Binge Eating Disorder: Treat Mental Health First

From the WebMD Archives

Binge eating disorder is a complex condition that affects the brain and then the body. At the most basic level, negative thoughts and habits trigger overeating. This is a mental health (psychological) problem. Eating too much over and over again can make you gain a lot of weight and cause other body (or physical) problems.

Since binge eating stems from the way your brain works, “treatment focuses on mental health, not weight loss,” says Jonathan H. Richardson, PsyD. He’s a psychologist at The Charis Center for Eating Disorders at Indiana University Health.

Weight gain is an effect, not the cause, of binge eating disorder. So, the main goal of treatment through therapy is to figure out why you're bingeing, and then to replace bad habits and thoughts with positive emotions and skills. That can help you get better.

Here are some reasons why eating disorder experts say you should focus on your mental health before the numbers on the scale.

Dieting Usually Backfires

Gaining weight might make you think about going on a diet. It does for many people. But if you have binge eating disorder, dieting can make you more likely to overeat.

“When you restrict certain foods or calories to lose weight, you feel deprived. [This] causes psychological and chemical changes that encourage you to keep bingeing,” says Sondra Kronberg, RD, CDN. She's a spokeswoman for the National Eating Disorders Association. “Bingeing makes you feel better, at least in the short term, but then you feel bad for doing it. So you try to make up for that by not eating enough, only to binge again.”

In treatment, you'll be encouraged to not diet -- ever. Even after you get better, dieting can trigger an urge to binge. That’s why dietitians and doctors who treat binge eating disorder don’t offer tips on how to eat to slim down.

During your treatment, you'll learn to:

  • Never skip meals, because hunger can lead to a binge.
  • Include protein with meals and snacks, which helps make you feel full and calms cravings.

Continued

Therapy Works

If you’re on the fence about getting help because it won’t be geared toward helping you lose weight, know this: “Treatment has a much higher success rate than weight loss,” Richardson says.

People do get better and stop bingeing. Research shows that therapy and/or medication work more than half the time. On the other hand, most diets don’t work, even for people who don’t have binge eating disorder.

Once you stop bingeing, you might lose some weight simply because you’re not eating as much as you used to. In some people, the switch to healthy eating boosts how fast they burn calories, Kronberg says.

At the very least, “if you [get] treatment and stop bingeing, you’ll probably stop gaining,” Richardson says.

Ask your doctors what kind of treatment might work best for you. Most types use some form of cognitive behavioral therapy (CBT). This helps you learn to spot negative thoughts that drive you to binge. It then teaches you to replace those bad thoughts with healthier, more realistic ones. For example:

Unhealthy thought: “I can’t stop eating. Why should I even try to stop myself from finishing this bag of chips?”

Healthier thought: “I can choose to put this bag of chips down and go in the other room until my craving passes.”

“Treatment helps you learn to accept yourself, and to give up unrealistic ideals that aren’t healthy,” Kronberg says. “You may never be a size three or look like a Barbie -- and that’s okay.” Instead, your therapist, doctor, or treatment team will encourage you to eat balanced, nutritious meals and make other healthy choices, like exercising regularly.

“It’s natural and understandable to feel bad about being overweight, because we have a culture that bombards us with messages that only thin is acceptable,” Richardson says. “Just remember that acting on that feeling and chasing after weight loss can sabotage what’s really important: your recovery and your health.”

If you're severely overweight, talk to your doctors about your options.

WebMD Feature Reviewed by Joseph Goldberg, MD on January 20, 2015

Sources

SOURCES:

Binge Eating Disorder Association: “Understanding BED”

Iacovino, J., Current Psychiatry Reports, August 2012.

Sondra Kronberg, MS, RD, CDN, clinical nutrition therapist, spokesperson for the National Eating Disorders Association; founder and nutritional director of the Eating Disorder Treatment Collaborative Nutrition Counseling Specialists and Eating Wellness Programs in Nassau County, Suffolk County, and New York City, New York.

Mayo Clinic: “Binge Eating Disorder: Treatments and Drugs”

National Association of Anorexia Nervosa and Associated Disorders: “Binge Eating Disorder”

National Institutes of Mental Health: “Eating Disorders: Binge-eating Disorder”

Jonathan Richardson, PsyD, psychologist at The Charis Center for Eating Disorders at Indiana University Health.

Jennifer J. Thomas, PhD, co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, Boston, Massachusetts; assistant professor of psychology, Department of Psychiatry, Harvard Medical School.

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