How to Help the Volume Eater - The Person with a Binge Eating Disorder
Possibly disproving my usual preaching that people following our diet
always lose weight and become healthier are a few
extraordinary people I call “volume eaters.” They eat very
large amounts of McDougall approved foods, and their weight
remains stubbornly fixed at a point too high for excellent
health—although they all lost initially after giving up the
high-fat, high-calorie Western diet. I can vividly recall
several men and a few woman who exemplify this behavior—and
I know there are many more out there (in fact, I am guilty
of a tinge of this behavior at times myself—“it takes one to
know one”).
In my
experience, a “big eater” might consume 2 plates filled 2
inches high with salad, potatoes, pasta, beans, and
vegetables. The volume eater will put down three to five such
plates—often in less than 20 minutes—a pattern repeated for
breakfast, lunch and dinner. Their conveyor belt style of
ingesting allows no time for the body and brain to register
that they have eaten. By the time their abdomen is
noticeably (and sometimes painfully) distended they will
have consumed 2,000 calories at a single meal, which could
mean 4,000 to 6,000 calories for the day. In the medical
world a person with this pattern of eating is thought to
suffer from a binge eating disorder.
Binge
eating disorder is characterized by ingestion of very large
meals without purging (throwing up) afterwards and is found
in a subset of overweight individuals. These people are
different for several reasons. They have been found to have
larger stomachs than the average person of comparable
physical size.1 Hormones governing eating and fat
storage compound their troubles—they have higher levels of
insulin (a hormone which forces fat into the fat cells) and
lower levels of appetite suppressing hormones, like ghrelin.1
Volume eaters seem to derive a heightened sense of pleasure
from eating, akin to that experienced by drug addicts using
heroin.2,3 These “opioid-mediated rewards” play
an important role in this form of hedonistic eating
behavior. Thinking back on the people I know who are volume
eaters, I would characterize their personalities as
“driven,” and by no coincidence all have been financially
successful in their individual businesses.
Possible Solutions
Binge
eating disorder is a nearly impossible condition to treat by
standard medical care. Many programs attempt psychological
and behavior change with little success. More drastic
treatments with gastric surgery (gastric banding and bypass)
and drugs such as the anti-epilepsy medication, topiramate,
are also used—unfortunately, the results are poor here too.4 Serious changes in eating behavior are the only real hope
for these extreme personalities.
The most
successful program for the treatment of people with serious
eating disorders is the Kempner Rice Diet.5 This
is a diet of rice, fruit,
and sugar, plus vitamin and iron supplements, devised by Walter Kempner, MD, of
Duke University in the 1940s to treat hypertension. The regular diet consists of about
2,000 calories daily and contains 5 gm or less of fat,
about 20 gm of #, and not more than 150 mg of sodium. However, the initial diet prescribed for
weight loss is even more restricted in calories (400 to 800
per day). In a study of the results published in the Annals of Internal Medicine, one hundred and six
massively obese patients were treated as outpatients with
the rice/reduction diet, exercise, and motivational
enhancement under daily supervision. The average weight loss
was 63.9 kg. (141 pounds). Forty-three patients achieved
normal weight. Men lost weight at a greater rate than women.
Along with the weight loss there were significant reductions
in blood pressure, blood sugar, triglycerides, and uric acid
levels. Heart sizes decreased, EKGs improved and blood
vessels in the eyes appeared healthier. (For more
information please contact: The Rice
Diet Clinic, 3543 Rose
of Sharon Road, Durham, NC 27712; Phone: (919) 383-7276 ext.
1; Fax: (919) 309-4695; ricediet@ricediet.com.)
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