Psychology - Mental Health News Article Review
Binge Eating in the News. A Critical Review
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Binge Eating in the News. A Critical Review
Binge Eating Disorder (BED) is a complex eating disorder characterised as recurrent
episodes of binge eating: The uncontrolled eating of an objectively large amount of food
(American Psychiatric Association, 2013). Biological vulnerabilities include genetical
heredity, brain abnormalities and the dysregulation of the stress response (Javaras et al., 2008;
Mitchell et al., 2010; Rosenberg et al., 2012). Negative interpersonal experiences, including
childhood abuse and bullying increase the risk of BED development (Copeland et al., 2015;
Grilo & Masheb, 2002). BED affects approximately 2% of the population, with similar
prevalence rates to other eating disorders (Kessler et al., 2013; Micali et al., 2017). Eating
disorders are often assumed to be a female phenomenon; however, prevalence rates and
distress are similar between genders (Striegel et al., 2012; Striegel-Moore et al., 2009;
Swanson et al., 2011). BED has severe consequences, with an increased risk of psychiatric
and medical comorbidity (Becker & Grilo, 2015; Mitchell, 2016). Effective treatments
include cognitive behavioural therapy (CBT), CBT based self-help, interpersonal therapy and
pharmacology including selective serotonin reuptake inhibitors and lisdexamfetamine
(Ghaderi et al., 2018; Hilbert et al., 2019). Lack of education, shame and stigma are barriers
to accessing treatment (Ali et al., 2017; Innes et al., 2016). It is critical truthful information is
released that meets ethical guidelines to minimise harm and encourage help-seeking
(Australian Psychological Society, 2007; Tu & Zimmerman, 2000).
The article reviewed (Foster, 2020) is focused on a 24 year-old woman, Faith
Hodgson, celebrating her figure after a history of disordered eating. The article does not
directly state Hodgson had BED; however, uses the term 'bingeing' and Hodgson states she
'obviously had an eating disorder'. As a teenager, she began developing body image issues
due to being 'larger than her friends', resulting in years of dieting and bingeing. Hodgson is
said to be free from dieting and is now a young Instagram 'influencer' in the 'plus sized
community'.
The article discusses some biological complications Hodgson faced, such as being
larger as an adolescent and starving herself for days (Foster, 2020); however, misses many
biological factors. Childhood obesity increases the vulnerability to dieting, which is
associated with eating disorder psychopathology (Fairburn et al., 1998; Stice et al., 2017).
BED has significant medical morbidity, increasing the likelihood of metabolic syndrome,
type 1 diabetes, liver disease, gastrointestinal problems and nutritional concerns (Mitchell,
2016; Mustelin et al., 2018; Olguin et al., 2016). Metabolic syndrome is the combination of
factors associated with an increased risk for obesity, type 2 diabetes, and cardiovascular
disease (Wassenaar et al., 2019). BED can have negative consequences on sleep, including
greater sleep disturbances and insomnia symptoms (Kenny et al., 2018; Tzischinsky et al.,
2000). Differences in brain activity and reward sensitivity may lead to impulsivity, loss of
control and executive functioning deficits (Hege et al., 2014; Schienle et al., 2009), all shown
to contribute to BED (Manasse et al., 2015; Schag et al., 2013; Steward et al., 2017).
Additionally, acute stressors can reduce neural inhibition, which may trigger BED
symptomology (Lyu & Jackson, 2016). Evidence that brain dysfunction is associated with
BED is shown by the effectiveness of lisdexamfetamine in reducing binge episodes (Fleck et
al., 2019; Hilbert et al., 2019).
• The article would benefit by addressing the biological complexities involved in eating
disorders to better inform readers about BED and other eating disorders. It is advised the
article emphasises the medical risks associated with BED.
The article briefly considers social factors, such as being the 'bigger one' in a social
group and quitting dance (Foster, 2020). Low social support, social withdrawal, and the
pressure to be thin have shown to be risk factors for the development of BED (Allen et al.,
2014; Stice et al., 2017). However, the article misses various social factors associated with
BED. Impaired psychosocial functioning, and exposure to certain life events within the
interpersonal domain increase the risk for BED (Palmisano & Vanderlinden, 2016; Pike et al.,
2006). Interpersonal problems, such as being extremely high or low in dominance (Blomquist
et al., 2012) and family factors, such as perceived criticism and warmth may trigger BED
(Schmidt et al., 2015). Social barriers are prevalent for eating disorders and impacts treatment
seeking (Becker et al., 2010).
• The article would benefit from informing readers about the social factors involved in
having weight concerns as well as discussing the risks of BED on psychosocial
functioning. This article would also benefit by offering some strategies or resources to
help individual's struggling with social functioning or weight concerns.
The article infers psychological consequences Hodgson faced; however, failed to
inform readers the psychological complexities of different eating disorders, including
diagnosis and treatment options. Shame and social anxiety increase the severity of BED and
body-image disturbances (Lewer et al., 2016; Melo et al., 2019; Sawaoka et al., 2012).
Negative affect, rumination and maladaptive emotional regulation can trigger BED,
suggesting that binge eating may function to alleviate negative emotions (Dakanalis et al.,
2016; Dingemans et al., 2017; Schaefer et al., 2020; Smith et al., 2018). Binge episodes, and
the loss of control over eating, can result in further psychological distress, including the onset
of depressive symptoms, drug use and reduced quality of life (Colles et al., 2008; Sonneville
et al., 2013; Winkler et al., 2014). This is evident by the high prevalence of psychiatric
comorbidity and suicidality for individual's with BED (Becker & Grilo, 2015; Conti et al.,
2017; Hudson et al., 2007; Welch et al., 2016). CBT is recommended as the first treatment
option to identify and challenge dysfunctional thoughts and behaviours (Hay et al., 2014).
CBT is suggested as the most effective treatment in reducing BED symptoms and associated
psychopathology (Ghaderi et al., 2018; Hilbert et al., 2020; Linardon et al., 2017).
• The article would benefit from informing readers the difference between occurrences of
disordered eating or body image concerns with a diagnosis of BED. The article could
have been improved by discussing the risks of additional psychiatric comorbidity
occurring with BED and emphasising the need to find appropriate psychological and
medical treatment if readers are concerned.
Given the complexity and risk associated with BED, it is critical information about
eating disorders meets ethical standards to minimise harm and ensure individuals are treated
with respect and dignity. The article misses many opportunities to include information about
BED, which may inadvertently harm others. The article did not provide appropriate
information regarding BED, or help-seeking which may violate standards B.1. and B.3. of the
Australian Psychological Society Code of Ethics (2007) regarding competence about BED
and taking responsibility to prevent harm. Additionally, the article discusses Hodgson's
Instagram and becoming an 'influencer' (Foster, 2020). This may violate standards B.8.1. and
C.2.3. of the Code of Ethics (2007), where collaboration with others promotes the interest and
safety of the client and communication of information must not create false expectations or
appeal to fears, anxiety or emotions.
• The article would benefit by providing more information and depth regarding BED, and
providing more resources available for readers which focuses on help-seeking and
psychoeducation for eating disorders.
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