How can treatment for binge eating help me?
The primary goals for treatment of binge eating disorder are to reduce binge eating episodes, address restrictive behaviors or mindsets which may be leading to a binge-restrictive cycle, and identify alternate strategies to cope with trauma and painful emotions. As shame, guilt, poor self-image, and other negative emotions often go hand-in-hand with binge eating, treatment may also address these feelings and any other co-occurring mental health issues, such as depression or anxiety. (1)
While there may be exceptions, treatment for eating disorders, including binge eating disorder help, typically occurs in the following order: (2)
- Address and treat life-threatening psychiatric and medical symptoms. In some cases, it is necessary to start treatment at an inpatient level of care to monitor symptoms until an individual is physically and medically stable to safely attend other levels of eating disorder care.
- Interrupt disordered eating behaviors i.e. binge eating episodes and purging if they occur, as well as restriction which may play a role in driving binging episodes.
- Nutritional rehabilitation and the establishment of consistent and adequate eating, helping a person enjoy food without feeling shame or anxiety.
- Challenge unhelpful and negative binge eating-related thoughts and behaviors, such as hiding food, eating in secret, and feeling guilt around food.
- Continue to address ongoing physical and mental health issues.
- Identifying physical and emotional triggers of binging episodes, working to address traumas and other mental health problems which may be contributing to eating disorder behaviors, and practicing alternative responses to known eating disorder triggers.
- Create a plan to help prevent relapse and what to do should a relapse occur.
What are the Treatment Options for Binge Eating Disorder?
Your treatment plan for your binge eating disorder will depend on the underlying causes and the severity of your disordered behaviors. Typically, a multidisciplinary team - including a physician, psychotherapist, psychiatrist, and dietician - will handle your care to address all aspects of an eating disorder.
Psychotherapies for Binge Eating Disorder
The first-line of treatment is psychological therapy, which may be carried out on a one-to-one basis, in a group setting, or even in a self-guided format. In some people, just one type of therapy may be required, although typically a combination of therapies are used together for best possible treatment outcomes.
While your treatment team will help determine which forms of therapy will be right for you, the most common include:
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) focuses on the interaction between thoughts, feelings, and behaviors. Through CBT, you will address the disordered and/or negative thinking patterns and emotions that trigger your binging episodes. (3) Once the underlying causes of these thoughts and feelings have been identified, strategies can be formed to help you change them into something more positive.
CBT for binge eating will also address any dietary restriction and help you incorporate your fear foods to help you establish regular patterns of eating. It also challenges your thoughts about your shape, weight, and body, and offers alternative skills for coping with these thoughts.
Therapist-led CBT is believed to be the most effective treatment for binge eating, but guided self-help CBT is another option. (4) In this form of therapy you’re given a manual to work through at home and you’ll discuss your progress and set further goals in regular meetings with a therapist.
Dialectical Behavior Therapy (DBT)
Dialectical behavioral therapy (DBT) can be helpful to people who binge eat as an emotional reaction to experiences and feelings that are difficult to cope with. (4) Through DBT, you’ll learn how to regulate your emotional responses, so you can deal with negative situations knowing you have multiple skills with which to respond besides eating disorder behaviors.
There are four main areas of treatment in DBT: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness (improving relationships). These elements will help you identify your triggers as well as implementing alternate responses when they occur. (5)
Interpersonal Psychotherapy (IPT)
Interpersonal psychotherapy (IPT) may be helpful for individuals who engage in binge eating as a coping mechanism for unresolved personal problems, such as relationship conflicts, life changes, and grief. (6)
The goal of IPT is to improve your interpersonal skills - i.e. how you relate to and communicate with others - which may help address binging triggered by problematic relationships and poor communication skills.
Either in a one-to-one or in a group format, over a 12 to 20 week period, you’ll identify the specific issues linked to your binge eating disorder, acknowledge them, and then work with your therapist to make constructive changes. (4)
Mindful eating, as the name suggests, uses the principles of mindfulness to give you a better awareness of your hunger and fullness cues, as well as emotional triggers that result in binging. Mindful eating exercises include: (7)
- Listening to your body’s hunger cues
- Tuning into what you can taste and smell when eating
- Chewing food slowly
- Recognizing hunger and fullness without fear
Mindful eating encourages eating with intention, enjoying food, and not restricting the type or amount of foods that are eaten. By paying attention to the sensory experiences of eating, instead of eating when you’re distracted - such as while watching TV - this practice helps you to identify your body’s cues and can help establish consistent and adequate eating patterns to decrease the likelihood of falling into a binge-restrict cycle.
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Medications for Binge Eating
Some people with binge eating disorder benefit from incorporating medication as well as therapy and nutrition counseling into their treatment program. This can be especially helpful for individuals who experience other mental health challenges, such as anxiety and depression, in addition to their eating disorders. Some people prefer to try therapeutic treatments for binge eating disorder before adding medication, and different people respond differently to the same medications for a variety of reasons, so this is always a personal decision that should be made after discussing options with your doctor and other treatment providers.
Tips for Supporting Your Recovery at Home
Working with expert eating disorder treatment providers in an outpatient setting or a higher level of care can be very helpful for many people in recovering from binge eating disorder. In addition to your treatment plan, there are some self-care strategies you can consider implementing at home to support your recovery. (5)
- Follow Your Treatment Plan: While providers can give you invaluable advice and support, challenging the eating disorder and learning new patterns will ultimately be achieved through your consistent practice over time. When setbacks or challenges occur, be compassionate with yourself and try to view them as learning opportunities, not evidence of failure.
- Stop Dieting: Restricting your food intake by dieting can trigger more binge episodes, resulting in a restriction-binge cycle that’s hard to break. Both restrictive behaviors and thoughts can contribute to this cycle, so practice challenging the idea that some foods are dangerous or off-limits.
- Avoid Banning Foods: Unless you have allergies, intolerances, or other medical reasons that certain foods are not safe for you to eat, all foods that you enjoy can be incorporated. Work with your team to incorporate all foods into your meals and snacks in order to prevent feelings of deprivation and scarcity which can maintain the binge-restrict cycle.
- Eat Regularly Through the Day: Many people who struggle with eating disorders avoid eating during the day and only eat at night. Having regular meals every few hours starting soon after you wake up can help to prevent extreme feelings of physical and mental restriction from developing.
- Accept Support: It’s so easy to become isolated when you’re suffering from an eating disorder. Many people who struggle with binge eating feel significant shame about these behaviors and develop secretive patterns. Allow yourself to accept the support from friends and family, and reach out to them when you’re struggling.
- Nurture Yourself: Find other ways to cope or distract yourself when you’re feeling negative emotions and allow yourself to explore new ways to have fun and add meaning to your life. Even on days when there are setbacks or recovery feels impossible, treating yourself with compassion and care can help to make continuing feel possible. Being kind to yourself will be such an important part of your recovery.
- Explore Movement as Desired : If you are interested in incorporating more physical activity or learning a new sport or skill, speak to your treatment team about exercise you can do that will fit in with your recovery plan. Depending on your physical and mental health needs, different types of movement may or may not be appropriate, and it is always up to you if or when it is something you want to engage in.
The Bottom Line
Treatment for binge eating disorder can be challenging, but help is available and it is never too late to reach out for support. Thankfully, there are effective treatments for binge eating disorder and recovery strategies that can help you work towards a life free of your eating disorder.