By Andy Bruce –Private Therapy Clinic Psychology Writer
What is a Binge Eating Disorder?
Binge Eating Disorder (BED) is when an individual recurrently consumes larger than normal amounts of food within a short period of time (e.g. less than 2 hours), often when not physically hungry. If these episodes are associated with feelings of lack of control, embarrassment, feeling uncomfortably full and subsequent distress/guilt results from having overeaten, then it is likely that an individual has a BED. Unlike other eating disorders such as bulimia nervosa, BED are not associated with inappropriate compensatory behaviours such as purging (e.g. vomiting, use of laxatives etc.). For this reason, BED can also frequently co-occur with cases of obesity.
What causes Binge Eating Disorders?
As with all eating disorders, the reasons why people develop BED are varied and complex. While they depend upon an individual’s life-experiences, emotional make-up and genetic predisposition, the contributory factors can broadly be broken down into three categories.
Biological – For many reasons our hormonal system can become imbalanced and begin to send improper messages about when and when not to eat, although not the only cause of a BED, imbalances such as these are thought to play a role in the development of BED..
From an evolutionary perspective, our supply of food would not have always been as abundant as it is today, making more prolonged periods of fasting and feasting a natural process. Unfortunately, a combination of our instinctual tendency to make the most of available food and the current abundance of food (particularly food that is highly processed, refined and less satiating) can sometimes have inevitable consequences.
Psychological – There are strong correlations between issues pertaining to depression, impulse control and expression of feelings with BED. These will often be tied into the development of BED and can be linked to a variety of the factors mentioned above and below. In any case, they should be identified and approached when dealing with BED.
Social –Throughout our lives, we can develop inappropriate associations with food that also contribute to BED by means of social and cultural factors. For example, if a person begins to turn to food for comfort or as a mechanism to deal with stress, it can begin to provide the foundation for maladaptive binge eating behaviour. When combined with obesity (and the common feelings of bodily dissatisfaction or criticism from others that can follow), such types of ‘emotional eating’ as a reaction to distress can lead to a BED.
Treatment of Binge Eating Disorders
Depending on an individual’s personal circumstance, a range of treatments are available for those with BED. In the first instance, the National Institute for Clinical Excellence (NICE) guidelines recommend one of three different possible interventions:
- Cognitive Behaviour Therapy for binge eating disorder (CBT-BED)
This involves working with a qualified practitioner to recognize, challenge and improve dysfunctional or maladaptive binge eating behaviours. It can include educational aspects surrounding food and healthy weight loss topics, but will also help a patient to manage their emotions in relation to food.
- Interpersonal psychotherapy (IPT)
This focuses more specifically relationship issues that can lead to BED. Originally developed to deal with depression, it helps patients to better communicate and create healthier relationships with those around them; in doing so it can promote appropriate mechanisms to help combat compulsive eating behaviour. It usually involves 16–20 hour-long one-to-one treatment sessions over 4 to 5 months
- Modified dialectical behaviour therapy (DBT)
This is a primarily focuses on enhancing patients’ emotion regulation skills, awareness and self-acceptance. It is a combination of CBT and mindfulness meditation techniques and typically involves up to 20 group and/or individual sessions lasting 2 hours once a week.
When BED co-occurs with obesity there is debate as to whether it is better to tackle the physical issues relating to obesity (i.e. weight loss) or the psychological issues relating to BED behaviour first. Wilson et al., 2010 found that compared with behavioural weight loss treatments, both IPT and self-help based CBT were more effective in creating remission from binge eating behaviour in obese patients, 2 years after treatment.
What available help is there for you?
At the Private therapy clinics we have CBT Therapists, Mindfulness Coaches and Psychotherapists that can help you tackle binge eating behaviour.
Please call our team on 020 3882 0684 or 075 1111 6565 for a free 15 minute confidential chat, or to arrange an appointment with an expert who will be able to help.