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This year’s theme for Mental Health Awareness Week is body image. In this blog, we cover a lesser known eating disorder; binge-eating disorder, with a personal and emotive account from someone who has experienced this condition. We have also included reccomended research on eating disorders which has been reviewed by our expert F1000Prime Faculty.⠀

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“It has been a really slow journey. I oscillated between anorexia, bulimia and binge eating across about 5 years. For most of that I was outwardly fine and I still had a life, but behind closed doors I was often in a bad way and my mental health was in shreds. It got better and worse but eventually about two years ago the stress of doing a Master’s degree made my eating behaviours erratic and I was wildly oscillating between bingeing, purging and restricting. I just completely broke down and couldn’t function.”

Coping with an eating disorder is both an isolating and distressing experience at any stage of life. But what if you had the added problem of also struggling to find a diagnosis which matched your symptoms? That’s exactly what happened to someone I know. The overriding narrative of much of her adolescent and adult life was taken over by her relentless search to answer the question: “what is wrong with me?”

“About six years ago when I was 19, I suddenly started compulsively eating on a near daily basis. I would come home from work and eat dinner, and then dessert, and that wouldn’t be enough, so I’d eat cereal and toast and whatever else was in the cupboards. It felt like no matter how much I ate I was never full and I just had to keep eating until eventually I would have eaten so much that I physically couldn’t eat anymore and I felt sick.

“For a long time I thought I was just being a pig, greedy, ‘fat’ and undisciplined, and saw myself and my own lack of discipline as the issue rather than any kind of disorder or illness.”

Throughout our friendship she has been diagnosed, treated and labelled with multiple different conditions; IBS, Depression, Acid reflux, Generalised eating disorder just to name just a few. Getting an accurate diagnosis for mental health conditions is just as important as a physical condition. With this information, you can take control and begin to see that your symptoms are not random, but part of a bigger issue. You can seek out specialised treatment, which is tailored to supporting your recovery. You can find articles, blogs, advice and other content from individuals struggling with the same condition, which can be a great source of comfort.

After many years, doctors, therapists and personal research my friend finally reached a diagnosis that not only fit but made complete sense. She had binge eating disorder.

“Some days were fine and I would manage to avoid it or it just wouldn’t happen, but for many, if not most days for a period of couple of months, I would binge eat. I felt like I had no control over what I was doing and would just eat compulsively to try and satisfy this feeling of really intense hunger that never really seemed to go away. It was really scary and I knew that something was wrong, but at the time I didn’t know it was a  form of eating disorder.”

Binge eating disorder or BED, is a mental illness which is characterised by reoccurring episodes of eating large amounts of food often to the point of discomfort. During the binge, many people report feelings of shame and loss of control. This is usually followed by intense emotions of guilt and in some cases, the need to take measures to ‘purge’ themselves of the food they’ve consumed. People who experience this condition can also develop intense anxiety around situations involving food, which can lead to them becoming socially isolated.

“Physically, binge eating makes you feel terrible anyway – stomach cramps, bloating, nausea, grogginess, lethargy – and if you’re experiencing several binges a week it really takes its toll, making physical exercise even as simple as walking really difficult, which only feeds into the cycle.”

Having a condition like binge eating disorder can also have a huge impact on other aspects of your mental health. Many people report low self-esteem and a lack of confidence, depression and anxiety. As is common in other eating disorders, changes in behaviour are usually what people around them notice first, before any physical symptoms become apparent.

“The rapid weight gain, water retention, bloating and stomach pain, as well as the guilt and frustration, also impacted my self-esteem and I felt really unattractive. This not only negatively affected my relationship with myself but also with romantic partners, who I began to draw away from physically and emotionally. It also had a big impact on my social life and I would go out less because I felt unattractive and also a mental and emotional mess.”

I can still recall the afternoon when she called me to tell me she had worked out what she had. I remember googling the symptoms on my phone whilst she continued talking to me. I felt a pit in my stomach as I made my way down the list and realised everything matched up. I felt awful and worried for my friend, concerned that she had been struggling with such a time consuming and emotionally draining condition. 

“When I did finally realise that something was actually wrong, it was still difficult to determine what it was. Indeed six years ago binge eating disorder wasn’t actually classed as an eating disorder in its own right, and it has only recently been officially recognised as such. Thankfully BED is now officially recognised as an eating disorder and I think that would mean that anyone suffering with it now would be able to self-diagnose much more easily.”

It was only when I tuned back into the conversation, that I realised she wasn’t describing the same dread I was feeling. She sounded positive, relieved and almost happy. I was confused, but as I listened to her happily regale me with the information she’d found, it dawned on me. She was relieved. 

“I didn’t feel like I had any proper grasp or understanding of my BED until I saw my most recent therapist and was diagnosed with anxiety very recently, and it was only when I started to focus on tending to my anxiety that I saw my binge eating improve drastically. I’m now out of regular therapy but occasionally go back to my therapist if I feel like I need extra support or something new comes up, but for the most part I feel like therapy has given me the tools I need to manage my mental health on my own.”

The first step to finding treatment, is usually an appointment with a GP. Following an initial assessment, the best suggested course of treatment is generally cognitive behavioural therapy (CBT). This kind of therapy is grounded in the idea that your emotions, thoughts and actions are interlinked.  It targets the negative thoughts or behaviours associated with eating disorders, breaking them down, making them more manageable and changing negative patterns to ultimately improve quality of life.

“I’m almost 25 now and I feel like I’ve only really just come to terms with my condition. I first went to a therapist two years ago, which was a major turning point, but the big breakthrough came last year when I went to a therapist who used a combination of hypnotherapy, CBT and mindfulness.”

There are also group CBT sessions, self-help materials based on the concepts of CBT and support groups. These services can help sufferers, friends and family to come to terms with the condition, manage the symptoms and reach and sustain recovery.

“I can now see a much more positive future for myself and my relationship with food now I’ve had therapy, although I know it won’t always be easy and it’s something that will get better and worse. I haven’t had a binge episode this year, which is the longest I’ve gone without having one since my disordered eating began, so I’m very happy about that.”

I have seen her go from strength to strength since her diagnosis. She has always been one of the strongest people I’ve known, and this experience has added to her strength rather that impeding it.

“My advice to people who might be suffering from something like me, is ask for help or talk to someone. Despite some negative experiences with GP’s, I think it’s still really important to go. If your GP is unhelpful, speak to another and change practices if you need to.  Speak to friends and family too, even if it’s only one or two people, it really helps you feel less isolated and having someone to listen to you and console you when you’re upset is all you need. There are also free hotlines and live web chats, which are important resources, especially if you’re feeling low and isolated or you’re struggling to confide in anyone.”

Binge eating disorder usually requires regular therapy, support and treatment. However, that doesn’t mean that people who experience it can’t reach their full potential and go on to succeed in everything they hope to.

I have wished many times that I could take this problem away from her, but I am deeply grateful to have the opportunity to see her grow, progress and ultimately flourish despite the issues she faces.

“I would like to say to anyone out there struggling, cut yourself some slack, stop pushing yourself, listen to yourself and to your body and tend to your needs. If you’re hungry, eat, if you’re tired, sleep, if you’re upset, cry, if you’re stressed, relax. It’s difficult to figure out what you need sometimes but the more you pay attention the better you learn to interpret the signs your body and mind give you.

“I’m trying to work towards a healthy and balanced relationship with food where I trust it and I trust myself around it more and more, and a healthy and balanced relationship with myself, which to me looks like understanding my physical, mental and emotional needs and tending to those the best I can. Also getting past the idea of ‘perfect’, because it doesn’t exist, especially when it comes to eating. I think it’s just about doing your best.”

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As it’s Mental Health Awareness week and this year’s theme is eating disorders, we would like to highlight papers recommended on F1000Prime which focus on eating disorders and their treatment.

If you like our recommendations, why not consider checking out F1000Prime? F1000Prime is our literature recommendation service, which has a peer-nominated global Faculty of more than 8,000 of the world’s leading biomedical scientists and clinicians. The Faculty select those articles which they think are particularly interesting and important and write recommendations explaining their selection. From the numerical ratings awarded, we have created a unique system for quantifying the importance of individual articles.

“Stress is a common precipitant to binge eating (BE). Animal models repeatedly demonstrate that rats, mice, and non-human primates subjected to stress exhibit hyperphagia of general food intake and binge-like eating. Consistent with the effects found in animal studies, this study by Collins et al. demonstrated that the effects of acute stress on eating behaviour exist in women and appear dependent upon BE status.” – Kelly Klump and Natasha Fowler,Michigan State University, USA

“In anorexia nervosa (AN) there is either an intense fear of gaining weight or of becoming fat or persistent behavior that interferes with weight gain (even though at significantly low weight). This systematic review highlights that AN is a chronic disorder with frequent relapse. The authors put forward standardized criteria for relapse, remission, and recovery.”-
Guido Frank, University of Colorado School of Medicine, Denver, USA

“This is one of a series of papers that has emerged in the past five years providing powerful evidence reinforcing and extending the place of cognitive behavioral therapy (CBT) as the leading approach in the treatment of adults with eating disorders.”- Glenn Waller, University of Sheffield, UK

Current Top 3 recommendations

Rankings are generated using the article recommended in F1000Prime during the preceding 30 days.

“This work by Borgia and others comes out to be a breakthrough finding in the field of intrinsically disordered proteins. The authors find two interacting disordered proteins that never attain structure rigidity or three-dimensional fold and tend to remain dynamic throughout the interaction, even though they bind each other extremely tightly with the binding affinity in low picomolar range.”-Andrey Kovalevsky and Viswanathan Gurumoorthy, Oak Ridge National Laboratory, Oak Ridge, USA

“The exciting findings of this study also provide also a very important mechanistic basis to identify novel breeding targets to improve stress resiliency of crops with minimal yield penalty. Thus, it may prove to be highly relevant within climate smart breeding approaches for climate change scenarios.” – Thomas Roitsch,University of Copenhagen, Taastrup, Denmark

“Using ribosome profiling, the authors have analyzed in a systematic way the assembly of protein complexes in yeast. Surprisingly, they found that the subunits of numerous protein complexes assemble co-translationally most probably to avoid aggregation of the proteins…This remarkable study shows an additional level of protein quality control, which couples protein synthesis, protein folding and assembly of protein complexes.” – Pascale Romby, University of Strasbourg, France

Hidden Jewels

Hidden Jewels rankings only include articles published in specialist journals, recommended in F1000Prime during the preceding 30 days.

“The link between developmental programs and growth is a poorly understood aspect of plant biology, as plant growth arrests in response to a variety of different stresses, but the molecular mechanisms are largely unknown. This study advances our understanding by demonstrating the interplay between ABA and TOR. This paper reveals a reciprocal interaction between TOR and ABA signaling.” –Leslie Sieburth,University of Utah, Salt Lake City, USA

“Becoming a PI is not just about being a good scientist, but also being a good leader. But what makes a good leader? Maestre offers ten simple rules for new (and established) PIs across the sciences to develop their teams and maintain a healthy and productive lab environment.” – Amy Milton, University of Cambridge, UK

“The authors of this excellent study show that binding of strigolactone (SL) to the unconventional receptor molecule D14 initiates SL signalling, and that SL hydrolysis by D14 is a distinct and subsequent process that may serve to maintain homeostatic levels of SL.”- Christiaan van der Schoot, Norwegian University of Life Sciences, Akershus, Norway