While most people overeat occasionally on special occasions like holidays, a person who suffers from binge eating disorder overeat excessively (or binge) at least once per week and have been in a pattern of doing so for at least three months or longer. In this post, we will discuss the facts about binge eating disorder and binge eating disorder treatment.
If you’re suffering from binge eating disorder you will experience binges during which they eat an unnecessarily large amount of food in a very short period of time. During a binge, you may feel as if you are unable to stop eating until you are full beyond your comfort level. You will also experience significant emotional suffering. Often patients suffer from a sense of embarrassment, disgust, or guilt after they binge.
What is Binge Eating Disorder?
Binge eating disorder is a very serious type of eating disorder that carries significant emotional suffering. There are many aspects of binge eating disorder not associated with food. Some common co-occuring mental health conditions include: PTSD, ADHD, anxiety, and depression. These conditions cause a person suffering from binge eating disorder to use food to try to numb these painful feelings. While food may act as a temporary relief, even more painful feelings often occur after their binge is over.
As binge eating disorder relates to food, a person with binge eating disorder will consume an unusually large amount of food in a very short time period. During a binge, a person may feel like they can’t stop eating and continue to eat until they are full beyond their comfort. In addition, patients of binge eating disorder often feel emotions of disgust with themselves, embarrassment at what they’ve done, or a guilt for overeating. This is a cycle that further exasperates their other mental health conditions.
Symptoms of Binge Eating Disorder
Binge eating disorder is the most common type of eating disorder in the U.S. according to NationalEatingDisorders.org. Let’s review the symptoms of binge eating disorder according to the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.
Binge eating disorder is a condition in which the sufferer engages in recurrent episodes of binge eating at least once a week for three months. This involves a eating a larger amount of food than normal in a short period of time and feeling out of control to stop bingeing. Some characterizations of binge eating disorder include:
- Eating more rapidly than normal,
- Eating until uncomfortably full
- Eating when not hungry
- Eating alone because of embarrassment, or feeling disgusted or guilty after eating
- Marked distress regarding their binge eating
- Regularly performing compensatory behaviors like individuals with bulimia nervos
The experience of binge eating disorder is exclusively not taking place during episodes of anorexia nervosa or bulimia nervosa.
Diagnosing Binge Eating Disorder: 5 Criteria to Meet
To make a diagnosis of binge eating disorder, a mental health professional must determine that a patient fulfills all of the criteria outlined by the DSM-5 including the following:
1. Regular binge eating instances during which both of the following take place:
- A patient regularly eats far more food than most people would in a similar time period under similar circumstances
To qualify as “regularly,” bingeing must occur at least once per week for no less than three concurrent months. The time period during a binge varies from person to person but generally fits inside a two hour window, and does not have to take place in one setting.
- A patient will feel that their eating is out of their control during their bingeing period
This period of being “out of control” can include either an inability to stop eating once a binge has begun or an inability to refrain from starting a binge.
2. Three or More of the Following Must Occur:
- Eating beyond feeling full
- Eating much faster than normal
- Eating huge amounts of food when not hungry
- Feeling a sense of emotional stress or pain after bingeing
- Eating in solitude to hide how much they are eating
3. A patient with binge eating disorder will feel very upset by their eating binges
4. A minimum of one weekly binge for at least three months straight
5. A patient with binge eating disorder will routinely try to “undo” their excessive eating
Unlike other eating disorders, a person suffering from binge eating disorder will not routinely try to “undo” their excessive eating by ways of over-exercising or vomiting.
Binge Eating Disorder Levels of Care
Many primary care physicians see patients with eating disorders (whether they realize it or not) and can have an important role in diagnosing and treating a patient with binge eating disorder. Primary care physicians may be on the first line to screen and diagnose binge eating disorder.
Outside of the primary care setting, there are several levels of care available for treating binge eating disorder. Let’s review your binge eating disorder treatment options:
Outpatient
Outpatient is often where binge eating disorder treatment begins. In outpatient treatment, a patient lives in their home and attends regular hourly sessions at their providers’ office(s) or on webcam. Outpatient treatment is appropriate for patients who are stable medically, motivated to change, can handle day to day activities on their own, and have enough support and structure in their home setting.
Intensive Outpatient
Intensive outpatient treatment typically occurs in a specialized setting, like a eating disorder clinic or hospital. Patients with binge eating disorder in an intensive outpatient setting typically live at home and attend sessions three to five times per week. These sessions typically last three hours each and may include: individual therapy, group therapy, and nutritional counseling. Intensive outpatient treatment is appropriate for patients who are medically stable, motivated to change, can handle day to day activities on their own, and have enough support and structure in their home setting, but may need help in an external structure beyond self-control.
Partial Hospitalization
Partial hospitalization treatment occurs in a specialized setting such as a hospital program or a stand-alone facility. Patients in partial hospitalization require a high level of supervision and monitoring, but must show that they don’t need full 24-hour monitoring. Patients must not be suicidal or so far medically compromised to the point of needing full hospitalization. In this setting, care is provided for approximately 5 – 12 hours per day, 4 – 7 days per week. Partial hospitalization for binge eating disorder is appropriate when a patient is highly symptomatic but can be alone without falling back into their symptoms.
Residential Treatment Center
Residential treatment centers are highly specialized and can operate independent of a hospital setting, but in some cases are connected to a hospital setting. A patient in a residential treatment center for binge eating disorder is not able to sustain progress without 24 hour supervision, and the severity of symptoms requires constant 24 hour monitoring to sustain normal, symptom free behavior and eating.
Residential treatment center treatment is useful in teaching a patient specialized approaches that help the patient develop daily living routines that create patterns of behavior helpful to recovery. This type of program may be appropriate when a patient is overwhelmed with symptoms and unable to refrain from reverting to behaviors that hurt their well being when alone. Generally a patient must enter residential treatment at their own will.
Inpatient Hospitalization
Inpatient hospitalization treatment is generally used for shorter periods of time to stabilize a patient before they start other levels of treatment. Inpatient hospitalization for binge eating disorder is typically used when a patient is at risk of suicide or highly disabled by their symptoms, which does not allow them to participate in lower levels of care.
Treatment Options for Binge Eating Disorder
When seeking treatment for binge eating disorder, a healthcare provider may choose nonpharmacologic treatment strategies that are evidence-based for the treatment of binge eating disorder including:
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Guided, Self Help Cognitive Behavioral Therapy
- Interpersonal Psychotherapy
- Group Therapy
- Nutritional Therapy and Counseling
- Expressive Arts Therapy
- Pharmacotherapy
Many times, a combination of the above treatment methods will be used. Perhaps the most important aspect to communicate to a patient struggling from binge eating disorder is that it is a serious condition for which there are proven treatment options available.
Getting Recovery From Binge Eating Disorder
If you or your loved one needs binge eating disorder treatment, there are professionals who can help. The first step to binge eating disorder recovery is acknowledging you need help and then seeking help.
According to Dr. Wendy Oliver Pyatt
Unfortunately, when working with someone who has gained weight from binge eating, healthcare providers often push dieting and caloric restriction, thereby unintentionally reinforcing the very deprivation mindset the sufferer needs to heal.
In contrast, if you come to us for treatment of this disorder, you’ll find our approach is centered on helping you move beyond the restrictive mindset and into self-trust. We use mindful eating as a foundation for recovery and help you work with your body instead of against it—developing mindfulness and self-awareness around food and hunger as you discover your own power to express your needs and ensure they are met.
Get Binge Eating Disorder Treatment
Dr. Wendy Oliver Pyatt is a licensed psychiatrist in South Miami, FL. She is the Founder and former Chief Medical Officer of Oliver-Pyatt Center and Clementine, and has been a thought leader in the field of eating disorders since 2003. Wendy was the State of Nevada Medical Director for Mental Health, and have extensive experience in pharmacotherapy. She is currently the cofounder of Galen Hope, a mental health treatment center in South Miami, Florida.
Visit Wendy’s practice listing: Wendy Oliver-Pyatt
Author: Wendy Oliver-Pyatt
Dr. Wendy Oliver-Pyatt is a board-certified psychiatrist with over 25 years of medical and clinical experience. She is known for her innovative, humane, and dignity-enhancing approach to medically and psychiatrically thorough care. She has developed a unique treatment approach that delves into the underlying issues that place a person at risk for mental health conditions, leading them to healing, health, and inner peace. A world-leading expert on treating eating disorders, she founded three residential treatment centers—Center for Hope of the Sierras, Oliver-Pyatt Centers, and Clementine—which have helped thousands of patients recover.
