In English, we speak of “binge eating disorder”. In French, bulimic hyperphagia or uncontrolled hyperphagia. The 5th version of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-V in English), released in the USA, would recognize it as an eating disorder in its own right. Still poorly understood, hyperphagia is characterized by recurrent episodes of binge eating, at least twice a week. To relieve a feeling of unease, the patient absorbs in less than two hours large quantities of food, well beyond satiety, without succeeding in restraining himself. “At first, the subject eats foods that taste good and then ends up eating whatever comes to hand, such as boxes of cold cassoulet, until he feels full and comes to feel calm”, describes Professor Philip Gorwood, psychiatrist at Sainte-Anne Hospital (Paris). The relief after this binge eating quickly gives way to feelings of self-loathing and guilt which only accentuate the suffering of the patients.
Uncontrolled weight gain
But unlike the bulimic patient, the person who suffers from uncontrolled hyperphagia does not seek to control his weight: he does not compensate for his bouts of bulimia by periods of fasting laxatives. “These episodes of binge eating are therefore paid for by weight gain”, continues Professor Gorwood. A veritable vicious circle: being overweight further exacerbates the discomfort of patients and food cravings increase.
Binge eating affects about 3 women for 2 men and is more likely to be found in thirty-somethings according to our specialist. Not easy to detect, it is up to the doctor to ask the right questions to his patient who comes to see him for a problem of overweight or obesity. Do you find yourself overeating in a short time beyond what you had planned with the feeling of losing control? Do you ever eat large amounts of food on the sly? Etc.
The behavioral and cognitive therapies, CBTs, which aim to modify unsuitable behavior towards food through concrete learning, are proving effective in treating binge eating disorder. In some cases, the doctor may decide to prescribe antidepressants to his patient. “Combining CBTs and antidepressants is possible”specifies Professor Gorwood who advises to send patients to a center specializing in the management of eating disorders.
Where to find help ?
On the Afdas-TCA website, www.anorexieboulimie-afdas.fryou will find useful addresses of patient associations and places of care in the section “Find help near me”.