Here is a link to an article on Binge Eating Disorder from WebMD; a very credible source of health related information. I believe they should update their information on binge eating in a way that will actually help the majority of people who suffer from these conditions.
I’ve been a Registered Dietitian/Nutritionist with a practice in medical nutrition therapy for over 35 years. For as long as I can remember, binge eating and bulimia have been presented as psychological disorders.
Eating patterns that include chronic binge-ing are different from occasionally going overboard at a meal or having an occasional splurge on ice cream, dessert, pizza, etc. ; Binge eaters feel compelled to start and finish a cake, a party sized bag of chips, plus a half gallon of ice cream in one evening and feel totally out of control and unable to stop.
When the binge is over, the person crashes while experiencing fatigue and guilt for what has transpired. In short order they may feel a headache, sweats, slight shaking, dizziness, anxiety, and depression. In the case of binge-ing with bulimia, the person feels compelled to purge their over- consumption by making themselves throw up, take laxatives, over-exercese…they are compelled to “rid” themselves of the food before it has the chance to turn to fat.
I would like to present a very different way of looking at binge-ing.
The Binge Provoker:
Take notice that the foods people binge on are mainly carbohydrate- based: pasta, bread, chips, cookies, cakes, pies, ice cream, pudding, pizza, fast food, etc are primarily composed of carbohydrate.
Carbohydrate is the fuel for the human body and serves as the main source of energy. When carbohydrates are consumed, your blood glucose naturally rises and the pancreas should release the exact correct amount of insulin to return blood glucose to the normal range as it helps usher excess blood glucose into the liver and muscle cells (to replenish glycogen stores). After the liver is replenished with glycogen and the glucose in the blood is returned to the normal range, any leftover blood glucose is stored in the fat cells. So…excess carbohydrate intakes leads to excess fat stored on and in the body.
I am willing to state that about 40% of binge-ers and bulimics have normal insulin release. When they go on a carb bender, their insulin is released normally, they end up with normal blood glucose and excess glucose is replaced in the liver, muscles and stored as fat. Binge-ers will become appropriately fat and bulimics will use purging, laxatives, or exercise in an effort to burn off the excess fat.
What about the other 60% of bingers? The majority of bingers?
Missing from all articles on binge eating and bulimia is the fact that about 60% of teens and adults who suffer from these conditions do NOT have normal insulin release. Here’s the sharp contrast between what happens in the body of a person with normal insulin release and then inside the body of person who makes excess insulin in response to carbohydrate intake.
(For ease, I will call those with normal insulin people with Metabolism A or Met A. Those who naturally produce excess insulin have Metabolism B or Met B).
The Met A Binge-er:
A person with normal insulin eats a few Christmas cookies. Their blood glucose rises, insulin releases in the appropriate amount, blood glucose returns to the normal range, and any excess blood glucose is stored in the liver, muscles, and fat tissue. Prompting the binge may be boredom, anxiety, anger, fatigue, stress. Without much thought, they reach for more cookies. They might do this over and over again until all the cookies are gone. They are ashamed and angry with themselves. “How could I eat an entire tray of cookies?” Although they did not control their eating… their body will process the cookies normally. Perhaps there is a psychological backdrop to compulsive eating in the face of normal insulin. When Met A’s binge, there may be a psychological trigger that prompts the binge.
The Met B Binge-er:
If a person is genetically predisposed to produce excess insulin in response to a rise in blood glucose, the scenario is MUCH different.
The person with uncontrolled Met B eats a few cookies and promises him/herself that will be it.
Blood glucose rises normally
But…their pancreas over-releases insulin
Excess insulin “opens” liver and muscle cells and helps refill them with glycogen. But excess insulin will then go on to open EXCESS fat cells. “Normal” blood glucose leaves the circulation and fills those extra opened fat cells. This leaves the person “fatter” with LOW circulating blood glucose.
Low blood glucose sets off an alarm in the brain; after all, the brain runs on glucose. The brain signals the person to get more cookies…QUICKLY…to normalize the blood sugar. The person feels compelled to have more cookies.
Sure enough, the next bunch of cookies causes their blood glucose to rise and the binger momentarily feels better as the hypoglycemia has subsided. But, just as quickly, excess insulin is once again released. Excess fat cells are opened and blood glucose is once again rendered LOW.
MORE COOKIES! This is a real compulsion driven by the brain demanding more carbohydrate to normalize blood glucose.
After the cookies are gone, the binge-er with uncontrolled Met B may open a bag of chips, finish it, and move onto ice cream.
Inside the body, blood glucose is on a wild roller coaster…up/down/down- too- low…and then up/down/down- too- low.
When the binge is over, the Met B person is exhausted, light headed, dizzy, perhaps nauseated, cranky and usually falls into a self-proclaimed “carb coma.” This is not a real coma…but it is a way to describe nearly passing out after eating in a binge due to excess insulin and resultant blood sugar swings.
How do I know if my binge-ing is due to excess insulin?
If you have are a person with bulimia or binge eating disorder or if you have patients with these eating disorders, please have fasting lab work drawn. The following FASTING labs will show if they have uncontrolled Metabolism B…a hormonal imbalance of insulin that CAN be corrected with the proper lifestyle.:
Fasting glucose….If it’s over 85, consider Met B
Total cholesterol…over 200?, consider Met B
LDL cholesterol…over 99?, consider Met B
Triglycerides….over 99 OR under 50? , consider Met B
Hemoglobin A1C….under 5.2 OR over 5.6? consider Met B
Fasting insulin…over 7?, consider Met B
Vitamin D level…under 40?, consider Met B
You will find that 60% of those with bulimia and binge eating disorder have labs that look like the uncontrolled Met B labs. For these people, the “help” will need to be both physical AND psychological.
The dietary treatment and lifestyle for uncontrolled insulin, insulin resistance, uncontrolled Met B is found in the book The Metabolism Miracle, Revised Edition by Diane Kress, RD CDE.
Ask your patients to give this easy to follow program an 8 week try. (It is a lifetime program, but they will feel remarkably better and in control after fewer than 8 weeks). If they like how they feel (and their labs and energy will all improve, too), this is the help they have been seeking. Once labs are normalized, if psychological treatment is warranted, the therapist will be working with a clean slate and normal physiology.
If your patients have normal fasting lab work (as it pertains to Met B), it is very probable that their condition has a psychological root cause.
Sometimes it is appropriate to look outside of the box that has been created by past medical research. Outside of the box on the eating disorders of binge eating and bulimia may lie a hormonal imbalance. When the hormone insulin is normalized, it may be MUCH easier to work on and help control the psychological aspect of these conditions.
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For less than $20.00, you can be part of the BIG 2017 Start up/Restart and change your weight, health, and wellness forever! Hope to see you there and have wonderful holidays!
The Metabolism Miracle, Revised Edition: https://www.amazon.com/Metabolism-Miracle-Revised-Control-Permanently/dp/0738218901/ref=sr_1_1?ie=UTF8&qid=1479411840&sr=8-1&keywords=the+metabolism+miracle
The Metabolism Miracle Cookbook: http://www.amazon.com/The-Metabolism-Miracle-Cookbook-Delicious/dp/0738214256/ref=pd_sim_b_1?ie=UTF8&refRID=0DC5FY8CN1D1YH85YNM
Miracle-Ville.com The Interactive Support Group for Followers of The Metabolism Miracle and The Diabetes Miracle: http://www.Miracle-Ville.com
The Metabolism Miracle Holiday Book: https://www.amazon.com/Metabolism-Miracle-Holiday-Book-Appetizers-ebook/dp/B01MXEBS3Y/ref=sr_1_1?ie=UTF8&qid=1479411912&sr=8-1&keywords=the+metabolism+miracle+holiday+book