Not hungry, but can't stop gobbling

PHOTO: The Straits Times

Before you dismiss your friends as being greedy, you should find out if there is an underlying reason they are eating so much, to the extent of feeling queasy or even unwell.

Dr Victor Kwok, head of the department of psychiatry at Sengkang Health, recalled that in secondary school, he had an obese classmate who could not stop eating when they were at a buffet.

Despite being advised to stop, the classmate kept on eating and eventually felt very uncomfortable because he had eaten too much.

Dr Kwok said: "This was puzzling to me then."

His classmate may have been suffering from binge-eating disorder. Although there is no official data in Singapore, it is estimated that the disorder is three times more common than anorexia and bulimia combined.

People with the disorder have episodes of binge-eating, where they would gobble large quantities of food in a short span of time.

Some characteristics of the disorder include:

•Uncontrollable intake of food.

•Eating more rapidly than usual.

• Eating alone due to embarrassment.

•Eating until one feels uncomfortably full.

This differs from overeating, which may happen at all-you-can- eat buffets, said Dr Kwok. At such buffets, most people try to eat more and even skip an earlier meal in order to eat their money's worth.

What sets overeating apart from binge-eating disorder is that there is no loss of control over the amount of food eaten.

At buffets, we pick and choose the items we want to eat, even if we eat to the point of slight discomfort. At the end of the day, we might even feel a sense of achievement.

But people with the disorder would feel disgusted and guilty after eating large amounts of food. In fact, they would eat a lot even though they do not feel hungry.

These binge-eating episodes would result in weight gain, increasing the person's risk of developing chronic diseases like Type 2 diabetes, high blood pressure and high cholesterol. Dr Kwok said that 40 to 50 per cent of people with the disorder could be overweight.

He cited the case of an undergraduate who piled on the kilos after uncontrollably stuffing himself with fried chicken and burgers at night. At meal-times, he also ate more than usual and did not bother to exercise regularly.

As a result, his weight ballooned to more than 100kg and he was so embarrassed that he did not want to leave his house.

If he woke up late, he would skip classes as he was afraid the other students would stare at him when he walked into the classroom, said Dr Kwok. The boy's parents thought he was just greedy and scolded him, telling him that he had lost his good looks. This lowered his self-esteem even more.

Watch out for these signs of depression

  • Distancing themselves from friends and loved ones
  • Sleepiness
  • Constantly overworking
  • As long as it does not interfere with their daily functions, such as taking care of the kids or themselves, leave them alone.
  • Smoking more cigarettes
  • Extreme dieting
  • Non-drinkers who begin drinking daily may not be consuming high amounts of alcohol but are unable to relax unless they do so.
  • Does a friend who is usually in control of their emotions begin frequently displaying bursts of anger?
  • Take notice when someone starts moving away from things that were healthy for them, such as spending a healthy amount of time with friends or exercising, to doing nothing, for over a year.
  • These are some extreme statements of failure that can be a cause for concern for friends and family members and should be taken seriously.
  • Some of the things that we would normally shrug off, such as loud noises or children laughing, seem to create extreme distress for the individual, showing that the person may have too much going on in life.
  • "If this person suddenly starts giving away their personal things and is happy doing it - please beware. "That is not a good sign," said Dr Anasuya, adding that it could be a sign of suicidal tendencies.
  • Sometimes, no matter how much one tries to offer support or advice to a loved one, their words have no effect on the depressed individual.
  • Helpers need to know when to take a step back or may end up becoming depressed themselves.

Dr Kwok said people with binge- eating disorder may also be suffering from depression and anxiety disorder. This could be due to dissatisfaction with their body or anxiety that people would comment about their weight.

Binge-eating and anxiety disorders share common factors like family discord or stress.

For those who are worried that a family member may have binge- eating disorder, Dr Kwok suggested approaching him in a private setting without being judgmental.

"You can say you are concerned about his loss of control during meals and that it could be a symptom of a medical problem that can be treated," Dr Kwok said, adding that such people may be reluctant to talk about their bingeing episodes due to shame or disgust.

People with the disorder can seek help from these healthcare professionals:

•Psychiatrists with training in eating disorders.

•Psychologists, who can offer cognitive behavioural therapy to help patients cope with triggers.

•Dietitians, who can give advice on a balanced food intake.

• Physiotherapists, who can suggest exercises for patients to maintain a healthy weight.

This article was first published on Jan 31, 2017.
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