“I had bulimia for a number of years. And that’s like a secret disease,” Diana, Princess of Wales, told journalist Martin Bashir in 1995. “You inflict upon yourself because your self-esteem is at a low ebb, and you don’t think you’re worthy or valuable. You fill your stomach up four or five times a day — some do it more — and it gives you a feeling of comfort.”
What is binge eating?
NEW ZEALAND – APRIL 1983: Diana, Princess of Wales wears a tiara in New Zealand during April of 1983. (Photo by Anwar Hussein/Getty Images)
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the act of binge-eating is described as consuming an overly large amount of food in a short time period (e.g., within any 2-hour period) than what most people would consume in that duraton and under similar circumstances, losing control over what or how much is being consumed (American Psychiatric Association, 1994). Its episodes predominantly occur secretly due to feelings of shame, during which patients eat until they feel uncomfortable or painfully full. Usually, it co-occurs with other types of eating disorders, such as anorexia nervosa (bulmc subtype) and bulimia nervosa (McManus & Waller, 1995).
Characteristics of binge-eaters
Lacey et al. (1986) found that 100% of all women with bulimia nervosa in their sample group reported experiencing loss, sexual conflicts, or difficult changes in their lives during the 6 months prior to their binge-eating habits. The study also highlighted additional characteristics like insecurities regarding femininity, problematic family relations, academic striving, marital conflicts, and susceptible peer relationships. In addition to these traits, other studies portrayed binge-eaters as having low self-esteem, high self-expectations, insecurities regarding appearance and weight, and limited satisfaction over accomplishments (McManus & Waller, 1995)
Proposed model for bingeing
Models of Bingeing as a Consequence of Eating Behaviour
Slade (1982) was the first to suggest that physiological privaton due to anorexia might cause food cravings leading to bingeing, which was later supported by consequent research such as the study by McManus & Waller in 1995. Yet, not all binge-eaters are motivated by food cravings or initial scarcity of food. Fairburn and Cooper (1989) highlighted the crucial role of low self-esteem in causing individuals to obsess over their appearance and employ strict diets, eventually bingeing because of starvation. It is important to note that bingeing might influence compensatory behaviors like purging. Since both bingeing and purging are believed to decrease one’s self-esteem, ths model conveys a dangerous cycle of behaviors induced by eating patterns (McManus & Waller, 1995).
Models of Bingeing as a Consequence of Emotional Difficulties
Cooper et al. (1988) argued that negative feelings such as guilt and helplessness increase during binge eating. A feeling of regret is often felt post-bingeing, which the individual tries to reduce by purging for a temporary sense of relief. However, anxiety and stress return after purging. Mizes (1985) was one of the first to explain this cycle of binge and purge, stating that purging gives a chance to decrease negative emotions by undoing the eating act. The cycle continues since it becomes an integral part of emotional regulation. Root and Fallon (1989) furthered this proposal and focused on bulimics, depicting bulimia as a way of coping with stress. Bulimia may sometimes facilitate the numbing of intense negative feelings (McManus & Waller, 1995).
Other Potential Models for Bingeing
Another cause proposed by Lacey et al. (1986) is the sociocultural pressure for having the so-called perfect body. In this context, the attitude of family members plays a vital role, since they may idealize physical beauty and model a particular eating pattern. The anxiety inflicted on the individual might become unbearable, and thus, bngeng mght be seen as a soluton. Moreover, certain events, such as bullying, might cause individuals to criticize themselves and have lower self-esteem, leading to binge eating as a way of calming distress and maintaining an emotional state (McManus & Waller, 1995).
Unlike the aforementioned causes, Heatherton and Baumeister (1991) presented binge eating as a consequence of cognitive narrowing, which is the deliberate shift to low awareness. Individuals may choose to have low awareness to escape from self-awareness due to having high standards. When those high standards are not achieved, they may feel the burden of failure, leading them to purposefully think less. This cognitive response allows the individual to take a break from extensive self- criticism. However, cognitive narrowing might also reduce the level of reasoning and increase overall inhibition, leading to more food intake and triggering binge- eating behavior once more (McManus & Waller, 1995).
All in all, there are numerous complex reasons behind the act of binge eating and purging, with the portrayal of a perfect body image being a likely predominant factor. The binge and purge cycle often relates to stress and anxiety, highlighting the important association between feelings and behavior.
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).
Bashr, M. (1995). The Panorama Interview. BBC UK. Interview. https://www.bbc.co.uk/news/specal/poltcs97/dana/panorama.html
Cooper, J. L., Morrison, T. L., Bigman, O. L., Abramowitz, S. I., Levin, S., & Krener, P. (1988). Mood changes and affective disorder in the bulimic binge—Purge cycle. International Journal of Eating Disorders, 7(4), 469– 474.
Fairburn, C. G., & Cooper, P. J. (1989). Eating disorders. Cognitive Behaviour Therapy for Psychiatric Problems, 277–314.
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110(1), 86–108.
Lacey, J. H., Coker, S., & Birtchnell, S. A. (1986). Bulimia: Factors associated with its etiology and maintenance. International Journal of Eating Disorders, 5(3), 475–487.
McManus, F., & Waller, G. (1995). A functional analysis of binge-eating. Clinical Psychology Review, 15(8), 845–863.
Mizes, J. S. (1985). Bulimia: A review of its symptomatology and treatment. Advances in Behaviour Research and Therapy, 7(1–2), 91– 142.
Root, M. P. P., & Fallon, P. (1989). Treating the Victimized Bulimic. Journal of Interpersonal Violence, 4(1), 90–100.
Slade, P. (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology, 21(3), 167–179.
