Overeating, the most common but least known eating disorder

• "My head and me" is the weekly program of

  20 Minutes

  devoted to the mental health of young people, broadcast on Snapchat.

• The purpose of this meeting: to lift the taboo on psychiatric disorders thanks to the testimonies of young people concerned and to try to find solutions to get better.

• In this seventh episode, we talk about binge eating, a very common but little known eating disorder.

While Léa is alone at home, after school, she opens a packet of chocolate ice cream.

She eats one, then two, then three, before finishing the packet.

Then she opens a second one and continues to chain the cones one after the other, mechanically, without feeling the slightest pleasure and until her stomach hurts.

Léa has just had yet another binge.

Unlike people with bulimia, she will not have compensatory behavior after this crisis.

In other words, she won't make herself vomit or take laxatives.

The young woman will remain with this pain in her stomach and this guilt in her head.

Like Léa, 3 to 5% of the population suffers from binge eating, according to the High Authority for Health, which is much more than anorexia or bulimia.

However, this eating disorder is much less publicized.

Knowing the symptoms of this disease makes it easier to detect it and therefore to be able to treat it.

Thanks to the insights of Dorine Pillault, dietician-nutritionist specializing in the management of obesity, Jean-Philippe Zermati, doctor-nutritionist, and the testimonies of patients, we explain to you what binge eating consists of and how to differentiate it from occasional non-pathological overeating.

Eating without hunger… until it hurts

“Binge eating consists of eating more than a person would eat in the same context and doing so in a limited time, in secret, without feeling the sensation of physiological hunger and until there is a physical discomfort, an aching stomach,” explains Dorine Pillault.

The DSM-5 retains these five criteria to define binge eating disorder.

It takes at least three to be diagnosed and the person must have at least one seizure per week for at least three months.

“The person having a seizure cannot control what is happening to them at all.

It's stronger than her, ”adds the specialist.

Ludovic, who has suffered from binge eating for more than five years, knows these crises well.

“Sometimes I go to McDo and I buy three menus, as if there were several of us when I'm all alone.

And I eat everything in robot mode, until I'm really sick of it.

Overeating people may even eat unthawed food, uncooked canned food, or even leftover food from the garbage can.

And after the crisis, comes the guilt.

"Feeling self-loathing and shame are also part of the characteristics of the disease," adds Dorine Pillault.

This guilt does not go away after a few minutes.

She is almost obsessive.

Too strong restrictions creating frustration

First of all, we must distinguish between two types of hyperphagia, according to Jean-Philippe Zermati.

The first is related to the frustration caused by repeated diets.

“When we are tired or stressed, we may want to eat a few squares of chocolate to decompress.

By eating them, we experience pleasure and once we have finished them, we feel that it has done us good and we move on to something else.

» Consumption of the comfort food will contribute to a regulation of the mood.

“In the compulsion, we feel the same desire but a voice tells us that it is not a good idea to eat this food.

So we hold back, then we end up giving in and we don't necessarily manage to stop.

That's half the tablet, or even more.

And it can turn into a binge eating disorder.

“This type of overeating is called severe reassurance overeating,” explains the doctor.

It concerns people who are trying to lose weight and continually deprive themselves of eating pleasure foods.

This is the case of Ludovic, on a diet since college on the advice of his family doctor.

Since then, the weight of the thirties has oscillated continuously between overweight and obesity.

“The foods I eat at these times are almost always foods that I forbade myself when I was on a diet.

For a period, I only ate sweets during my attacks, which I don't like.

»

An emotional anesthesia

For Jean-Philippe Zermati, this can be explained physiologically.

When you crave a food, the brain secretes dopamine which triggers the craving to calm the craving.

“But if you fight the craving, the dopamine goes up again and again because the craving isn't being met.

After a while, dopamine takes over and this is where the binge can occur.

The more severe the control, the greater the loss of control and therefore the seizures will be great”, sums up the doctor.

This type of hyperphagia is to be differentiated from that linked to emotional anesthesia.

“Crises respond to extremely violent emotions.

We eat to anesthetize psychic pain.

This is what Daria Marx says, in her documentary, confiding that if she had not had binge attacks, she would have died.

In this case, food is used in the same way as drugs or mutilations.

“Physical pain can blur psychological pain.

There is really a desire to switch off their brains,” explains the doctor.

Being overweight leads to a vicious circle

Overeating sufferers are overwhelmingly overweight or obese because they eat more than their physiological needs.

This weight gain accentuates the suffering of the patient and this malaise can give rise to a new crisis.

Dorine Pillault analyzes this vicious circle as a pattern of negative thoughts.

“A triggering event will provoke negative thoughts that will lead to a crisis.

This crisis will give rise to negative thoughts which will in turn trigger a crisis.

The doctor explains it physiologically: “The more the person is overwhelmed with having started the crisis, the more cortisol, the stress hormone, is secreted and the more violent the crisis will become.

»

All episodes of "My head and me"

“In the collective imagination, someone who eats too much lacks willpower.

We are not trying to understand what is deepest in people's discomfort, ”laments the specialist.

Work on eating behavior or psychotherapeutic follow-up, depending on the form of hyperphagia, can reduce the number of attacks.

And, eventually, to make them disappear.

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