Thursday, November 02, 2006

Do Restaurants Trigger Binge Eating?

Hot off the Reuters newswire is a story about how perhaps eating at restaurants triggers binge eating.

The story builds off a paper by Dr. Gayle M. Timmerman from the University of Austin Texas who published a study on the matter in the Western Journal of Nursing Research.

In the study Dr. Timmerman utilized food diaries to track the dietary intake of 71 self-reported binge eaters and 46 dieters who don't have a bingeing history. They then tracked calories consumed in restaurants by bingers and non-bingers and concluded that binge eaters were more likely to binge in restaurants.

I have two major problems with the study.

The first is the fact that food diary work is notoriously inaccurate in terms of intake, but more importantly, food diary work is often extremely stressful and difficult for patients who truly suffer with binge eating disorder. The fact that only 3 of the 117 food diaries were excluded due to questionable content to me suggests immediately that something's up with this study because there's no way that if you asked 117 folks to keep a food diary, that 97.5% actually kept them, let alone kept them accurately enough to be worth inclusion into a study.

The second problem I have is that what was not included in the analysis was daily caloric distribution.

One of the primary triggers for binge eating behaviours is hunger. The most common cause of hunger in our society is meal and snack skipping. While the study did control for total daily calories, not discussing caloric distribution to me makes it impossible to interpret the results.

One of the most commonly adopted backfiring strategies for many dieters involves the notion that if they know they're going to go out for dinner, they'll cut back on their daytime calories to compensate for those they'll consume at night. Often this will involve skipping meals or skipping snacks or purposely having very light meals that day.

This of course then leads to hunger and combining hunger with a restaurant and a predisposition to binge eating is a recipe guessed it, binge eating.

Dr. Timmerman concludes that,

"Restaurants provide ample delicious food cues which when coupled with negative emotions provide a high risk environment that challenges non-purge binge eaters' control of food intake."

I would likely want the data reanalyzed for frequency of meals, distribution of protein and I imagine the conclusion that would then be drawn would look something like,
"Restaurants provide ample delicious food cues which when coupled with meal skipping, snack skipping and hunger provides a high risk environment that challenges everyone's, especially binge eaters', control of food intake."

As I've said many times before - you don't crave green leafy salads when you're hungry.

Best advice I can give is the same advice I give my patients:

Never sit down to any meal, especially a restaurant meal, hungry.