Excerpt: 'Crave: Why You Binge Eat and How to Stop'

The urges to eat are often as intense as they are spontaneous; we will talk later in this book about what triggers a mere craving or a full-fledged binge episode, but patients have told me that when it happens, for whatever reason, they feel "powerless" to resist the urge and often "zone out" while eating. So while the initial craving may be for a certain food group, restaurant, snack cake, or donut shop, what happens during the binge itself has very little to do with taste. Recently a colleague of mine confessed to me that she was concerned that her husband might be a closet binge eater. When I asked her why she thought that, she admitted that she had caught him feasting on a rather peculiar binge of saltine crackers and mayonnaise in the middle of the night!

Clearly, binge eating is not merely the idle cravings of a nervous or hungry eater, who may eat a handful of chips or a single donut. Binge eating involves the super-sizing of our cravings to the point of an uncontrollable urge that snowballs until the binge eater literally feels "helpless" to resist the urge to binge.

Binge eaters don't just consume a handful of potato chips; they'll down a whole bag in a sitting — and that may just be a teaser for the grand finale that's to come. A bowl of ice cream may just be the appetizer for the whole pint — and then another, if it's handy — or even if there's a convenience store within easy driving distance. A single donut? Forget it; the binge eater wants six and, stomach swollen, blood sugar idling near the redline, will contemplate getting in the car and heading through the nearest drive-thru to round out the dozen.

Binge eating disorder is classified by a distinct and measurable pattern of behavior that has manifested itself in the individual's life, often over many months or years. Does this sound like someone you know or love?

Maybe a lot like… you?

Then we're both right where we're supposed to be. My name is Cynthia Bulik, Ph.D., and I am Director of the Eating Disorders Program at the University of North Carolina at Chapel Hill. It is my mission to inform as many people as possible about the dangers of binge eating, to help those who already feel trapped to escape, and to prevent others from falling into the dangerous cycle of binge eating. Be it prevention or treatment, success is my ultimate goal.

As so often happens in the field of medicine, my interest in binge eating came about through a combination of happenstance and career path. After receiving my bachelor's degree from the University of Notre Dame and my master's and doctorate degrees from the University of California at Berkeley, I became interested in eating disorders while researching childhood depression. Mood and food are so intricately intertwined and it seemed whenever I was doing research on depression I was reading about appetite and weight and, whenever I was working on eating disorders, I was hearing about depression and anxiety. We know these systems are linked in our psychology, but we are now discovering that they are also linked in our biology.

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