Binge Eating Disorder: Treatment Options

Binge Eating Disorder (BED) is a condition in which people eat large amounts of food in a short period. They usually aren’t hungry when they eat. While they’re eating, they can feel out of control, eat faster than normal, and continue until they’re uncomfortably full.

According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), BED is more common than anorexia nervosa or bulimia nervosa. It affects one out of every 35 adults in the United States. About 2 percent of men and 3 to 5 percent of women are affected.

Unlike people with more well-known eating disorders, people with BED don’t purge to make up for overeating, although some go on a fast or a severe diet occasionally. That puts them at risk for obesity and its effects, including high blood pressure, type 2 diabetes, and heart disease.

Like anorexia nervosa and bulimia nervosa, BED has a strong psychological component. People with BED may have unusual eating behaviors, such as ritualistic eating practices or eating in secret. They may show signs of anger, anxiety, or shame. In fact, bingeing may be a way of relieving tension or numbing their emotional pain.

Your eating habits, your emotions while eating, and the way you feel about yourself may hold clues to this disorder.

Talk to your healthcare provider about BED if you:

• eat secretly
• steal, hide, or hoard food
• have odd eating patterns, such as having no planned mealtimes, skipping meals, fasting, limiting your food choices, or not allowing foods to touch each other on your plate
• feel angry, anxious, worthless, or ashamed before eating
• feel lonely, moody, or irritable in general
• have negative perceptions or feelings toward your body
• avoid conflicts or go out of your way to make others happy
• have a strong need to be in control

Discuss your weight history, too. BED puts people at risk for obesity, but obesity isn't an automatic sign of BED. An honest conversation with a healthcare provider may be the first step on your road to recovery.

Reducing or eliminating unhealthy eating habits can be difficult. Instead of eating based on mental or emotional needs, it’s important that you begin eating only to meet your nutritional needs. Balanced meal plans using healthy food choices can help you establish a positive relationship with food.

Here are some things you can do on your own to eliminate binge eating:

• Find an activity. Eating when you’re bored is never a good idea. Take up a new hobby, pick up a book, or go for a walk.
• Manage stress. Instead of stress eating, try meditating or doing breathing exercises to better handle stress.
• Limit temptation. If you’re prone to bingeing on sweets or other unhealthy foods, try removing these from your kitchen. It can be easier to resist the urge if the option isn’t available to you.
• Let cravings pass. Listening to your stomach can help you distinguish between physical and emotional hunger. If your stomach isn’t rumbling or if you’ve eaten recently, allow the craving to subside.
• Get a full night’s rest. If you don’t get enough sleep, you may turn to food to boost your energy.

Although there are things you can do on your own to stop binge eating, it’s important that you seek professional support. Treating BED is about more than just eliminating your unhealthy eating habits. An effective treatment program will also address the root of the problem, or what triggers your binge eating. Working through any mental, emotional, or psychological triggers can help reduce the possibility of these unhealthy habits returning.

If you think a loved one is struggling with BED, talk with them about your concerns. Although this may be a hard conversation to have, showing your concern and offering your support may help them on the journey to recovery. Encourage them to seek treatment, but understand that the decision to change has to come from them.

BED can put you at risk for serious health problems. Fortunately, effective treatments are available. With careful planning and commitment to a treatment plan, you can achieve a cure.

The overall goal of BED treatment is wellness. This involves reducing or stopping bingeing episodes, achieving a healthy weight, and correcting any thoughts, behaviors, feelings, or situations that can trigger a binge. This can be achieved several ways:

Outpatient Programs

Sometimes, it’s more beneficial to treat BED on an outpatient basis. Your treatment team may include a therapist, nutritionist, and a doctor. A psychiatrist or cardiologist may also be added to the team if you need them.

This treatment program typically includes appointments once or twice per week with the therapist and doctor. You may have to check in more often with your doctor so that they can monitor any changes to your health. Outpatient treatment may last for a few months to several years, depending on your needs.

If more intensive treatment is necessary, you may attend two or more meetings each week. Instead of having multiple appointments, all of your needs will be taken care of at one facility during these meetings. This typically includes individual and group counseling, as well as nutritional therapy. 

Residential or Inpatient Programs

Residential treatment is often recommended if you have previously tried at least two different methods with little success. You may stay at a hospital or treatment center for one to three months and receive holistic care. This approach focuses on treating the mind, body, and soul for overall wellness.

Your treatment plan may include individual and group counseling, nutrition therapy, and a creative outlet such as art therapy.

Inpatient treatment is more intensive and often lasts less than 21 days. Care is provided around-the-clock with medical stabilization in mind. Once you’re considered stable, you’ll likely be discharged to a resident treatment center for continued care.

Psychological Counseling

Three types of psychological counseling are often used for BED. These include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and interpersonal therapy (IPT).

Cognitive Behavioral Therapy (CBT)

CBT can help you explore patterns of thinking that lead to self-destructive behavior and change these patterns so they can cope with their problems. It can help you pinpoint the stressors that trigger binge-eating behaviors and come up with a plan to control them. CBT is helpful in about half of all people with this disorder.

Dialectical Behavioral Therapy (DBT)

DBT is a type of CBT. It helps people accept uncomfortable thoughts, feelings, and behaviors and makes them realize that they can be changed. People also learn coping skills to fight the effects of these negative symptoms.

Interpersonal Therapy (IPT)

IPT is particularly useful for people with depression who often have difficulty interacting with others and blame themselves for the problems that result from this difficulty. IPT helps them build social skills and organize their lives.

Medications

Antidepressants and similar medications are sometimes used when psychotherapy doesn’t work. Your healthcare provider will evaluate your general health before selecting the medication to make sure it doesn’t interfere with any other drugs you may be taking for another condition.

Lisdexamfetamine (Vyvanse) was originally used to treat attention deficit hyperactivity disorder (ADHD). The FDA has approved it to treat BED. Your doctor may also consider the use of topiramate (Topamax), which is generally used to treat seizures, to help with symptoms of BED. Some antidepressants may help with BED symptoms, particularly selective serotonin reuptake inhibitors (SSRIs).

Weight Loss

Not everyone with BED is obese, but about one in three people in weight loss programs has BED. A key part of a healthy weight loss program is a healthy meal plan. Because people with BED tend to have unusual eating patterns, they may have difficulty following such a plan. If you keep in mind that the overall goal is wellness and not just weight loss, you may find it easier to change your eating behaviors under the guidance of your healthcare provider and a qualified weight loss counselor.

Complementary Therapies

While working to stay healthy and alter your behavior, you may benefit from some complementary therapies. Massage and acupuncture can help ease tension, anxiety, and the symptoms of depression. You can also try mind-body therapies like yoga, tai chi, and meditation. These disciplines may help improve your sense of well-being and connectedness to your body.

It’s vital that you stick to your treatment plan and not give up, even when you have to alter your therapies. It may take a while to settle in on the right combination of treatments and to feel some sense of control. Most people who seek treatment for binge eating disorder experience significant improvement.

Support Groups

These groups typically meet in person once per week to provide peer support. You may share your personal triumphs and struggles, inviting feedback or suggestions from the group. This social network is built on empathy and trust, as person in the group is affected by BED in some way.

BED may feel overwhelming, but it doesn’t have to be. By sharing your feelings around bingeing episodes, you can steer your healthcare provider toward an accurate diagnosis and a good treatment plan. Thus, the key to overcoming BED is getting to know yourself and not being afraid to seek help.