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Question
Posted by: Bernie | 2010/12/06

DO I HAVE AN EATING DISORDER?

Dear Dr Graham, my height is 1.55m and I weigh 85kg. My problem is that I know that I eat incorrectly, but continue to do so despite the knowledge. I use medication for Hypertension, Cholestrol and depression. I love to exercise but there is always a reason why I cant get to it. I can easily find myself eating a pack of biscuits or an entire slab of choclate by myself. My family now has to suffer because I dont buy these things so that I cant eat it. I spoke to a psychologist once who told me that when I need to eat that instead of grabbing sweet things, I should eat something healthy - I bought a box of rice cakes and ate it all in one go! As a child I always ate very slowly, but always ate all my food. When I became a young adult I was very shy of eating out. When I binge eat it is mostly sweet things. When there is nothing sweet in the house, I will make breakfast cereal with lots of sugar. I dont just eat when I am hungry, I eat when I am bored, I eat when I feel down, I eat when I am angry, I eat when I am restless, the problem is that I eat when it dont need to eat!!!!!!! Your advice will be appreciated!!! Thank you very much, Regards, Baronise

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Our expert says:
Expert ImageEating Disorders Expert

Hello Baronise,
Yes, it certainly sounds like you are describing a Binge-Eating Disorder (BED), which you will not yet find in the psychiatric diagnostic manual, but which will likely be included in the next edition. However, it would now be technically diagnosed as a non-specified eating disorder (EDNOS) and poses a serious problem for you, given that your weight has reached a serious level. Looking at your weight to height ratio, your Body Mass Index is just above 35, which places you well within the Obese weight category. This likely explains your hypertention and raised cholestrol levels, and you need to watch out that you are not yet pre-diabetic. I might be sounding quite alarmist, but there is much that you can do. First, you need to consider returning to therapy to address your emotional eating, as you have already identified that you eat in response to many uncomfortable emotions. Your therapy will help you deal more appropriately with your feelings and emotionally difficult situations. Second, I suggest that you begin consulting with a registered dietician (preferably one who specialised in treating eating disorders) and start on a meal plan that will help bring your weight down in a sensible and gradual manner. Please do not resort to quick fad diets. Your depression is something that you need to continue receiving treatment for, as it might be that your comfort eating is in response to an emotional emptiness. You need to consider that this is not a quick-fix situation you are facing. Your therapeutic process is going to take time and needs to confront challenges at many levels - emotionally, psychiatrically, socially and physically. Only as a last resort, is bariatric surgery an option that you can consider. You do actually just qualify, given your medical concerns and weight (Body Mass Index above 35), but you will need to demonstatre that you can eat in a controlled manner for some time preceeding surgery if you ever seek this route. It is also very expensive, but an increasing number of medical aids are covering these procedures. Ony consider a Centre of Excellence and surgeons with experience and good resputations. However, I strongly recommend you first look at returning to therapy, consider medication for your depression (if you are not already medicated), get into an individualsed and supervised exercise programme through a biokineticist and see a dietician. With hard work and support, you will likely make some very good progress. It is not as simple as substituting sweets for rice cakes. You need to ultimately get to the root of your emotional hunger and resolve what is happening emotionally. However, this process takes time and hard work on your side. I hope this advice helps you. Please email me if you would like some specific referrals for professionals in your area.
Regards,
Graham

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

6
Our users say:
Posted by: Meridethwienbergc | 2011/03/24

Reply to Meridethwienbergc
Posted by: Bernie | 2010/12/14

Dear Dr. Graham

Thank you so much for the response.

I have taken up your advice and arranged to see my therapist again after the holidays. I have also arranged to start exercising again with immediate effect and will endeavor to curb my eating.

Kind regards
Baronise

Reply to Bernie
Posted by: Eating Disorders and Obesity Expert | 2010/12/11

Hello Baronise,
Yes, it certainly sounds like you are describing a Binge-Eating Disorder (BED), which you will not yet find in the psychiatric diagnostic manual, but which will likely be included in the next edition. However, it would now be technically diagnosed as a non-specified eating disorder (EDNOS) and poses a serious problem for you, given that your weight has reached a serious level. Looking at your weight to height ratio, your Body Mass Index is just above 35, which places you well within the Obese weight category. This likely explains your hypertention and raised cholestrol levels, and you need to watch out that you are not yet pre-diabetic. I might be sounding quite alarmist, but there is much that you can do. First, you need to consider returning to therapy to address your emotional eating, as you have already identified that you eat in response to many uncomfortable emotions. Your therapy will help you deal more appropriately with your feelings and emotionally difficult situations. Second, I suggest that you begin consulting with a registered dietician (preferably one who specialised in treating eating disorders) and start on a meal plan that will help bring your weight down in a sensible and gradual manner. Please do not resort to quick fad diets. Your depression is something that you need to continue receiving treatment for, as it might be that your comfort eating is in response to an emotional emptiness. You need to consider that this is not a quick-fix situation you are facing. Your therapeutic process is going to take time and needs to confront challenges at many levels - emotionally, psychiatrically, socially and physically. Only as a last resort, is bariatric surgery an option that you can consider. You do actually just qualify, given your medical concerns and weight (Body Mass Index above 35), but you will need to demonstatre that you can eat in a controlled manner for some time preceeding surgery if you ever seek this route. It is also very expensive, but an increasing number of medical aids are covering these procedures. Ony consider a Centre of Excellence and surgeons with experience and good resputations. However, I strongly recommend you first look at returning to therapy, consider medication for your depression (if you are not already medicated), get into an individualsed and supervised exercise programme through a biokineticist and see a dietician. With hard work and support, you will likely make some very good progress. It is not as simple as substituting sweets for rice cakes. You need to ultimately get to the root of your emotional hunger and resolve what is happening emotionally. However, this process takes time and hard work on your side. I hope this advice helps you. Please email me if you would like some specific referrals for professionals in your area.
Regards,
Graham

Reply to Eating Disorders and Obesity Expert
Posted by: Jenny | 2010/12/07

Hey Bernie, no i cant remember either - i suffered with bulimia aswell for years, but stopped that. Now im just fat and miserable and cant stop eating, whatever it is. Even healthy stuff. If my mom makes a salad - EVERYTHING has to go!

Reply to Jenny
Posted by: bernie | 2010/12/06

Hi Jenny when did this start with you? I cant remember having this problem as a child - I think it just came up over the last number of years.

Reply to bernie
Posted by: Jenny | 2010/12/06

Baronise, u will not believe this. I am 1.58m tall weigh 88kg and have EXACTLY the same prob!! I cannot buy a pack of sweets and just eat 2 or 3 i gotto finish the packet!! Or a slab choc - one block is not enough the whole thing must go, even if ive had enough i will finish it. i just cannot leave any leftovers!!

Reply to Jenny

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