Article Contributed By: JoAnne Nuccio, LHMC, CAP
Many times I receive a desperate call from someone who identifies themselves as being a “food addict” or “compulsive eater”. When this person arrives at my office, they may or may not be overweight, but they most certainly are overwhelmed and tortured with self-deprecating thoughts about their lack of self-control and will power to stop eating when they are no longer hungry.
They describe themselves as experiencing urges to eat excessive amounts of food mindlessly, or to eat so they “numb out” from uncomfortable feelings such as anxiety, anger, or fear. These individuals are consumed with thoughts about food and their next binge episode or for the next opportunity to get their “fix”- often in secrecy.
No Pleasure and All Shame
They consume large amounts of food in a relatively short period of time, and are left with feelings of self-disgust, and plagued by guilt, shame and remorse after an uncontrollable eating episode. In addition, this eating pattern can leave someone with intense fears surrounding issues of gaining weight.
Oftentimes, their weight has increased as the behavior continues to progress and take over one’s life. Health issues due to obesity and weight fluctuations may develop. The frustration this person experiences with being unable to stop the behavior finally brings them to seek out professional help.
Getting to the Thoughts and Feelings Behind BED
When I work with someone struggling with compulsive overeating issues, not only will I be attentive to the details they express to me about the nature of these “binge” episodes, but also to the thoughts and feelings that may be at the root of this difficulty with food and emotions.
Together, we explore the presenting and co-occurring psychological and psychosocial issues that may be underlying this behavior. As a clinician, I think of this compulsion to overeat, as described above, in terms of a disorder called Binge-Eating Disorder (BED), which can be potentially life-threatening, and also to which some controversy surrounded its newly proposed diagnostic classification.
Nevertheless, understanding the emotional challenges and stressors a person is experiencing, and how they have become imprisoned by the distortions of themselves in relationship to food, stress, weight and their own bodies, is where we can begin the journey of healing for this disorder and/or compulsive behavior.
The Definitions of BED and Compulsive Overeating
Let us examine definitions of both Binge-Eating Disorder and Compulsive Overeating in order to understand these terms better. Compulsive overeating (a.k.a. food addiction) is the most common term referred to in our society for people who identify with this intense urge or compulsion (impulsive behavior) to consume large amounts of food in a relatively short period of time.
This can mean thousands of calories are consumed without the use of compensatory behaviors – such as purging (by means of vomiting, laxative use or excessive exercise) or restricting calories to counteract the binge episode, such as in the case of Anorexia Nervosa and Bulimia. The term Binge Eating Disorder, also describes someone who struggles with this type of eating-disordered behavioral pattern.
A person would most likely be diagnosed as having an Eating Disorder Not Otherwise Specified (EDNOS) by clinicians who treat this compulsive overeating behavior. However, the new Diagnostic Statistical Manual of Mental Disorders (DSM-5) will now classify Binge-Eating Disorder under its own diagnosis. “Binge Eating Disorder (BED) is characterized by recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.
This disorder is associated with marked distress and occurs, on average, at least once a week over three months.” (American Psychiatric Association).
The Similar Symptoms of BED and Compulsive Overeating
Binge Eating Disorder and Compulsive Overeating seem almost identical in the description of symptoms expressed by people who struggle with food in this way. According to the National Centre for Eating Disorders, “Definitions of Binge or Compulsive Overeating include some or all of the following features which occur with regularity at least 3 times per week.
- Eating faster than usual
- Eating past the point of fullness
- Eating when not physically hungry
- Eating alone or in secret
- Feeling upset or guilty after overeating
- Feeling that you are abnormal
- Feeling “taken over” or “driven” as if by an other presence in respect of eating
Relationship to Obsessive-Compulsive Disorder
As I mentioned previously, individuals who seek treatment for compulsive eating, also may identify themselves as being a food addict-referring to a preoccupation with the “substance” of food. They will describe their eating episodes much like a person who is addicted to drugs or alcohol.
In a similar way, there was controversy surrounding Binge-Eating Disorder and its placement in the DSM-5. “The urges experienced by those with Binge-Eating Disorder are similar to the urges experienced in some Impulse Control Disorders such as Trichotillomania (compulsive hair pulling) and Pathological Gambling. This would suggest the possibility that Binge-Eating Disorder could potentially be conceptualized as an Impulse-Control Disorder.” 
There was further debate that compulsive overeaters express their challenges with food similarly to those who struggle with Obsessive Compulsive Disorder (OCD), and although BED has compulsive and obsessive features to it, there are too many significant differences that would not warrant Binge-Eating Disorder as a type of OCD.
“Despite the above ambiguities, the APA’s current plan is for Binge Eating Disorder to be listed in the DSM-5 as an Eating Disorder, along with Anorexia and Bulimia. This seems intuitively appropriate, despite the fact that compulsive overeating has characteristics of Impulse Control Disorders, Addiction Disorders, and OCD.” 
Are They Really the Same?
The question of whether or not Compulsive Overeating and Binge-Eating Disorder are the same will probably remain debatable for some. However, as a clinician who works with those who are struggling, it is the severity of the symptoms that concern me the most and how I may help that someone gain more productive coping skills to avoid the urges to binge and compulsively eat.
Psychotherapy and Mindfulness-Based Cognitive Therapy have shown to be highly effective tools to helping someone with this behavior- no matter what we decide to name it.  http://www.ocdla.com/blog/binge-eating-compulsive-overeating-treatment-1086