Binge Eating Disorder Treatment Options

Conditions & Diseases: Eating & Weight Disorders

Binge Eating Disorder

Binge Eating Disorder Treatment

Binge eating disorder is a serious eating disorder that needs to be properly addressed. Although the main goal of the treatment is to reduce and completely eliminate binge eating and some individuals are trying to achieve this goal with personal resources, the need for professional help and expertise is necessary for a better outcome. The treatment for any eating disorder includes the joint efforts of a group of specialists such as psychologists, nutritionists, physicians, and obesity specialists. In addition to overcoming the compulsive nature of overeating and binge episodes, losing weight is a second concern in binge eaters with weight problem (overweight or obese).

Although there is no standard protocol treatment to address binge eating disorder, approximately 80 percent of the individuals that receive profession help for their eating disorder will recover completely or make great progress towards recuperating from compulsive eating.

Psychotherapy

One of the main approaches in treating binge eating disorder and the most successful is addressing psychological aspects of the disorder by focusing on improving the emotional well-being of the individual. There are different psychological approaches used in treating individuals with binge eating disorder:

1). Cognitive-Behavioral Therapy

Cognitive behavioral therapy is a form of psychotherapy that concentrates on changing dysfunctional thoughts and behaviors that lead and trigger binge eating. It is one of the most common approaches used in individuals with eating disorders. "CBT for BED focuses on the ways in which excessive body shape and weight concern promotes binge eating, and the extreme valuation of shape and weight as a basis for one's self-esteem." (2) Although individuals with binge eating disorder don't undereat during the day and lose control during binge eating episodes as bulimics do, they do have strict rules regarding what they allow themselves to eat similar to bulimics and they go through frequent periods of yo-yo dieting which alternates losing weight with gaining it back.

Through cognitive behavioral techniques, the therapist is helping individuals with binge eating disorder to normalize their eating habits by adopting more flexible and healthier eating patterns, eliminate the connection between self-esteem and body weight or shape, identifying new sources to build the self-esteem, and accepting their body size and shape. Reinforcing the need for accepting the body size and weight is one of the first goals of the treatment before addressing the need to lose weight. Losing weight is rather a secondary goal that it should rather naturally result as an outcome of healthy lifestyle changes "... rather than a prerequisite for self-regard, and perhaps should be deferred until the binge-eating behavior has come under control." (2) However, the shift in goals can be hard to achieve as for many individuals with BED and as for their families the goal of losing weight comes in first place.

Cognitive behavioral therapy emphasizes the need to understand and become aware of the strong connection between thoughts, feeling/emotions and behaviors associated with binge eating and equipping the individuals with adaptive cognitions and behavioral patterns that allow a binge eater to overcome binge-prone situations.

2). Interpersonal Psychotherapy

Individuals with binge eating disorder exhibit impulsive behaviors and have difficulties expressing feelings which negatively affects their interpersonal relationships. One form of psychotherapy that addresses relationship problems and interpersonal issues is interpersonal psychotherapy. Most individuals with binge eating disorder feel isolated and alone and use food to comfort their void. Interpersonal psychotherapy focuses on improving the person's interpersonal relationships and communication skills which will improve how they relate with family members, friends, and other people in order to receive more emotional support in the future and therefore reduce the need to eat compulsively.

3). Group Therapy/Supportive Groups

Breaking away from the patterns of compulsive eating is a difficult task and the risk of relapse is high. Individuals that suffer from eating disorder can find relief sharing their struggle and experience with others that go through same problems. These groups are coordinated by trained psychotherapists that make sure the exchange between the group therapy members centers around issues that are related to their condition and each member actively participates in the discussion.

Medication

Although medication can be prescribed for individuals with binge eating disorder, there is no medicated treatment that will cure the disorder. Medication is administered in order to help with secondary symptoms of the eating disorder such as depression or improve body mass index and speed the weight loss.

Studies that investigate the efficiency of medication in helping individuals with binge eating disorder offer mixed results. Although firm conclusions cannot be drawn, some studies suggest that approaches that combine psychotherapy with medication are more effective than each form of treatment used individually.

The most common type of medication prescribed for individuals with binge eating disorder include:

1). Antidepressants. Antidepressants seem to be efficient in reducing binge eating in individuals with bulimia, and are prescribed in binge eaters. Although there is not enough data to support or deny the efficiency of antidepressants in helping binge eater, some studies do show that the relapse rate is high when the drug is discontinued. Some of the most common group of antidepressants prescribed in binge eating disorder include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Prozac, Zoloft, Effexor, and tricyclic antidepressants (TCAs). Although it is not clear how exactly antidepressants work in reducing binge eating, it is believed that they affect certain brain chemicals that regulate the mood.

Caution is recommended when antidepressants are prescribed because in addition to their benefits, these group of drugs have potentially harmful side effects such as increased suicidal thoughts.

2). Anticonvulsants. Although anticonvulsants such as Topamax are normally prescribed for patients suffering from epilepsy in order to control seizures, some studies suggest that this type of medication can reduce binge eating episodes and increase weight loss. However, anticonvulsants have serious side effects such as fatigue, dizziness, burning or tingling sensations, drowsiness, and trouble thinking.

3). Appetite suppressants. Certain medication prescribed to lose weight can be also used to help individuals with binge eating disorder especially if they suffer for obesity. The only FDA approved medication for the long term treatment of obesity is sibutramine (Meridia) (included in the group of the antidepressants serotonin and norepinephrine reuptake inhibitors). The drug seems to be more efficient in binge eaters that are obese as it suppresses hunger, creates a sensation of being full, and leads to weight loss.

Behavioral Weight Loss Programs

Individuals that suffer or have been treated for binge eating disorder cannot lose weight using restrictive weight loss programs because the diet can trigger binge eating episodes. Behavioral weight loss programs should be the last resource used by individuals with BED after they address the emotional and psychological factors that triggered and contributed to their eating disorder. Losing the excessive weight is the last goal in the treatment of binge eating disorder. These type of weight losing programs are conducted under strict medical supervision to ensure that the body's nutritional requirements are being followed and met. Some of these programs follow a very low calorie diet in order to help the individual lose weight.

Article by Alina Morrow
MS Psychology
Medical Writer
OmniMedicalSearch.com