Binge eating may be hereditary

(Correction: Because of a photographer's error, a photo caption with a story in yesterday's Nation pages about binge eating disorder wrongly described Tara Capobianco, a speaker at a session held in Newton. Capobianco recovered from an eating disorder five years ago.)

Binge eating disorder, a frequent compulsion for out-of-control eating that goes far beyond the point of feeling stuffed, now appears to run in families, and that genetic heritage may help explain a piece of the current obesity epidemic, researchers reported yesterday.

A new study has found that a person is twice as likely to binge eat if he or she has a relative who also has the disorder. The study of 300 overweight people and nearly 900 of their family members also found that having a binge-eating relative more than doubles a person's chances of becoming severely obese.

Binge-eating disorder is a psychiatric diagnosis that includes major eating jags -- the whole plate of brownies, the whole gallon of ice cream -- at least twice a week for months, and causes terrible distress for the eater. The study's powerful new evidence suggests that ''some forms of obesity may be due to a chemical imbalance in the brain -- which is likely hereditary -- rather than just a disorder of metabolism in the body," said Dr. James I. Hudson of Harvard's McLean Hospital, lead author of the new paper.

It is not clear what that brain abnormality is, Hudson said. It could have to do with a built-in tendency to act impulsively, or a hard-wired propensity to overeat, or even mood disorders such as depression, which often accompany binge-eating. But it does seem clear that in the current American environment of over-plentiful food and sedentary living, people with such a flaw would be especially likely to grow and stay fat, he said.

''Like the alcoholic who loses control after the first drink, these people can't stop at just one cookie," Hudson said.

If the abnormality can be pinpointed, it might lead to new ways to treat binge eating. For those with the disorder -- which is believed to affect 2 to 5 percent of the population at some point and up to 30 or 40 percent of the obese -- news of the genetic element may also lift some of the stigma and encourage people to seek treatment, specialists say.

Evidence of a genetic vulnerability can ''lift some of the scourge, some of the blame, some of the shame," said Emily Fox Kales, an instructor at Harvard Medical School and founder of Feeding Ourselves, an Arlington-based center that counsels binge eaters among others.

''And if a behavior is not shame-based," she said, ''it also means that people don't have to isolate themselves and be so stigmatized by that behavior that guess what they do? They stay at home and eat more."

Binge-eating has become an area of inquiry lately, specialists say, in part because it is linked to obesity and is more common than anorexia, which involves self-starvation, or bulimia, in which sufferers binge and then make themselves vomit.

Evidence is mounting that anorexia, too, has a genetic element: Another study released yesterday found that the disease was more than half-determined by genetics, with environment accounting for the rest. And a third study found that girls who suffer from depression or anxiety are likelier to be overweight as adults. All three were published in this month's issue of the Archives of General Psychiatry.

Skeptics have questioned whether binge-eating deserves to be considered a full-fledged psychiatric disorder; rather, they argue, it may be a temporary and normal response to an abundance of available food.

But backers of the diagnosis say the disorder essentially amounts to bulimia, which is acknowledged as a mental disorder, without the vomiting. It tends to affect women, often old enough to care somewhat less about their weight and thus less willing to vomit after a binge.

Lisa Du Breuil, a 40-year-old psychiatric social worker who was a binge eater from her early teens until her mid-20s, recalls a life of constant dieting, ''and when I wasn't dieting, I was binging, because the opposite of every diet is a binge."

The binges would usually come at the end of a day of dieting, she said, ''when I would feel like I just couldn't hold on anymore, and I would just want to 'veg' out, and I would use food to do that.

''It's awful because you feel like such a failure, and you feel like 'There must be something really wrong with me because I can't seem to be in control,'" she said.

She eventually stopped binging by using an approach that focuses on eating according to the body's natural cues of hunger and fullness. She now facilitates a monthly ''Hope and Inspiration" group for binge eaters for the Massachusetts Eating Disorders Association.

The new study was funded by the pharmaceutical company Ortho-McNeil, which has tested its antiepilepsy drug, topiramate, for effectiveness in binge-eating disorder with initially positive results. Hudson said the firm had no role in the study's design or results.

Carey Goldberg can be reached at goldberg@globe.com.