When it comes to eating disorders, you’re probably already familiar with anorexia and bulimia. One you might not know about, however, is binge-eating disorder (BED). So, we asked Dr. Lauren Salvatore, a psychologist at Northwell Health, to share more about this behavioral health disorder and its treatment options.
What is binge-eating disorder?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes binge-eating disorder as consuming a larger amount of food than most people would in a similar, short time frame, such as a two-hour period. It’s accompanied by feeling a lack of control during the food binge and notable distress regarding the behavior itself.
To meet the criteria for BED, three or more of the following must also be associated with the behavior:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not physically hungry
- Eating alone due to embarrassment or shame over how much you’re eating
- Feeling disgusted, depressed, or guilty after overeating
Finally, binge eating must occur at least once a week for three months to qualify as a diagnosed disorder.
What causes binge-eating disorder?
Although it only recently (2013) became recognized in the DSM as a diagnosis, BED is actually the most common of all eating disorders. It reportedly affects nearly 3% of the U.S. population.
There are many reasons a person might develop a binge-eating disorder. As Salvatore explains, while binging is the behavior, it’s a combination of biology—such as brain function—and external stressors. So, when you combine a biological disposition to BED with stress, it can result in the development of the disorder. There are many different types of stressors that can contribute to its development, and these will be different for everyone.
How it is treated?
Binge-eating disorder is typically treated with psychotherapy (talk therapy). In addition, patients may be prescribed medication by a psychiatrist or primary care physician to treat a related or underlying condition like anxiety or depression, or to suppress the appetite on a short-term basis.
There’s also a drug called lisdexamfetamine that helps with impulse control. Originally prescribed for ADHD, the medication was more recently approved by the U.S. Food and Drug Administration to treat BED.
When it comes to psychotherapy, several types are particularly effective for eating disorders, including:
Cognitive behavioral therapy (CBT), a proven method of replacing unhelpful patterns of thinking and behaving with more beneficial ones.
Enhanced cognitive behavioral therapy (CBT-E), a type of CBT specifically structured around eating disorders.
Dialectical behavior therapy (DBT), which can help individuals regulate emotions and better tolerate stressors.
All three are manualized, meaning there’s an evidence-based roadmap for treating the disorder while still allowing for customization to address the patient’s unique challenges and needs. It’s important to find providers that have experience treating BED. With that being said, the most important thing is finding a treatment and provider that makes you feel comfortable, so you’ll keep up with your treatment.
