell the difference between being “out of control” and just not knowing how to stop eating something I like to eat. When I was very overweight, “moderation” just wasn’t in my vocabulary. If the food was there and I liked it, most likely I would eat it until it was gone or others started complaining. Not many cookies in the package survived to be eaten another day when I was around. And I felt miserable about not being able to stop myself from overeating. When I first shifted into weight loss mode, I didn’t get much better at stopping before I’d eaten the whole thing, at least not with my favorite foods—I just made sure that I didn’t have super-sized portions of those “trigger foods” within reach. Fortunately, I rarely felt tempted to binge on the leftover steamed broccoli or baked chicken breasts.

At this point, I still don’t feel very confident that I can stop myself from eating more than I want to eat with certain foods, if they’re right in front of me. I made the mistake the other day of falling for one of those promotional deals you see in the impulse buying section at the checkout aisle at the grocery store—buy 2 packs of Peanut M&Ms (one of my favorites) and get two free. I told myself that I could make those 4 packs last at least 4 days. Wrong—they didn’t make it past the first night.

But I don't think that an occasional (or even weekly) problem like this necessarily qualifies as "binge eating" in the clinical sense this diagnosis uses the term. It doesn't cause me all that much distress, because I know that I can almost always decide not to buy the M&Ms in the first place, and keep my house stocked with foods that don’t trigger serious overeating for me--even when I’m feeling the need to do some serious emotional eating. And part of what enables me to do that is believing that I’m not out of control when it comes to eating—I just need to be careful about applying my efforts at the right point in the chain of events that gets the food out of the store and into my mouth. For me, that means trying to make my decisions pretty early in the behavior chain--i.e, before the food is already in the house, and I'm obsessing about eating it. When I do that, I don't really feel out of control or spend a lot of time worrying about my eating.

It bothers me that the APA description of binge eating focuses so much on what the individual experiences during an episode of binge eating itself, and ignores all the other links in the behavior chain which lead up to the episode, or other emotional and practical problems that may contribute to binge eating, or factors that might help prevent it. But that’s a problem that runs all through the DSM diagnostic system. Most of the listed disorders are simply collections of symptoms, with no or little reference to context, situation, or other personal and social factors that influence a person’s thinking, feeling, or behavior. That may be necessary to facilitate rigorous scientific research and data gathering. But it’s often this background information that points the way to individualized solutions and treatments that work, and that needs research, too.

It will be great if including this new diagnosis of Binge Eating in the DSM prompts more awareness and more research to improve our understanding of this very real problem, and also gets insurance companies to support treatment. But we all need to remember that no person is just a diagnosis, and that no diagnosis provides a complete explanation for why people do what they do. No one binge eats because they fit the diagnostic criteria for "binge eating disorder." We do it for our own reasons, and those can be identified and changed. And we all have strengths and capacities we can draw on, with the right encouragement and support, to understand our problems, learn how to handle them better, and make choices that will help us feel capable and empowered. Sometimes, calling something a "mental disorder" can make it easy to forget those basic facts.

So, even if you do feel like you qualify for this diagnosis of Binge Eating disorder, don’t let that define you or your options. Look for the ways you can exert some control over your thinking, feelings, and choices before you find yourself in the middle of a binge. And get some help if you need it--working with a good therapist and/or support group can make all the difference in the world.

And this is the proposed definition for the DSM V:

DSM-5 Proposed Diagnostic Criteria for Binge Eating Disorder

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1. eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances

2. a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. The binge-eating episodes are associated with three (or more) of the following:

1. eating much more rapidly than normal

2. eating until feeling uncomfortably full

3. eating large amounts of food when not feeling physically hungry

4. eating alone because of being embarrassed by how much one is eating

5. feeling disgusted with oneself, depressed, or very guilty after overeating

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least once a week for three months.

E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (i.e., purging) and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

What do you think about this new diagnosis?


"The reason we struggle with insecurity is because we compare our behind-the-scenes with everyone else’s highlight reel." - Steven Furtick

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