Health: Battle Of The Binge

Ron Saxen's problem with binge eating started when he was 11. He hid the disorder well enough--through exercise and yo-yo dieting--to sign a modeling contract at the age of 21, when he was 6 feet 1 and weighed 179 pounds. But the pressure to remain thin proved to be too much. He quit the catwalk and eventually ballooned to 295 pounds. "In the darkest days, I would get two Big Macs, a large order of fries and a chocolate shake, then pull into Taco Bell before finishing my McDonald's," says Saxen, author of "The Good Eater: The True Story of One Man's Struggle With Binge Eating Disorder" due out next month.

But Saxen, now 44 and recovering, is one of the lucky ones. This month Harvard researchers found that binge-eating disorder, or BED, is the most common eating disorder in the United States--more prevalent than anorexia and bulimia nervosa combined. Its definition: single bursts of uncontrolled eating that last less than two hours and occur at least twice a week. Because of the disorder's close link with obesity, "it's a major public-health burden," says the study's lead author, James Hudson. The study suggests more than 30 percent of sufferers are male--a higher percentage than in anorexia or bulimia. A guide to diagnosis and treatment:

Recognize the symptoms. "It's not unusual to see cases where patients say BED goes back to childhood--even as young as 8," says study coauthor Harrison Pope.

He suggests looking for unexplained weight gain and any signs of "surreptitious eating." Evenings are when binge eaters most often lose control.

Find a good therapist. BED has no proven cause, but it's often linked with depression and anxiety. Therapy, particularly cognitive-behavioral therapy ( nacbt.org ), can help. Call the psychiatry department at the nearest medical school and ask for a referral. Or visit sites like edreferral.com , the Academy for Eating Disorders' aed web.org and the Alliance for Eating Disorders Awareness ( eatingdisorderinfo.org )--but make sure to check therapists' credentials yourself.

Try support groups. They're not for everyone, but some binge eaters benefit from groups like Eating Disorders Anonymous ( eatingdisordersanon ymous.org ), Overeaters Anonymous ( oa.org ) or Weight Watchers ( weightwatchers.com ).

Consider medications. There are no FDA-approved treatments for binge-eating disorder. Still, your doctor may prescribe a Prozac-like antidepressant or an antiseizure drug that's sometimes prescribed "off label" because it curbs appetite.

Distract yourself. Bingers often talk about "going into a trance," says psychologist Joyce Nash, author of "Binge No More." So, before breaking open that bag of chips, stop, take a deep breath and wait 10 minutes. Taking a shower can also help break the spell.

Start exercising. Exercise is "non-negotiable," says Nash. Even if a binge eater stops gorging, he doesn't automatically lose weight. The change requires sufferers to turn to a healthy activity--like walking--to manage their emotions and escape unpleasant feelings. It's not easy to do, but examples like Saxen's show that recovery is within everyone's grasp.

GETTING HELP These books and studies can help you decide on the best course of treatment.

"Management of Eating Disorders" Find this free federal report at ahrq.gov

"Intuitive Eating " by Evelyn Tribole and Elyse Resch ($13.95)

"Passing for Thin: A Memoir" by Frances Kuffel ($14)