Last week Marty, the Healthywage coach, suggested some helpful questions to help determine if you’re a binge eater (see 10/26 blog). He used the guidelines from Overeater’s Anonymous (OA). This model of treatment is called the addiction model of binge eating.
Experts are split as to whether binge eating really is an addiction similar to alcoholism. Healy reports in an LA Times article dated 11/23/09 that brain imaging studies show significant overlap between the brain circuits activated by a drug addict’s “craving” and those of a binge eater pondering an eating jag.
On the other side of the debate, Steven Wonderlich, a University of North Dakota eating specialist, cautions that the brain’s reward circuitry is complex, involved in many behaviors including but not limited to pathological craving. Therefore, we need more research before making this connection conclusive.
What we DO know for certain is that people who binge eat often experience other problems such as anxiety, depression, and relationship issues. Because of these co-existing issues, the treatment is often done by a team of experts including a psychotherapist, psychiatrist, and nutritionist.
Goals for treatment:
1. To normalize eating by sticking to regularly scheduled meals and snacks throughout the day in appropriate portion sizes.
2. To improve emotional well-being by treating the underlying anxiety, depression, shame, poor self-image, self-disgust, and other negative emotions.
3. When necessary, to lose weight.
4. To learn behavioral maintenance strategies once you’ve reached goal weight.
Types of therapies used to treat binge eating:
- Cognitive Behavioral Therapy
- Interpersonal Therapy
- Dialectical Behavior Therapy
DBT is a comprehensive treatment program based on cognitive and behavioral principles and complemented by the use of acceptance-based strategies derived primarily from Zen Buddhism. DBT teaches you skills to tolerate distress, regulate your emotions, and improve your relationships with others. These skills can reduce the desire to binge eat.
These treatments are sometimes combined with medications such as antidepressants and/or Topomax, an anticonvulsant drug used to reduce binge eating episodes.
Although the treatment options available for binge eating vary, the essential components are to address the underlying thoughts and emotions that trigger your unhealthy relationship with food.
Which method seems best for you?
Ellen Resnick is a psychotherapist in private practice in San Francisco and Redwood City, California. She specializes in Cognitive Behavioral Therapy and incorporates the use of mindfulness into the treatment of depression, anxiety, and emotional overeating. She runs a holistic weight loss program called Center for Thoughtful Weight Loss, www.thoughtfulweightloss.com.
You can email Ellen at firstname.lastname@example.org
Copyright © 2010 Ellen N. Resnick, LCSW