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THE LEAN PLATE

Secret lives of bingers and nighttime noshers

Though less serious than anorexia or bulimia, compulsive overeating is still risky.

January 23, 2006|Sally Squires | Special to The Times

One woman from San Francisco summed up her eating problem this way: "I rarely overeat when I'm around other people.... All my friends marvel at how 'good' I am. They don't know what goes on behind closed doors! When I'm home alone, I have very little self-control," she says. "I will devour anything that isn't nailed down ... and I feel disgusting afterward."

Such habits aren't rare.

Many people "attempt to control their eating during the day and then lose control at the end of the day when they're starving," says psychologist Gayle Brooks, clinical director of the Renfrew Center's Florida office. The center treats eating disorders and has clinics throughout the East Coast. "That's when this can move into compulsive behavior."

This "disordered eating" -- a form of compulsive overeating -- is considered less serious than the better-known disorders, anorexia or bulimia. Although there appears to be a spectrum of disordered eating, two types in particular are under study.

One is binge-eating disorder, which involves compulsively eating up to a day's worth of calories in two hours or less. The other is night-eating syndrome. People with this syndrome either eat at least 25% of daily calories after dinner, as a bedtime snack, or wake up at least three times a night to eat. These extra calories add up, not only to unwanted pounds, but also to an increased risk for heart disease, diabetes, arthritis, sleep apnea and certain types of cancer.

Exactly how many people are affected is unknown. But clinical experience and a few studies suggest that about 2% of the general population has disordered eating. That means these syndromes occur more frequently than anorexia and rival the incidence of bulimia, says University of Pennsylvania psychologist Kelly C. Allison. Plus, Allison says, plenty of people "suffer from these things at a sub-clinical level as well."

Though binge eating and night eating may seem similar, research suggests that they are two distinct conditions. An occasional bout of overeating or a couple of midnight feeding frenzies are not likely signs of illness. But when such episodes are frequent or severe, there may be a problem. Here are some ways to assess -- and possibly control -- problem eating:

* Ask: Am I in control? Craving food well beyond satisfying hunger is a warning sign of disordered eating. So is difficulty stopping. So if you find yourself frequenting all-you-can-eat restaurants or regularly standing in the kitchen sampling the chocolate cake, then the chips, then a spoonful of ice cream and so on, you might have a problem.

* Check how much you eat after dinner. Constant noshing is a warning sign. Large bedtime "snacks" to help you sleep can be a symptom of night-eating syndrome as can stowing food in the bedroom.

* Eat breakfast. Even if you binged the night before, eating breakfast is the best way to get back on track. A recent Yale University study examined the eating patterns of nearly 200 obese men and women with binge-eating disorder and found that breakfast was the most skipped meal.

* Consume at least three meals daily. It may help control overeating. People with disordered eating often skip meals, find themselves justifiably ravenous, then have trouble feeling satisfied when they do eat. In the Yale study, which was published in the journal Obesity Research, participants with binge-eating disorder who ate three meals per day weighed significantly less and had significantly fewer binges than those with the disorder who regularly skipped meals.

* Close the kitchen at night. There's no evidence to suggest that calories consumed at night are metabolized any differently than during the day. But closing the kitchen means you're less likely to engage in mindless eating. "So figure out a reasonable time to get out of the kitchen after you have cleaned up," Allison says. For the same reasons, avoid eating in front of the television.

* If overeating persists, seek medical assistance. Left untreated, disordered eating can quickly add pounds. Consider psychotherapy to treat underlying depression, anxiety or other emotional problems that may fuel eating. Nutritional counseling and exercise training may also help.

And a small study at the University of Pennsylvania found that the antidepressant Zoloft may be helpful in treating some people with night-eating syndrome. Although many antidepressants can lead to added weight, Zoloft appears to be "weight neutral," Allison says, so it's unlikely to add pounds.

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