Have you ever found yourself eating a lot after a bad day? You’re not hungry, but you still feel compelled to eat that last piece of pizza or reach for that pint of ice cream in your freezer. Do you feel guilty about your excessive eating, but unable to control it? If so, it may be a sign of binge eating disorder (BED).
People may binge eat as a way to try to cope with emotional distress. Fortunately, there are different treatment options to help binge eaters. Psychotherapy is a foundation of treatment. It may include cognitive behavioral therapy (CBT) as well as nutritional counseling.
Another method to try is called dialectical behavior therapy (DBT), which can help you control your emotions without turning to food.
What Is Dialectical Behavior Therapy (DBT)?
DBT may be used to treat the following mental health conditions:
- substance abuse
- post-traumatic stress disorder (PTSD)
- eating disorders
DBT is based on achieving a balance between acceptance and change. The idea is to increase awareness of unpleasant emotions and learn skills to cope with them in more effective ways than through binge eating.
How Does DBT Work?
Your therapist(s) will work with you to increase your motivation to change and give you the skills you need to overcome your eating disorder. During therapy, you’ll move through four stages:
- going from being out of control of your behavior to being in control of it
- moving from being emotionally closed off to fully experiencing your emotions
- working towards solving everyday life problems
- transitioning to feeling more complete and connected to the world around you
How Is Cognitive Behavioral Therapy (CBT) Different from DBT?
CBT helps you change the unhealthy eating behaviors and thoughts that cause you to binge eat. CBT always addresses eating behaviors before addressing thoughts. DBT is more emotion-based.
CBT may be administered individually or in group or self-help format. DBT for binge eating disorder may also be administered in a group setting or on an individual basis.
What Happens During a DBT Session?
DBT therapy sessions can be conducted in a group setting, in a private, one-on-one consultation with a therapist, or over the phone with a therapist.
During each session, you’ll learn new ways to cope with the emotions and behaviors that are driving you to eat. There is a focus on mindfulness and healthful emotional coping strategies to help decrease your likelihood of binge eating. You will also learn how to change inaccurate or judgmental thoughts into accurate or non-judgmental ones.
You’ll come away from the sessions with a set of new skills, such as:
- Mindfulness: keeping your mind in the present moment, without judging yourself or the situation
- Distress tolerance: learning how to accept difficult situations without getting overly emotional
- Emotion regulation: learning how to identify, accept, and change your emotions
- Interpersonal effectiveness: learning how to ask for what you want, say “no,” build relationships, and deal with conflict
In between sessions, you’ll likely be assigned “homework,” or rather a set of skills to practice on your own.
Can Dialectical Behavior Therapy Help People Stop Binge Eating?
Studies have shown that DBT can work. Most research, however, has focused on the effectiveness of DBT for treating suicidal behavior and difficulty controlling emotions rather than binge eating. The American Psychiatric Association officially recommends DBT for the treatment of borderline personality disorder.
People who have tried DBT for binge eating have had some success. In one study, binge eaters who underwent DBT had a better quality of life and binged less often six months later than they did at the start of the study.
DBT is an emotion regulation based therapy. It primarily helps people with binge eating disorder through enhancing mindfulness of current emotions, and then teaching a variety of coping skills that can be used instead of binge eating to cope with those emotions.
Binge eaters who use DBT are often able to stop their habits for the long term. DBT can also help relieve the unpleasant feelings that often go along with binge eating, such as depression or a desire to commit suicide.
Interested in learning more about treating binge eating disorder? Read our Treatment Options article.