Whenever I start eating, I can't stop, even when I'm not hungry. I can't even pick up a piece of gum without this happening. I feel so out of control while I'm eating, and after a while, I cry and cry and begin to feel unspeakably dirty, even though I wash my hands and arms constantly. Then if I can't stop eating, I beat myself up, literally. At first I thought I was just being a glutton, but now I am seriously beginning to suspect I'm losing it. I do want to note that I am not one to model myself after other, thinner women. Please give me your thoughts.

-- Chibi

The behavior you describe sounds like a lot more than "just being a glutton." If desire for food was all that was driving your eating, you'd enjoy the experience more and feel little or no recrimination afterward.

By suggesting that you are not trying to lose weight, you also lessen the chances that your compulsive eating is a reaction against the restrictions of chronic dieting. Most -- but not all -- of the compulsive eaters I've worked with have spent years trying to deny their natural appetites and restrict their eating. But at some level their appetite breaks out of its cage and takes control. Compulsive eaters also frequently use food and eating as their primary sources of comfort. They may have difficulty asserting their needs and desires with others; instead, they swallow their emotions and try to numb them with food. They may have done that for so long that they aren't even able to identify WHAT they truly feel -- emotionally as well as physically.

I can't say for sure what's going on with you without a complete (face-to-face) assessment. But your crying, feeling "unspeakably dirty" no matter how much you wash your hands and arms, and beating yourself up suggests to me that there may be more going on with you than the compulsive eating born out of dieting or difficulty expressing feelings. And although many people with obsessive-compulsive disorder engage in repeated handwashing or other compulsive behavior, there may be more to your distress than OCD.

Perhaps some of your feelings and behavior relates to experiences in your past, even childhood. Even experiences in the dim recesses of our memory can influence our contemporary feelings and behavior. Did you ever go hungry as a child, or go through long periods of time with not enough to eat? If so, you may be reacting to the sight, smell and taste of food as would a starving person, even though you are in no danger today (I hope) of such deprivation. Was there ever a time in your past when you felt dirty or ashamed, or hated yourself -- or were told you should be ashamed of yourself -- in regard to eating or food?

I think the best bet is for you to see a clinical psychologist for a thorough assessment and possible treatment. A psychologist can help you understand the reasons for your behavior and, more important, help you change it. Although a psychologist doesn't prescribe medication, he or she can refer you to a psychiatrist or other physician for adjunctive psychopharmacological treatment should that seem beneficial. Good luck.