Binge Eating: A Live Chat with Christopher Fairburn MD, author of Overcoming Eating Disorders

How to curb the binge eating urge

WebMD Weight Loss Clinic - Live Events Transcript
Event Date: March 2003

Binge eating is probably the most common eating disorder, but its cycle of shame and powerless feelings can make it hard to reach out for help. We learned where to turn for support and treatment when WebMD Live welcomed eating disorder expert Christopher G. Fairburn, MD, author of Overcoming Eating Disorders.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to WebMD Live, Dr. Fairburn. How prevalent is binge eating?

Fairburn: This not an easy question to answer. In part that's because one has to define what you mean by binge eating. One person's binge could be another person's snack. If you asked people on questionnaires, do you binge eat, somewhere between a quarter and half the female population will say yes.

However, there are technical definitions of what is a binge used by clinical researchers, and if these definitions are used to define clinically significant binge eating, then the number of people in the population who binge eat is much smaller than the one I just said. Using the technical definition of binge eating, then between about 5% to 10% of women regularly binge eat. And of these, less than half have an "eating disorder."

Moderator: What is the technical definition?

Fairburn: Perhaps I should explain how clinicians define binge eating. There are two features that have to be present for an episode of eating to be classed as a "binge."

  • The amount eaten must have been truly large for the circumstances at the time; in other words, the context is taken into account. So for example, one has to eat more on Thanksgiving Day for an episode of eating to be classed as a binge, because everyone eats more on Thanksgiving Day.
  • There must be a sense of loss of control over eating at the time. In other words, the person must feel their eating is outside their control.

Now what I've described is the technical definition of the binge, but there is something I'd like to add: This is that some people have repeated binges that are quite small in size. For example, this is seen in anorexia nervosa. These episodes of eating are very distressing for people and they are accompanied by a sense of loss of control. Technically, they are not classed as true binges, but are subjective binges.

I have to stress how important it is that there is loss of control during the episode. For it is this feature that distinguishes binge eating from simple overeating that we all engage in at times.

Member: Doctor, I'm 15 and I'm more than positive that I am a binge eater. I'm not "overweight" but the doctor says he thinks I'm just a "carb addict." I've gone on a diet where I couldn't eat a lot of carbs. That didn't help. This has been going on since October. What is your advice?

Fairburn: There are a few extra things I need to know.

  • Do your binges involve eating large amounts of food?
  • Do you feel out of control at the time?
  • Between your binges, do you diet a lot?
  • Do you make yourself sick or vomit after your binges?

Member: They CAN involve eating a very large amount, but in the past four months or so, my mom has been keeping all junk food out of the house. So when I do binge, it's on fruit and yogurt, and I have a real problem with bread. I do feel out of control, definitely. I do not make myself sick, but I constantly worry about what I'm going to eat, how I'm going to feel after I eat; it's always on my mind. All I want to do is eat. I'll say to myself, "Today, I'm not going to eat a lot; I'm going to have this and this for breakfast," etc.

Fairburn: You sound as if you have a binge eating problem and it might well be a good idea to try to tackle it. What many people do in the first instance is to follow one of the self-help programs, since they can be very helpful. Alternatively, or if the program does not work, then you might want to get help from a psychologist or school counselor.

Moderator: Of course, diagnosing over the web is not what we are trying to do here. Finding a doctor who will listen to you and see you in person is always the next step. Good luck to you!

Also, Dr. Fairburn tells me he's too modest and embarrassed to say that the best-tested self-help program is his own. You can read all about it in his book.

Member: Dr. Fairburn, if you know you have a problem with binging, overeating, AND body image but your insurance won't cover a therapist, what resources can you turn to? Do you think Overeaters Anonymous is helpful?

Fairburn: Overeaters Anonymous provides many people with binge eating problems with a lot of support and encouragement. But as someone who specializes in helping people with binge eating problems and researching their cause and treatment, I have to admit that I have reservations about some of the claims made by Overeaters Anonymous. For example, it is sometimes claimed by OA that people who binge eat are addicted to certain foods. There is no evidence whatsoever that this is the case. So I think Overeaters Anonymous can be very helpful in the support it provides, but some of the information and recommendations it makes are not consistent with the scientific evidence about the causes and treatments of binge eating problems.