Find out in this post what compulsive eating is and what is meant by binge eating disorders and how to deal with them. discover now


Compulsive eating

Hunger refers to a physiological feeling of emptiness, usually accompanied by gastric contractions. It is therefore a physiological stimulus regulated by internal hormonal stimuli. However, a distinction must be made between:

  • biological hunger, which is a signal that our brain sends to meet the vital need for nourishment and therefore must be satisfied. Biological hunger is authentic hunger, which leads to the intake of food in quantities useful to reach satiety: it arises slowly and gradually increases and is a concrete need of the organism which, once the need is satisfied, interrupts the stimulus and communicates satiety which is not immediate. The stomach needs time to send the satiety signal to the brain. The communication between the stomach and the brain is not very fast because some enzymes involved in the sense of satiety are released after about thirty minutes from the start of the meal.
  • nervous hunger, or “psychological hunger”, which can be triggered by one or more emotions, but does not respond to a physical need for survival and must therefore be controlled. When we eat in response to nervous or emotional hunger, it is as if we cannot distinguish the signals that are useful for survival from those that are not. Emotional hunger suddenly bursts with a high intensity, is hardly bearable, because it requires immediate satisfaction with food, and is more difficult to calm, because it derives from a psychological need and its impulse continues until the exhaustion of the source of an emotional nature that triggered it.

Appetite, on the other hand, refers to a pleasant sense of anticipation linked to waiting for food and is connected to external sensory stimuli (smell, sight) deriving from external environmental factors.

Hunger and satiety: how our body regulates body weight

The combination of hunger and appetite is a stimulus for the introduction of food, which results in satiety. The control of these stimuli, necessary for the maintenance of body weight, depends on the integration of numerous peripheral signals consisting of hormones (such as for example ghrelin which regulates the hunger signal and leptin, insulin, cholecystokinin (CCK) and glucagon like peptide. 1 (GLP-1) which regulate satiety signals), neurotransmitters (such as: norepinephrine, which stimulates food intake, in particular carbohydrates; serotonin, which induces a sense of satiety; dopamine, important in the balance between satisfaction and craving for food, and the urge to eat protein foods) and metabolic factors themselves which, together with psychological factors (for example a stressful condition can increase appetite) and cultural factors, influence the secretion of various hypothalamic hormones.

Specifically, the arcuate nucleus of the hypothalamus is the center of appetite: here are the sensors that monitor the levels of lipids and sugars in the circulation and others that respond to specific hormones. Adjacent to the arcuate nucleus is the paraventricular nucleus, which plays a role in integrating nutritional signals with the thyroid and pituitary axis. Various afferent signals arrive at the arcuate nucleus including hunger signals and satiety signals. Hormonal signals and other peripheral stimuli are processed in the brain by neurotransmitters. The activity of the hypothalamus is regulated by the limbic system, which is the part of the nervous system that processes instincts, mood, emotions.

Eating does not only mean satisfying the sense of hunger, but it is also conviviality, that is, pleasure, consolation and refuge.

Compulsive eating: causes and consequences

Faced with conditions of anxiety, stress, confusion, sadness, anger, boredom, agitation, a sense of inadequacy, loneliness, fatigue, some of us think we find the right refuge in food. This can trigger mechanisms that can be defined as automatic or unconscious that lead to the use of a sometimes inappropriate regulation strategy: I feel sad, I eat and the sadness disappears. All this could create a vicious circle from which it becomes difficult to get out: negative situation, emotions, food, gratification, guilt and devaluation. Each time the negative situation arises, this pattern is repeated until an inadequate relationship with food is created. This happens because, for most people, it is easier to “silence” what they are feeling rather than face and process the feeling.

Compulsive eating: the disorders of binge eating

Remaining on the theme “nervous hunger”, one cannot fail to speak of “binge eating disorder” (in English “Binge Eating Disorder”, BED): this term means a situation similar to bulimia or anorexia but with a well-defined and autonomous clinical picture. The criteria used for the diagnosis of Binge Eating Disorder are:

– recurrent episodes of binge eating, where “binging” means: eating in a limited period of time (eg 2 hours) a quantity of food that is unquestionably greater than what most people would eat in the same period of time in similar circumstances; feeling of lack of control over the act of eating or not being able to control what or how much one is eating.

– episodes of compulsive binging are associated with at least three of the following characteristics: eating much faster than normal; eating until you have a painful feeling of overflow; eating large amounts of food while not feeling hungry; eating alone because of the embarrassment of the quantities of food ingested; feeling self-loathing, depression, or intense guilt after overeating.

– episodes of compulsive binging cause suffering and discomfort and usually occur at least once a week for at least 3 months. It may happen that periods of absolute fasting alternate with periods of large binges in the same person.

Binge Eating Disorder causes an increase in body weight, with the consequent imbalances at the endocrine, neuroendocrine and psychological levels. This type of disorder is nothing more than a form of bulimia with a total absence of compensatory mechanisms, such as vomiting. Furthermore, unlike bulimia, those who suffer from binge eating disorders while experiencing a sense of shame and dissatisfaction with their body, do not pursue an ideal of thinness: they feel shame in losing control over food but not always of importance. excessive weight and / or body figure to evaluate themselves.

Symptoms of Binge Eating Disorder: those affected by BED are almost always considerably overweight and suffer psychologically from this condition much more than obese people who eat non-compulsively; the subject repeatedly tries to follow diets aimed at weight loss without succeeding, deriving anger, frustration, depression from these failures. As with bulimia and anorexia, the origin of the BED disorder is complex, multifactorial, and at least in part also influenced by a genetic predisposition, to which are added a series of unfavorable personal, family, social and environmental factors. Sleep was also closely related to the alterations in eating behavior typical of BED.

How to Cope with Nervous Hunger and Binge Eating Disorder

Patients with eating disorders very often require a personalized and accurate approach that evaluates, in addition to the nutritional status, the existing psychopathological status and the motivation for change. The psychotherapeutic approach that seems to give the best long-term results is cognitive-behavioral therapy, aimed at redefining the relationship with food and providing the tools to react favorably to negative stimuli that can commonly be encountered in daily life and that represent the main trigger for binges. Very often antidepressants are associated with this cognitive-behavioral therapy and if necessary, to obtain a rapid weight loss and / or the patient’s inability to adhere to dietary plans compatible with weight loss, it is possible to evaluate the use of substances that reduce the sense of hunger or reduce the absorption of nutrients. Among the plants of choice for this problem are griffonia, gimnema, opuntia.

Dr. Laura Comollo

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