Treatment of Binge-Eating Disorder

There is no “one size fits all” treatment for binge-eating disorder, although the goals for those with this condition are to reduce binging behavior, improve emotional problems that contribute to the problem, and to reduce weight if necessary with healthy diet and exercise. Treatments used for binge-eating disorder include:

Therapy

Therapy sessions, whether individual or as part of a group, can help people to understand an eating problem and learn new ways of behaving. Types of therapy that have proven useful in binge-eating disorder are:

• Cognitive behavioral therapy - This type of therapy helps people to understand that it is their own thoughts and feelings – not external events, situations, or people – that cause their inappropriate eating behaviors. The premise is that if you can identify your feelings and how they lead to binge eating, you can learn skills to deal with the feelings in a new (and healthier) way – even if the situation remains the same. For example, if a stressful job deadline causes a binge on fast food during lunch, new ways to handle the job stress – rather than overeating – would be taught.

Cognitive behavioral therapy can help those with binge-eating disorder to get in touch with feelings and thought patterns, especially those that contribute to disordered eating. One common thought pattern is “all or nothing” thinking; many people who binge eat break a “diet” or period of normal eating with one brownie, for example. Then, feeling ashamed of eating a “forbidden” food, they decide that they might just as well eat the whole pan of brownies, since they’ve already ruined the diet. In examining this thought pattern with cognitive behavioral therapy, a person might learn that there are no “bad” foods, just those that are good for you and not as good for you, and an occasional brownie treat doesn’t ruin everything.

While cognitive behavioral therapy helps with reducing binging behavior, it hasn’t proven as effective in helping to reduce weight.

• Interpersonal therapy - Since many people with binge-eating disorders have impulsive behaviors or difficulty expressing their feelings, they tend to have problems with interpersonal relationships. They may feel isolated and lonely as well, which may lead to seeking comfort through food. Interpersonal therapy focuses upon relationships and communication skills, helping to improve both – and reduce binge eating as a result.
• Psychoeducational groups - Because part of conquering an eating disorder consists of learning about it, psychoeducational groups help by structuring group meetings around a theme or topic, such as eating as a coping strategy, developing alternative coping strategies, improving body image, or cultural expectations of thinness. In addition to attending group sessions, members are given assigned reading and homework.

Medications

There is no one medication that is approved by the Food and Drug Administration (FDA) to help specifically with binge-eating disorder. But some studies indicate that therapy and medications may work better in treating this condition than either treatment alone. Medications that have been used include:

• Antidepressants - Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Prozac, Zoloft, or Effexor, may help to change brain chemistry problems that contribute to binge eating as well as treating depressive symptoms. Caution must be used with antidepressants, especially in adolescents, as these drugs may increase thoughts of suicide.
• Anticonvulsants - Some studies have found that certain medications, such as topiramate (Topamax), used to control seizures, may be effective in treating binge-eating disorder. More research is needed before anticonvulsants will be approved for treatment of binge-eating disorder.
• Anti-obesity agents - Certain medications used for weight loss, such as sibutramine (Meridia), can help with binge-eating disorder, especially if obesity is present.

Weight loss programs

It is not advisable to lose weight with a restrictive weight loss program if you have binge eating disorder, because diets may actually trigger binge-eating behaviors. It is advisable to treat the binge-eating disorder first or if weight loss is necessary, to use a program that is behavioral in focus; that is, one that focuses upon thoughts and feelings that trigger binge-eating episodes.

Self help

Many people with binge-eating disorder find that books and other educational media as well as support groups, are beneficial – especially when combined with professional treatment, such as therapy and/or medications. There are also many tips to help people recover. Some of them are:

• Stick to medication and therapy program - Treatment for any mental health condition has its ups and downs. Sticking with professional treatment will increase chances of recovery.
• Avoid restrictive diets - Dieting can worsen a binge-eating condition. It’s important to eat regular meals throughout the day, beginning with breakfast, so deprivation doesn’t trigger a binge.
• Monitor your environment - Avoid stocking up on food that will tempt a binge.
• Spend time with friends - Spending time with loved ones, whether friends or family, will help with a feeling of support and encouragement.
• Get physical - Regular physical activity will help with weight loss and with symptoms of depression or anxiety.

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