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

Psychologist explains why people binge eat and what role genetics plays.

ByABC News via via logo
March 16, 2009, 4:24 PM

March 17, 2009 — -- Clinical psychologist Cynthia M. Bulik is an expert on binge eating and has written a new book on how to conquer food cravings.

In "Crave," Bulik discusses just how much genetics play a role in the disorder and explain why people crave the foods they do.

Read an excerpt of "Crave" below and click here to visit Binge Eating Disorder Association's Web site..

"Binge eating tops the list of eating disorders affecting Americans, with the first-ever national survey on eating disorders finding it much more prevalent than either anorexia or bulimia."

~ HealthDay News

It's a common scenario played out in millions of households around the country every single day: a woman eats her favorite ice cream straight from the carton until she reaches the bottom, or a man goes to his favorite sports bar and practically inhales 20 buffalo wings — each is simply trying to satisfy intense, at times overwhelming, cravings. Some crave sweets; others crave pasta — whatever the target — it finds it's way from hand to mouth.

Every binge is different, just as every craving is different and every binge eater is different, but the scenario is most often the same: binge-eaters like to be alone with their behavior, often turning to late-night, early morning or even what I call "backseat" binges to ensure that no one sees their so-called "shameful" activities. Maybe the kids are asleep, the parents are out of town, the spouse is still at work, or the roommate just left for that big business trip or is still taking her semester exam.

My patients have told me countless horror stories of how far they went to conceal a binge; driving across city, county, or even state lines so no one they know will witness them driving from fast food restaurant to convenience store, or binging from drive-thru to drive-thru in record time. Some have even hidden in a closet with a grocery bag full of clandestine food.

For those willing to look a little more deeply past the carefully constructed façade, some telltale signs of a classic binge eater might be: snack cake wrappers wedged between sofa cushions, "caches" of food hidden throughout the house, fast food receipts stacked like Monopoly money in glove boxes and greasy wrappers littering the car floorboards. But not everyone leaves a trail; some binge eaters spend as much time covering their tracks as they do shopping for the binge itself.

Regardless, the cravings can seem insatiable. Day or night, alone or with someone just in the other room, the binge-eater can hardly refuse the cravings that cause him or her to ingest 500, 1,000 or even sometimes as many as 3,000 or more calories in a single sitting.

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.

You are not alone; not anymore. Thanks to decades of research in the field, hundreds of patient case studies and reams of research conducted on this very topic, I can help you get an upper hand on your own eating and, together, we can conquer your concerns about binge eating.

Binge eating disorder is a highly treatable condition. When we give patients path-breaking tools to "curb the crave" at our program at UNC, most of those who use them can — and do — triumph over their binge eating. You will hear about these patients, men and women, young and old, and how they conquered their disorder using a variety of strategies in their personal arsenal; you will learn these strategies as well.

What about gaining weight? I know how closely concerns over weight and binge eating are linked, and that is why losing weight and keeping it off are a critical part of both treatment and self-discovery for everyone trying to get control over their binge eating. Once you can to identify the causes of your cravings, it becomes easier to lose weight — as well as to bring your binges under control.

Across the country, many effective forms of treatment exist to help sufferers overcome their disorder, including:

Specific treatment programs will be discussed later, but I wanted to introduce them early so that you know that effective options do exist – and many may be well within your reach. Whatever form of treatment you seek out for yourself – or for others – rest assured that right now, by following the guidelines in this book, you are taking the first critical step toward getting help.

I deal with people every day who are going through what you are going through and I know firsthand how much courage it takes first of all to admit there is a problem and, secondly, to address the problem with specific, safe, effective steps toward long-term recovery.

There is nothing fancy about my approach. In fact, it is down to earth, user friendly, and very practical. Strategies to "Curb the Crave" include surprisingly simple methods you will soon be able to implement in your daily routine:

My research and the latest studies done by colleagues in the field reveal how our genes can put some of us at greater risk for binge-eating and its almost universal byproduct, obesity. However, this research has also proven one reassuring fact: no one needs to be a prisoner of his or her genes any longer; everyone can learn to make better eating decisions and control his or her diet on a lifelong basis.But the solution has to be personalized. Some generic, "cookie cutter" approach won't work. You have to identify the "crave-ology" profile that jibes most with your experience and select the tools that work best for you. Some typical binge-eating profiles include the:

Maybe some of these will sound familiar right off the bat, while others require further explanation. You may identify yourself as one type or a combination or you may feel like "all of the above." However you decide to classify yourself, I urge you to use this book as your toolbox; these are the tools you can use to help yourself recover — or help a friend, family member or loved one recover — from binge eating disorder. A special section of the book in Chapter 9 lists resources for you to turn to for information and referrals. They can help; I can help; most of all you can help yourself triumph over binge eating disorder!

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