Section Three ????????Sequencing (9%) ?????（此題與?Blank Filling ?二選一）

Directions: In?this?section,?you?will?read?a?long?passage?with?six?paragraphs?removed.?Please reorganize the?six?paragraphs in the order?from 47 to 52?so as to make?a?coherent

passage. Please?write?down?the?letters?(A~F) before?the?paragraphs?on?your ANSWER?SHEET.

?

Bed Confessions

BED. It’s?something?shared by men and women in?more?ways?than?one.?BED,?or?Binge Eating Disorder, has become an emotional and?health concern for men across the?United States. This eating disorder, which affects more than?1 million men in America,?has ?only ?recently ?been ?recognized ?by ?the ?American ?Psychiatric ?Association ?as ?a?disorder of?its own, that needs further?study.

Ninety-five percent of?the U.S. population has cravings for “pleasure” or “comfort”?foods. ?The ?other ?five??percent??crave??alcohol,??cigarettes,??or??some??other??addictive????substance. Having cravings, and fulfilling them, is a natural human?instinct.

(47) ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

A typical binge may include eating anywhere from?1000 to?15000 calories?at?a

time. In fact, it is not uncommon?to?actually?have?a?“food?hangover”?the?day?following?an?especially?large?binge.?The?foods?consumed?are?usually?high?in?fat?and?are?eaten?in?a?relatively?short?period?of?time, putting?an?enormous?amount?of?stress?on?the?digestive?and endocrine（內分泌的）?systems. BED is different from the two other characteristic eating?disorders, anorexia and bulimia. Anorexia is?a?condition?of slow,?self starvation; bulimia is a binging and vomiting syndrome.

(48) ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

BED is a unique eating disorder, especially when it?comes to?men.?While?only?5%?to?10% of?people with anorexia and bulimia nervosa are male, it is?estimated that?BED??affects a?much greater?proportion of?men.?According to Dr. Anne Becker of?the Harvard??Eating Disorders Center, “The ratio of?females to males?with?this?disorder?is?about?1.5??to?1.0?or?about 40% men.” Dr. Becker?adds,?“Binge?eating?disorder has?become?more??recognizable?by?doctors?as?more?attention?is?given?to?weight?control?in?the?clinical??setting.”

(49) ?(50) ?Unlike bulimia, where people eat and then purge, there is no counteraction to

bingeing. Therefore, weight gain is a likely?effect.?As?noted?above,?men?with?BED?are?often?overweight to begin with.?The?effects?of?BED?on health?include?all the?possible consequences of?overweight or obesity—diabetes, hypertension, and heart disease.

(51) ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????(52) ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Treatment?with?medications?such?as?antidepressants?maybe?helpful?for?some

individuals.?Self-help?groups?also?may?be?a?source?of?support.?Researchers?are?still?trying to?determine which method?or?combination?of?methods?is the?most?effective?in controlling binge eating disorder. The type of?treatment that is best for?an?individual?is?a matter?for?discussion between the patient?and?his?or?her?health?care?provider.?Some?organizations do provide professional and confidential treatment and information, such?as the National Eating Disorders Organization, Overeaters Anonymous, and Males and?Eating?Disorders, etc..

?

A ?????There ?are ?some??common??characteristics??of ?men ?who ?have ?BED.??Most??are?overweight,?with?a?history?of?depression,?low?assertiveness,?and?poor ?self-esteem.?Similar?to ?all?people?with ?eating ?disorders,?men?with?BED?view?themselves?in ?a?negative light and allow food to control their lives in order to compensate for their lack?of?control in other areas such as?work?or?family?matters.

B ?????BED?is?formally?characterized?by?the?American?Psychiatric?Association?in?the?Diagnostic?and?Statistical?Manual?for?Mental?Disorders??(DSM-IV)?according?to?the following?five?criteria:

1)??Recurring binge eating ??（暴食）?episodes. An episode of?binge?eating?is?characterized?by?both?of?the?following:

????eating an amount of?food that is definitely larger than most people would?eat in a similar amount of?time under?similar circumstances;

????a sense of?lack of?control over eating?during the?episode. ??2) The binge eating episodes are associated with the?following:

????eating much more rapidly than you usually would

????eating?until?you?feel?uncomfortably?full

????eating?large?amounts?of?food?when?you?don’t?physically?feel?hungry

????eating?alone?because?of?embarrassment?at?how?much?you?are?eating

????feeling disgusted with yourself, depressed, or very guilty after overeating?3) Binge eating causes emotional and physical?stress?or remorse.

4)?The binge eating occurs, on average, at least?two?days?a week?for?six?months?or?more.

5) ?The?binge eating is not followed by other inappropriate behaviors such as purging,?fasting,?excessive?exercises?and?does?not?occur?exclusively?during?episodes?of other??eating disorders, such as anorexia nervosa (神經性厭食癥） or?bulimia nervosa（神經性貪食癥）?.

C?An?ever?more?serious?consequence?is?death.?According?to?Dr.?Ken?Stephenson,?a?psychotherapist who?specializes?in treating males?with?eating?disorders,?“People with?eating?disorders?have?the?highest?mortality?rate?of?all?psychiatric?patients.”?Isn’t?that?a good enough reason to seek help now?

D?Another?common?characteristic?of men?with?BED?is?that?they?fail?to?address?their?own?personal?needs,?and?instead,?turn?to?food.?For?these?men,?food?can?be?a?great?sedative（鎮(zhèn)靜劑） ?and a means of?suppressing feelings of?anger, guilt, despondency,

and sadness. Men with?eating disorders tend to eat in private, not wanting to alert others?to their habit. This increases the?feelings?of?isolation?and?sadness,?and?creates?another?vicious cycle.

E Men with symptoms of?BED need to?seek treatment?as?soon?as possible.?The?longer?a?person?waits, the?greater?the?risk?to?their?health.?Treatment?of?the?disorder?generally includes??cognitive-behavioral??or??interpersonal??therapy??performed??by??a??licensed?clinician.?Cognitive-behavioral?therapy?teaches?patients?techniques?to?monitor?and?change?their?eating?habits?as?well?as?to?change?the?way?they?respond?to?difficult?situations.?Interpersonal?psychotherapy?helps people?examine?their?relationships?with?friends and family and make changes in problem?areas.

F But BED is more than?an?occasional?craving?for?a?sweet?snack.?At?first,?eating?may?satisfy cravings. But eventually the eating?becomes more and more frequent, and?higher?in calories and fat. This overeating leads to feelings of?self-disgust and guilt, which may?cause?aperson?to?eat?even?more.

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