Imagine stuffing yourself with a day's worth of food in two hours or less. Imagine feeling disgusted, depressed and guilty once you finally stop. Then imagine doing it again, repeatedly and uncontrollably, once a week or more for months on end.
You have just imagined yourself with binge eating disorder (BED), a psychiatric condition similar to other eating disorders like bulimia, minus the countervailing purging behaviour, and compulsive overeating, but without the constant fantasizing about food. Some BED sufferers, in fact, have very negative associations with food. Moreover, until now, researchers knew little about the underlying causes of BED.
David M. Dunkley, a psychiatric researcher and clinical psychologist at the Jewish General Hospital (JGH) in Montreal, and his colleagues studied a group of 170 BED sufferers and discovered that the severity of the condition -- reflected by greater body dissatisfaction and depressive symptoms -- appears to be linked to very specific histories of childhood sexual or emotional abuse, which in turn lead to self-criticism.
Their results were published recently in the International Journal of Eating Disorders.
"Childhood sexual abuse or emotional abuse were associated with greater body dissatisfaction in BED, whereas physical abuse or physical or emotional neglect were not," explained Dunkley, a project director at the Lady Davis Institute for Medical Research at the JGH and Assistant Professor of Psychiatry at McGill University.
According to the Public Health Agency of Canada, an estimated two percent of the adult population in North America suffers from binge eating disorder, approximately 450,000 Canadians and nearly four million Americans. It is twice as common among women as among men.
"I definitely suggest that therapists focus on self-criticism in cases of suspected childhood maltreatment in BED," continued Dunkley. "We did look at alternative theories, like childhood emotional abuse leading to depression which leads to body dissatisfaction and self-criticism. But it doesn't seem to work that way. Self-criticism is the mediator. Without it, it doesn't seem to progress to greater body dissatisfaction in BED."
- David M. Dunkley, Robin M. Masheb, Carlos M. Grilo. Childhood maltreatment, depressive symptoms, and body dissatisfaction in patients with binge eating disorder: The mediating role of self-criticism. International Journal of Eating Disorders, 2010; DOI: 10.1002/eat.20796
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