Outpatient Care for Binge Eating: What to Expect

From the WebMD Archives

If you struggle with binge eating and want to stop, outpatient care is a good option. You'll regularly get treated at a health care center or clinic, but you won't have to stay overnight.

This form of treatment helps nearly 70% of people with binge eating disorder recover, research shows.

Your doctor may recommend outpatient care, or you can seek it yourself. You should first check if your health insurance provider requires a doctor’s referral.

Outpatient Care: Where to Find It

You can find this kind of care for binge eating at:

In most cases, treatment begins with weekly or biweekly care, “because people with binge eating disorder often respond really well to that,” says Jennifer J. Thomas, PhD. She’s the co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital.

Types of Therapy

Outpatient therapy can last several months or longer. There are different types. Your type may depend on where you get treatment and what your insurance covers.

Cognitive behavioral therapy (CBT) is one of the most common and effective forms used to treat binge eating. It helps you turn negative thoughts into healthier, more realistic ones so you can change your behavior.

Say, for instance, you tend to ask yourself: “I have no control over my eating, so why should I try to quit?” With CBT, you'd learn to say something like: “There are things I can do to avoid a binge. I’ll try calling a friend to distract myself until the urge passes.”

Guided self-help is a form of CBT that involves using materials (such as a workbook) that teach you how to recognize things that trigger your binges, improve your body image, and prevent a relapse.

Interpersonal therapy focuses on your relationships with others and your life situation.

Additional individual or group therapy can provide extra support. "Hearing from someone else who changed their behavior can be more motivating than having an expert say, 'You can do this,'" says Angela Guarda, MD. She's the director of the Johns Hopkins Eating Disorders Program.

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If you have depression or anxiety, you may also need an appointment with a psychiatrist.

Your health insurance should cover outpatient treatment for eating disorders under mental health benefits. Check with your insurer.

If you don’t have coverage and can’t afford the full cost of treatment, ask your doctor for referrals to therapists who work on a “sliding scale” basis. That means your therapist will work with you to create a comfortable payment arrangement.

What Outpatient Care Won’t Do

Don’t expect a diet plan. “The focus of outpatient care isn’t on what to eat, but instead how to establish a normal pattern of eating,” Thomas says.

Your health care team might check your weight from time to time, but treatment isn’t about shedding pounds. Dieting can actually trigger bingeing, so it’s important not to worry about slimming down while you’re recovering.

How to Improve Your Treatment Success

You play a big role in your recovery. Take these important steps:

  • Tell your doctors if you're depressed or anxious. Talk therapy or medications can help improve your mood and reduce or stop your binges.
  • Tell your doctors if you drink alcohol regularly. Drinking may make you more likely to binge.
  • Give it time. Outpatient therapy takes 4 to 6 months and sometimes longer. Stick with it. “There is no magic wand. Recovering from binge eating disorder is work, and in the beginning it’s going to feel difficult,” Guarda says. “But over time, if you follow your treatment plan, you will stop bingeing.”

If You Need More Help

After about 6 weeks of treatment, your doctor or therapist will ask how you’re feeling and whether you’re bingeing less often. Showing some improvement within the first few months of treatment often tells doctors that the approach is working.

If you’re still bingeing as much as you were when you started treatment, or if you have severe depression or other health concerns, you may need to try a different approach.

One option is called intensive outpatient care. You'll spend a longer amount of time each week getting help from a variety of professionals. You may see a dietitian, a group facilitator, a family therapist, a psychologist, a psychiatrist, and an occupational therapist during different sessions.

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If you have severe binge eating disorder or thoughts of harming yourself, your doctor may recommend inpatient care. This is around-the-clock care at a hospital or medical center.

For more information about binge eating, treatment, and how to find support and professional help, visit the National Eating Disorders Association.

WebMD Feature Reviewed by Joseph Goldberg, MD on December 15, 2014

Sources

SOURCES:

Aguera, Z., BMC Psychiatry, November 2013.

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.

Angela Guarda, MD, associate professor of psychiatry at the Johns Hopkins School of medicine; director of the Johns Hopkins Eating Disorders Program, Baltimore, Maryland.

International Society for Interpersonal Psychotherapy: “About IPT.”

Massachusetts General Hospital Eating Disorders Clinical and Research Program: “Treatment Options.”

National Institutes of Health: “Eating Disorders: Treating binge-eating disorder.”

Johns Hopkins Medicine: “Outpatient and Consultation Clinic.”

The Charis Center for Eating Disorders at Indiana University Methodist Hospitals: “Levels of Care.”

Iacovino, J. Current Psychiatry Reports, August 2012.

American Psychological Association: “Level of Care Guidelines for Eating Disorders.”

Mayo Clinic: “Binge-eating Disorder Treatments and Drugs,” “Binge-eating Disorder: Complications.”

Walter Kaye, MD, director of the University of California, San Diego Medical Center Eating Disorder Treatment and Research Program; board member and spokesperson, National Eating Disorders Association.

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