Running head: BEINGE EATING LEADS TO SEVERE WEIGHT GAIN

Binge Eating Leads to Severe Weight Gain and Increased Hospitalization due to Sequelae from
Obesity
Patricia M. Delgado
University of Central Florida

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

2
Abstract
Binge eating disorder (BED) poses a significant health risk for individuals, especially since it is
closely associated with obesity. Obesity by itself plays a major role in the development of many
chronic illnesses. Obesity on its own can be treated in the primary care setting, but factors such
as the presence of BED can impair a patients efforts to manage their weight and eating habits
without effective psychological therapy. BED can also prove to be an obstacle for health care
providers to effectively treat and counsel their patients regarding their weight issues. Therefore,
it is important to identify when BED is present alongside obesity, and provide the appropriate
resources and referrals for the individual to seek help, remission from their eating disorder, and
possibly lose enough weight to get to a healthier body mass index and avoid hospitalization.

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

3
Binge Eating Leads to Severe Weight Gain and Increased Hospitalization due to Sequelae from
Obesity
Eating disorders, especially binge eating disorder (BED), pose a significant health risk to
people of all ages and backgrounds, and especially to those individuals already obese (Villarejo
et al., 2012). According to Ramacciotti et al. (2008), BED is characterized by recurrent episodes
of binge-eating in the presence of other instances of eating discontrol, such as: eating more
rapidly than normal, eating until feeling uncomfortable, eating when not hungry, eating alone,
and feeling disgusted with oneself after overeating. Of the three main eating disorders, BED is
the disorder that most evenly affects both men and women, and involves the least amount of
medical and psychological history for its prevalence (Fairburn & Harrison, 2003). According to
Hudson et al. (2003), the lifetime prevalence for binge-eating disorder is 3.5% among women,
and 2.0% for men, and is associated with current severe obesity (body mass index [BMI] > 40).
Obesity itself is not considered an eating disorder, but rather a general medical condition.
According to the Centers for Disease Control and Prevention (CDC), an adult is considered
obese if their BMI is greater than 30.0 (CDC, 2011). Obesity has been linked to many physical
ailments that typically land people in the hospital. Some of these include heart disease, diabetes,
certain types of cancer, hypertension and stroke, chronic pain, and complications with pregnancy
(Bogart, 2013). Accounting for just hip and knee replacement procedures alone, overweight and
obese persons make up 90% of those hospital admissions each year (Bogart, 2013).
In recent years, the idea of obesity being a risk factor versus a result of psychopathology
is being investigated more and more. Regardless, it has been noted in clinical practice that
obesity itself is a cause for psychological distress (Ramacciotti et al., 2008) and increases the risk
for recurrent binge-eating episodes. These pose a barrier for primary health care providers to see

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

4
a change in their patients eating habits when utilizing standard nutrition and weight counseling
techniques (Villarejo et al., 2012).
Problem Statement
Obesity represents a significant problem among many patients, especially those with
BED. The eating disorder itself, left untreated, can lead to severe weight gain, and subsequently
land the afflicted individual into the hospital for problems aggravated by the obese state.
Significance
As previously mentioned, BED affects both men and women. In fact, some studies
suggest that the prevalence of BED in men is almost equal to that of women (Mitchison et al.,
2013). In an article published in the European Eating Disorders Review, a study revealed the
increasing prevalence of BED among obese individuals. It also found that obese patients with an
eating disorder as a comorbidity had a more severe case of BED, general greater
psychopathology, and poorer prognosis when compared with individuals without lifetime obesity
(Villarejo et al., 2012). These factors make it difficult for health care providers to assist these
patients in weight loss and nutrition counseling, since the pathology is psychological. It is clear
how obesity and BED can create a dangerous cycle for the individual at risk, and cause
substantial frustration for the health care providers attempting to treat and counsel them.
With or without the presence of BED, obesity is a risk factor for many of the chronic and
acute illnesses nurses and other medical professionals see in the hospital. Obesity by itself can
predispose an individual to heart disease even if no other risk factors are present. It raises blood
pressure, increases generalized inflammation, and increases blood viscosity (Bogart, 2013). All
of these effects can lead to conditions such as diabetes mellitus, pulmonary embolism, and an
increased risk of cancer (Seidel et al., 2011).

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

5
In addition to the costs to the obese individual, there are also negative consequences to
society as a whole associated with the condition. In 2011, it was estimated that the cost to United
States (US) businesses from extremely overweight individuals was $12.8 billion in absenteeism,
and $30 billion from reduced productivity on the job (Bogart, 2013). Between 1998 and 2006,
annual medical costs related to obesity rose from 6.5% to 9.1% in the US. During this same time
frame, the per capita spending on obese individuals was greater than 40% of that for individuals
of healthy weight (Bogart, 2013). It is clear obesity poses a problem for our healthcare system,
and for the obese individuals themselves. Obesity is a challenge for todays health care providers
to prevent and manage, especially with such high prevalence of eating disorders such as BED,
which can be a barrier to healthy eating habits and positive change in lifestyle.
Summary
After reviewing the literature regarding BED and its relationship with obesity, it is clear
how important it is for healthcare providers to be able to identify and manage obesity on an
individual basis. A pilot study by Saeidi, Johnson and Sahota (2013) demonstrates how, with
proper training and support, nurses can utilize the primary care setting as means to address and
treat patients with obesity, in addition to preventing overweight individuals from becoming
obese. In fact, obese individuals without BED as a comorbidity are effectively able to address
their eating habits, and respond to basic primary care intervention strategies. The key is in
identifying not only the condition of obesity in patients, but the cause and presence of BED as
well.
The most effective nursing intervention based on the analysis would be to increase
development and implementation of facilitated self-help weight and eating disorder management
programs within the primary care setting. In addition, more attention and resources need to be

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

6
provided for overweight individuals that may have an underlying eating disorder that sabotages
their health practices. Primary care practitioners should have the education and experience to
know when a psychiatric or psychological referral must be made, or have a mental health
professional on staff to identify and manage patients eating disorders before they end up
hospitalized with a new chronic illness.

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

7
References
Bogart, W. A. (2013). Law as a Tool in 'The War on Obesity': Useful Interventions, Maybe, But,
First, What's the Problem?. Journal Of Law, Medicine & Ethics, 41(1), 28-41.
Centers for Disease Control and Prevention. (2011). About BMI for adults. Retrieved on October
24, 2013, from
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Why.
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2012). The prevalence and correlates of
eating disorders in the national comorbidity survey replication. Biological Psychiatry,
72(2), 164.
Fairburn, C. G. & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416.
Mitchison, D., Mond, J., Slewa-Younan, S., & Hay, P. (2013). Sex differences in health-related
quality of life impairment associated with eating disorder features: A general population
study. International Journal Of Eating Disorders, 46(4), 375-380.
Ramacciotti, C., Coli, E., Bondi, E., Burgalassi, A., Massimetti, G., & Dell'Osso, L.(2008).
Shared psychopathology in obese subjects with and without binge-eating disorder.
International Journal Of Eating Disorders, 41(7), 643-649.
Saeidi, S., Johnson, M., & Sahota, P. (2013). The management of obesity in primary care: a pilot
study. Practice Nursing, 24(10), 510-514.
Seidel, H.M., Ball, J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2011).
Mosbys Guide to Physical Examination [7th Ed.]. St. Louis, MO: Elsevier Saunders.
Villarejo, C., Fernndez-Aranda, F., Jimnez-Murcia, S., Peas-Lled, E., Granero, R., Penelo,
E., & Menchn, J. (2012). Lifetime Obesity in Patients with Eating Disorders:

BINGE EATING LEADS TO SEVERE WEIGHT GAIN

8
Increasing Prevalence, Clinical and Personality Correlates. European Eating Disorders
Review, 20(3), 250-254.