Are you a binge eater? Here's what you need to know about this eating disorder

Don't let the title of Courtney Barnett's newest track fool you. Released last month, the Australian singer's Three Packs A Day – which seemingly hints at a nicotine addiction – is actually an 'ode to ramen'...

...so say most music websites.

But as the song progresses to the second and third verses, another picture emerges:

That MSG tastes good to me
I disagree with all your warnings
It can't be true they use glue
To keep the noodles stuck together

Two minutes seems like a lifetime
Burn my tongue, patience is a virtue.

I'm down to three packs a day
I sneak away to find a kettle
I withdraw from all my friends
And their dinner plans...

It's unclear to what extent Barnett was hooked to ramen before she was "down to three packs a day." But her admission of decamping from her friend circle because of her eating habit is sure to strike a chord with the likes of Nidhi Saluja.

***

"I was well aware that I'd feel nauseous by the end of it all. But I just couldn't stop," Saluja remembers. It was on a business trip to Taiwan few years ago that the 35-year-old financial analyst from Delhi found herself holed up in a room, depressed. So that night until the next morning, she finished three noodle packets.

Each packet, Saluja points out, had 24 ramen blocks.

Loneliness, ennui and stress are Saluja's triggers for binge eating. "I don't think. I just eat. I have no other coping mechanism," she underlines.

Binge eating disorder (BED) – the recurring pattern of having uncharacteristically large amounts of food in a short time when not hungry, and without self-induced purging (that would be bulimia) – is the most common eating disorder in the US, as per the National Eating Disorders Association. Marked by self-loathing or guilt after a binge, it affects 3.5% of women and 2% of men, with the female to male prevalence being 60:40.

BED features in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013, and debates ensue over whether pathologising it does more harm than good. But there's no denying that awareness of, and support mechanisms for BED are scant compared to other eating disorders. One, many confuse it with overeating. And two, it's often brushed off as a mountain out of a molehill – particularly in India, feels Saluja.

Binge eaters gravitate towards particular foods during episodes. And while much is made of sweets being 'coping foods', Saluja opts for items ranging from umami to sour.

"Prior to my college exams, I'd finish a whole jar of pickle with a loaf of bread," she says. "And my mother, aghast, would wonder what had happened."

***

There are no official figures for BED in India, says Sunita Simon Kurpad, professor of Psychiatry and Medical Ethics at St John's Medical College in Bangalore. "To diagnose BED, one needs to fulfil criteria like 'distress', which may lead to falsely low figures. But given the prevalence of obesity here, binge eating may not be uncommon."

Note: BED also affects those who aren't obese. But an eating cycle borne of, and precipitating depression, makes one feel even worse after weight gain – more detached from, and disgusted with the body. The result is a never-ending cycle fuelled by general attitudes toward overweight and obese people. And unlike drugs, alcohol and cigarettes, food isn't considered addictive or something that can ensnare you in its vice-like grip.

"Addictions that don't seem to obviously harm go under the radar till major medical consequences occur," stresses Kurpad. "Any pleasurable activity results in brain surges of chemicals like dopamine, which make us want to repeat it again – whether amphetamines, pedas, or a half-hour jog. But most of us settle for the quicker, easier high."

***

Unlike Nidhi Saluja, whose binge eating has waxed and waned since childhood, Imtiaz Burhani's BED was triggered by business failure and resultant depression. The sexagenarian may be on an upswing now, but the situation seven years ago was bleak, shares his son Latif.

"He had resigned himself to his room, finishing packets of farsan in one go. The hunger, the void, never went away," he says.

Imtiaz Burhani came around when his son returned to India from London and stayed for good. But in the years Latif was away, wife Farhana was grappling with the seriousness of his BED. Not only did her husband go from 80 to 115kg, he'd also lost the will to leave the house.

"People ribbed him about his bingeing, not understanding how low he'd sunk in his own eyes. If there were gulab jamuns around, he'd keep having them, not knowing when to stop."

She pauses.

"He found apnapan only in food."

***

How does one combat BED when support groups or rehabilitation centres for it don't exist? Dr Rajendra Barve of Parivartan Clinic recommends 'mindful eating' as one of the best ways to ward off bingeing. But bingeing, he says, is not only common in those with depression and bipolar disorder. People struggling to remain occupied may also take to bingeing. This trigger is common in smokers too, Barve points out.

"Mindful eating requires you to treat food as an experience rather than take it for granted. It involves all senses, so you appreciate the smell and texture of food, not just its taste. When this happens, you eat slowly and consume less, but feel more content."

And as far as cravings go, depriving oneself is never recommended, he says. Having a bit every day is fine. Although, adds Barve: "The real challenge for an addict is not to stop. It's to start all over again."

BED, being more a symptom than a disorder, may lurk as long as its root causes do.

Dr Anjali Chhabria of Mindtemple counseling centre believes the tone for our relationships with food is set in childhood itself. "The link between food and emotionality is complex. Causes of BED can range from food being given a lot of importance at home and being an obese child to food as a form of rebellion," she says. "The more comfort food gave you as a child, the more likely you are to turn to it as an adult."

This is so in Nidhi Saluja's case. Her family was so poor, she says, that fried items, sweets and even fruits were used as positive reinforcements by her parents.

"Maybe that's why my body took to it. When I get urges now, I divert my attention by writing or praying. But I don't know when I'll 'relapse'...

...I'd like, just for once, for food to be food, and not a drug."