When Christmas comes daily - without cheer

Binge eating. For most of us, the closest we might get to it is at Christmas or other special occasions when we can't help but over-eat. For about five per cent of us, however, binge eating is a serious and continuing problem, a debilitating disease that we need help to cure.

Of those who seek treatment, about two- thirds manage to recover. But the other third either don't respond to treatment or recover for a while, then slip back to old habits. It's this group that has prompted a unique research project in Christchurch.

The study will involve up to 200 women, and is still taking in new patients.

So what qualifies as binge eating?

"Eating abnormally large quantities of food in one sitting and having a sense of being out of control, of not being able to stop; of feeling compelled to eat," says Dr Virginia McIntosh, the project's lead researcher. In other words, binge eating is something entirely different from someone who might pick away at a packet of biscuits all day, and find they've eaten the whole packet.

Binge eating is something of a hidden illness, says McIntosh. "There are people who have never spoken to their family about it, or their GP. Some patients are women in their 50s or 60s who have had eating problems since they were teenagers but never spoken to anyone about it." As well as the impact it has on a person's physical health, it can also cause enormous amounts of grief, with secrecy and unhappiness harming relationships.

The Binge Eating Psychotherapy study offers sufferers treatment, with the study comparing three different models of psychotherapy treatment. Therapy involves six months of weekly sessions followed by six months of monthly sessions.

"The study aims to enhance the effectiveness of therapy for binge eating - not only to help women recover from binge eating, but also to stay well in the long-term," says McIntosh.

Traditionally, binge eating has been treated by a form of cognitive behaviour therapy. But although this has been successful for most sufferers, there has been a significant number for whom it has not worked. This Christchurch study is unusual in that it is adding two other forms of therapy into the mix - one that focuses on the role of appetite in binge eating, and one that focuses on a person's wider history, the patterns, or schema, set up in their lives from early childhood.

Patients are randomly assigned to one or other of the treatments, and tracked throughout the study.

The study is being done through the Clinical Research Unit of the Christchurch School of Medicine, Otago University, with funding from the Health Research Council of New Zealand.

"We're incredibly fortunate in Christchurch to have this unit where we can run clinical trials, and particularly psychotherapy research," says McIntosh. "We're the only centre in New Zealand to be running clinical trials for mental health problems on this scale."

Help wanted

Are you so skinny people accuse you of not eating enough? Of starving yourself? If so, you could be just who researcher Kathryn Taylor is looking for. "Some women are naturally very thin and function well at a low weight. Women like this may be asked by others if they have an eating disorder when they do not," she says. Taylor is looking for volunteers for a study on eating, and needs both women who suffer from anorexia nervosa, and who are naturally very thin but don't suffer from an eating disorder. Her study will look at the role played by a hormone called ghrelin in learning and memory abilities. She needs female volunteers between the age of 18 and 50 who will do a one-day assessment which will involve blood tests, a computer task, questionnaires and an interview. Volunteers will receive a $100 voucher for their time and transport costs. Ghrelin is a hormone that is produced in the stomach and is the only hormone to circulate in the blood that is known to be involved with hunger and increased appetite, says Taylor. Because of its role in appetite and eating, researchers are interested in studying patterns of ghrelin in people with eating disorders. Taylor's research will also explore the idea that ghrelin may have an effect on brain function by enhancing learning and memory. If you'd like to be part of this study, please phone 372 0400.

Dr McIntosh will give a public talk as part of the University of Otago Health Lecture Series on Wednesday, March 17, at 7.30pm in the Christchurch Hospital-based Rolleston Lecture Theatre. Phone 364 1199.

Think you might be suitable for the binge- eating study? Want help through psychotherapy treatment? Contact Sarah Rowe on 372 0400.

- © Fairfax NZ News