• Shawn Wilson, Ph.D.

Why Can't I Stop Eating? Identifying Binge Eating Disorder and Treatment

Photo credit: Bethany Newman

When people think about eating disorders, our minds typically go to anorexia and bulimia. Images of underweight girls who vomit after eating have dominated media coverage of eating disorders. However, eating disorders represent a wide range of eating problems and individuals with eating disorders can range from being underweight to overweight.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included a new eating disorder that was not listed in previous editions of the DSM. The new disorder is called binge eating disorder (BED), which is characterized by frequent episodes of overeating where an individual eats much more than what is typical for a meal (i.e., binges).

One of the important hallmarks of these binges is that there has to be a perceived loss of control during the binges. In addition, individuals often feel guilty, depressed, or embarrassed about the food binges. An important distinction between BED and other eating disorders is that there are no 'compensatory behaviors' (i.e., vomiting after the meal, excessive exercise, use of laxatives) after the food binge.

Another distinct characteristic of BED is that most people with BED are normal weight or overweight. This reality contrasts with public perception that eating disorders only apply to individuals who are underweight.

An article written for The Atlantic, discusses how BED is largely a neglected eating disorder in media coverage and how cognitive-behavioral therapy can be used to treat BED. The author does a nice job writing about how BED is highly treatable, although only about half of those with BED pursue treatment. Unfortunately, as BED is not commonly identified as an eating disorder, those with BED symptoms may not get recognized by loved ones or even by medical and psychological professionals as having a problem with eating.

The author also briefly references her own treatment for BED and interviews other individuals who have pursued treatment for BED. The article is a nice mix of discussing the science of BED treatment as well as the personal impact BED has on individuals.

Modern treatment for BED and other eating disorders moves away from having a strict approach with food and instead encourages more holistic eating. By taking away the label that certain foods are 'taboo,' individuals are less likely to engage in cycles of binge eating that result in shame and guilt. Often restricting foods ironically leads to the very food binges a person was hoping to avoid.

Other treatment topics discussed in the article include the importance of watching one's thoughts without acting on the thoughts (i.e., consistent with thought monitoring mindfulness exercises), body acceptance at every stage of treatment, finding different coping skills to manage stress other than eating food, and that while individuals often lose some weight from BED treatment, this weight loss is a side effect of treatment and not a central goal of treatment.

An interesting point the article makes is that those seeking BED treatment are often considered by insurance companies as being too high functioning to require insurance to cover their treatment. It is clear that insurance companies need to change their policies given the negative impact food binges can have on both an individual's physical and mental well-being.

Overall, the Atlantic article is well written and provides a nice overview of the current state of affairs for individuals with BED. Definitely worth the read, particularly as the article feels uplifting given the success of the individuals the author interviewed in treating their BED symptoms.

Article link: https://www.theatlantic.com/health/archive/2017/08/how-therapy-can-cure-overeating/537537/

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© 2020 by Shawn Wilson