Online Binge Eating Disorder Treatment: Find Binge Eating Disorder Recovery Today
If you have binge eating disorder, you experience binges during which you consume an unusually large amount of food quickly.
If you have binge eating disorder, you experience binges during which you consume an unusually large amount of food in a short period of time. At these times, you may feel unable to stop eating until you are uncomfortably full. You are undoubtedly also experiencing significant emotional suffering, with a sense of embarrassment, disgust, or guilt regularly striking after binging.
While most people overeat occasionally (like on holidays), sufferers of binge eating disorder binge at least once a week and have been doing so for three straight months or longer.
Several bio-psycho-social factors play a part in the development of binge eating disorder. The most pronounced is a very restrictive mindset around food and calorie consumption. Also, a history of shame around eating is common for sufferers of this disorder—including a history of being bullied as a child or being around a family member who had his or her own fears about food and weight. Many with binge eating disorder experienced having harsh restrictions on food placed on them when they were young, which led to developing their own food scarcity mindset.
In addition, there are commonly co-occurring mental health conditions including anxiety, post-traumatic stress disorder, ADHD, and depression. These and other conditions cause the sufferer to use food to numb painful feelings. But this only creates more painful feelings once the binge is over.
What is Binge Eating Disorder?
Binge eating disorder is a serious type of eating disorder associated with a significant emotional suffering. There are many aspects of Binge Eating Disorder that do not have to do with food specifically. As it relates to food, a person with binge eating disorder consumes an unusually large amount of food in a short period of time. During a binge, a person may feel like they can’t stop eating and often eat until they are uncomfortably full.
While it can be normal for everyone to overeat occasionally (like on holidays), those affected by binge eating disorder binge eat at least once a week for three months straight. Those affected by binge eating disorder also have a sense of embarrassment, disgust, or guilt after eating.
Binge Eating Disorder Symptoms
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
- Bingeing involves 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
- The person may experience marked distress regarding their binge eating
- A person with binge eating disorder will not regularly perform compensatory behaviors like individuals with bulimia nervosa
- The experience of binge eating disorder is exclusively not taking place during episodes of anorexia nervosa or bulimia nervosa
Diagnosing Binge Eating Disorder
To make a diagnosis of Binge Eating Disorder, a clinician must determine whether a patient fulfills all of the DSM-5 diagnostic criteria, as follows:
1. Regular binge eating instances during which both of the following are taking place:
- Regularly eating far more food than most people would in a similar time period under similar circumstances
To qualify as “regular binge eating,” the instances must take place at least once per week for three months
The time period during which binge eating instances take place can vary by individual, but it is generally considered to be less than two hours and does not have to be in one setting
- Feeling that one's eating is out of control during a binge
The feeling of not being in control can be either the inability to keep from starting to eat or the inability to stop eating once a binge eating episode has begun
2. Binge eating instances that include three or more of the following:
- Eating extremely fast
- Eating beyond feeling full
- Eating large amounts of food when not hungry
- Eating alone to hide how much one is eating
- Feeling emotional distress after a binge
3. Being very upset by one’s eating binges
4. Binge eating takes place on at least a weekly basis for three months
5. Unlike people with other eating disorders, adults with BED do not routinely try to “undo” their excessive eating with extreme actions like throwing up or over-exercising
Binge Eating Disorder Levels of Care
Many primary care physicians - with or without special training about eating orders in general or binge eating disorder in particular— see patients with eating disorders (whether they realize this or not) and can play an important role in diagnosing and treating those with binge eating disorder. Often this begins with patients going to see their doctor because they want to lose weight, or for some other reason entirely. Such patients are frequently unaware of having binge eating disorder, and the primary care physicians may be the first one to screen for and diagnose it.
Outside of the primary care setting, there are a few levels of care available to individuals with eating disorders. Let’s review binge eating disorder treatment options:
- Often where the treatment process begins
- Patient lives at home and attends hourly sessions at their providers’ offices
- Appropriate for patients who are medically stable, motivated, self-sufficient, and have adequate support and structure at home
- Typically occurs in a specialized setting (e.g., an eating disorder clinic or hospital)
- Patients live at home and attend sessions three to five times a week that last approximately three hours each
- Program may include numerous types of therapy, including, but not limited to, individual, group, and nutritional counseling
- Appropriate for patients who are medically stable, self-sufficient, and have adequate support and structure at home, but may need some degree of external structure beyond self-control
Partial Hospitalization (Full-Day Outpatient Care)
- Occurs in a specialized setting and can be connected to a hospital program or a free-standing facility
- Patient requires a high level of supervision and monitoring
- Patient must be able to demonstrate some ability to retain the gains made in treatment without 24-hour monitoring
- Patient must not be a suicide risk or medically compromised to the point of requiring hospitalization
- Patient must have sufficient resources and motivation to attend program
- Patient’s home or living environment must be one that can be supportive of the recovery process
- Wide variety in quality of programming and hours of available treatment across programs, making it critical that patient’s needs and circumstances are appropriate for this level of care
- Care is typically 5– 12 hours per day, 4– 7 days per week.
- Appropriate when patient is highly symptomatic but can tolerate some time alone without reverting into symptoms
Residential Treatment Center
- Highly specialized programs that can be operated independent of hospital setting, but sometimes connected to a hospital setting
- Indicated when patient is not able to retain gains without 24-hour monitoring
- May be indicated when severity of symptoms necessitates constant monitoring in order to initiate and sustain symptom-free behavior and normalized eating
- May be indicated for patients whose activities of daily living are compromised by the disorder May be indicated for the development of a normalized, healthy lifestyle conducive to long-term health and well being
- May include specialized approaches that help the patient develop routines and activities of daily living that create patterns of behavior that are conducive to recovery
- Useful in situations with a high degree of psychiatric comorbidity that require intensified focus during treatment
- Sometimes indicated on the basis of a lack of supportive and safe environment where the patient can be expected be able to make meaningful, retainable progress
- May be appropriate when patient is overwhelmed with symptoms and unable to refrain from reverting to symptoms or other behaviors that compromise their well being when alone
- Appropriate for patients with either lower or higher levels of motivation, but generally patients must enter treatment voluntarily
- Generally used for a period of short-term stabilization proceeding initiation of treatment at lower levels of care
- Indicated in situation where patient is a suicide risk or gravely disabled by symptoms and unable to participate in residential or lower levels of care due to presenting symptoms, which may include depression, poor motivation, poor insight, and/ or other factors that limit ability to meaningfully participate in lower levels of care
- Appropriate in situations where hospital-based medical care is indicated (i.e., IV lines or other more invasive medical treatments are needed)
Binge Eating Disorder Treatment Options
When treating adults with binge eating disorder, healthcare providers may employ nonpharmacologic treatment strategies, including psychotherapy and nutritional counseling, or pharmacologic treatment. There are several evidence-based psychotherapy techniques for the treatment of binge eating disorder, including:
Cognitive Behavioral Therapy (CBT)
A form of psychotherapy subjected to a great deal of scientific research, cognitive behavioral therapy has proven effective for a wide range of disorders, including binge eating disorder. Cognitive behavioral therapy is founded on the principle that emotions, thoughts, and behaviors are intricately connected. The aims of cognitive behavioral therapy are to help patients identify distorted thinking, modify negative beliefs, relate to others more authentically, and change self-sabotaging behaviors. cognitive behavioral therapy encourages binge eating disorder patients to regulate their eating habits by:
- Setting goals
- Developing flexible control when eating
- Modifying negative views about themselves
When undergoing cognitive behavioral therapy, a person may be asked to complete “homework assignments”— activities, reading, or practice exercises— that build on their regular therapy sessions. They may also be encouraged to apply what they are learning to their daily lives.
Dialectical Behavioral Therapy (DBT)
Originally developed for the treatment of borderline personality disorder, dialectical behavioral therapy is a type of cognitive behavioral therapy. Dialectical behavioral therapy involves teaching skills in four specific areas, and these dialectical behavioral therapy skills can help those with binge eating disorder to heal their relationship with food and gain control over their bingeing behavior. The four areas of dialectical behavioral therapy skills training include:
This entails paying attention to thoughts and the present moment in a non-judgmental way. By paying attention, one remembers that a thought may or may not be true. A person with binge eating disorder has thoughts and/ or feelings they may act on impulsively. These may involve negative self-judgment or other feelings they want to push away. Becoming mindful of these thoughts enables them to have an internal conversation about whether the thoughts are accurate before launching into a potentially self-destructive behavior.
This includes strategies for effectively asking for what you need, saying no, and dealing with interpersonal conflict. Typically, binge eating disorder patients may struggle to validate their own interpersonal experience and/ or interpersonal needs. Some individuals with binge eating disorder may avoid their needs almost completely— avoid discussion of needs and/ or sharing emotional content and even be unaware of feeling states. Others with binge eating disorder go back and forth between avoiding their needs and having intense confrontations about them. Interpersonal effectiveness training helps them learn to communicate their needs clearly as opposed to making demands. In some cases, this training contributes to repairing relationships that have been severely strained.
Human beings have a natural tendency to want to push pain away, which can mean going into avoidance mode. For someone with binge eating disorder, attempting to avoid pain, either consciously or unconsciously, can be a trigger for bingeing. Distress tolerance training is about accepting the situations or circumstances in life we cannot change that involve pain. This means learning to accept life exactly as it is— a practice sometimes referred to as “radical acceptance”— so we can manage challenges effectively, and even find meaning in them, rather than trying to avoid them. While distress tolerance is about overcoming avoidance, it can involve a variety of strategies for diverting attention from distressing thoughts in a healthy way, including self-soothing activities like taking a bath or meditating, making contact with others, doing something physical, or engaging in prayer or affirmations.
Those with binge eating disorder may have emotions such as sadness, shame, and/ or anger that have not been addressed and that they try, either consciously or unconsciously, to manage through the dissociative bingeing process. Additionally, binge eating disorder is a red flag for other co-occurring psychiatric issues, such as depression and anxiety. Emotion regulation involves helping individuals identify their emotions and work through obstacles to changing them. As a person learns to experience the present emotion mindfully and take effective approaches in response, their vulnerability to being flooded and controlled by negative emotions lessens.
Guided, Self-Help Cognitive Behavioral Therapy
With guided, self-help cognitive behavioral therapy, patients receive self-help manuals specifically geared to binge eating disorder and have regular, brief meetings with a therapist. Like traditional cognitive behavioral therapy, self-help programs promote regular eating patterns through self-monitoring and developing problem-solving techniques. Guided, self-help cognitive behavioral therapy addresses the need to widely disseminate cognitive behavioral therapy techniques to patients with binge eating disorder. While studies have demonstrated the efficacy of self-help for treating binge eating disorder, we must be careful not to assume that self-help is an ideal solution and/ or sufficient care for all patients suffering from this complex disorder, as clinical wisdom indicates this not to be the case. Further, any assumption on the part of the provider that a patient can get better exclusively by using guided self-help cognitive behavioral therapy can undermine the patient and leave them feeling more shame and/ or hopelessness. That being said, it is clear that for some patients with binge eating disorder, guided self-help cognitive behavioral therapy can be an effective component of the treatment process.
Interpersonal Psychotherapy (IPT)
Interpersonal psychotherapy is an empirically validated, time-limited form of psycho-dynamic therapy initially developed to treat adult depression, which has subsequently been modified for the treatment of numerous other conditions including, substance abuse and eating disorders. It focuses on the relationship between the presenting symptoms and the individual’s interpersonal issues, which are divided into four categories: grief, interpersonal disputes, interpersonal deficits, and role transitions. Interpersonal psychotherapy helps patients with binge eating disorder recognize how underlying relationship issues can drive their binge eating. As this realization grows, patients learn strategies for identifying and expressing emotions as well as dealing with emotional baggage. In the process, individuals develop a more positive self-image and a greater capacity to request and receive the emotional support they need. Through improved communication skills and relationships, binge eating disorder patients grow in their ability to manage negative feelings without turning to food as a coping mechanism.
Group therapy can be highly effective for those with binge eating disorder. In the context of a group, individuals with binge eating disorder often have dramatic breakthroughs by realizing they are not alone in their feelings of isolation and despair. In fact, it can be easier and more effective for patients to hear supportive advice from another person who is suffering in the same way than from a therapist. The sharing of experiences and feelings among group members frequently reveals that what the individual with binge eating disorder had perceived as an exclusively personal struggle is actually a universal human concern. This can serve to validate all the group members’ experience, which, in turn, helps raise the participating individuals’ self-esteem and sense of connection to others.
Often people with binge eating disorder have experienced significant interpersonal rejection and learned to expect interpersonal disappointment. As a result, they may cease expressing their genuine emotions to other people because it may leave them feeling vulnerable and exposed. In a group therapy process, those with binge eating disorder can begin to share more openly and have a positive experience. Frequently individuals with binge eating disorder discover through group therapy that other members enjoy them for who they authentically are. This can lead to greater self-esteem and increased trust that relationships can evolve in a positive way and authenticity pays off in interpersonal interactions— all of which may be an entirely new reality for a person affected by binge eating disorder.
While group therapy can be an important component of treating binge eating disorder, it generally should not be the only form of treatment that patients receive.
Nutritional Therapy and Counseling
Individuals with binge eating disorder may benefit from nutritional therapy and counseling. Unlike psychotherapy, which focuses on the underlying emotions driving the binge eating, nutritional therapy pays particular attention to the real-time experience of the patient’s behaviors around and struggles with food. Note that the diagnosis of binge eating disorder is made without regard to weight. Nutritional therapy for those with binge eating disorder should not focus on weight, either, but rather on the life circumstances, behaviors, thoughts, feelings, and triggers associated with binge eating. It should also incorporate support for patients in developing a healthy relationship with food.
A Final Note About Binge Eating Disorder Treatment Options
In addition to a combination of the aforementioned treatments, binge eating disorder patients may receive various types of expressive arts therapy and pharmacotherapy. Perhaps the most important aspect to communicate to a person with binge eating disorder is that they have a serious condition for which there is treatment. It’s important that your healthcare provider sends the message that they understand you, and imply that if you’re not getting better, it’s because you are not trying hard enough.
Types of Healthcare Professionals That Participate in Binge Eating Disorder Treatment
To determine the appropriate level of care, a thorough patient evaluation is essential. When a multidisciplinary team of healthcare professionals is required, in addition to the primary care physician, the team may include:
Certified Eating Disorder Clinicians
A certified eating disorder clinician is certified by The International Association of Eating Disorders Professionals Foundation (IAEDP). A certified eating disorder clinician specialize in treatment of individuals with eating disorders.
Staff Psychiatrist and/or Medical Provider
A staff psychiatrist and/or a medical provider may supervise a patient’s entire healthcare team. Participates as a leader in formulating the patient’s treatment plan and ensures that the plan is carried out. May handle complex cases and any medical complications or psychiatric emergencies that come up. May also manage medication.
Clinical Psychologist, Licensed Mental Health Counselor, Licensed Marriage and Family Therapist
A clinical psychologist leads various therapy sessions, including individual, group, and family therapy. Each of these individual practitioners may have a particular subspecialty. For example, clinical psychologists may be able to provide specific assessments. Perhaps the most critical point to consider is not the type of clinician, but rather the clinician’s understanding of binge eating disorder treatment.
Licensed Social Worker
A licensed social worker may lead an individual, a group, and family therapy sessions. May also act as patient advocates and help coordinate care with other healthcare professionals.
A dietitian can help correct nutritional deficiencies binge eating disorder patients may have developed and can address underlying cognitions around food and weight, which may contribute to under-eating and dysregulation. May help patients with specific nutrition plans and fears or anxieties around food to establish a healthier relationship with eating. May help patients become aware of hunger and satiety cues and develop structure with meals when needed. It is CRITICAL that nutritionists and ALL providers of care for a person suffering from Binge Eating Disorder, to NOT endorse weight loss as a goal or push weight loss and dieting, which only causes further psychic injury to the sufferer.
There are many other practitioners that can be helpful, such as expressive arts therapists, which may include the visual arts, movement, drama, music, writing, and other creative processes. Additionally, yoga instructors and other types of movement therapists can have a positive influence.
Finding Binge Eating Disorder Recovery
If you think you or a loved one needs binge eating disorder treatment, you’ve come to the right place. The first step to binge eating disorder recovery is acknowledging you need help and then seeking help.
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 Online Binge Eating Disorder Treatment
My name is Wendy Oliver-Pyatt, I am a consultant psychiatrist in Miami, Florida. I believe that compassion, when directed towards self and others, can lead to profound health and healing. If you need online binge eating disorder treatment, I can help! I have created a unique treatment model in which you will have the opportunity to work with providers who I specifically refer to based on your current experience, diagnosis and needs. I build this team around you and will coordinate your care with the goal to find meaning in your experience, and free you of your symptoms so that you can feel more at peace, and have greater capacity to adapt to life circumstances, to challenge yourself, to be creative, to develop intimacy and to have a fulfilling lifestyle With more than 20 years of clinical experience and a vast network of clinical partners, I’ve developed a unique treatment approach that delves into the underlying issues that place a person at risk for mental health conditions. Together we will create a protocol and treatment plan that is well coordinated, and that can guide you on your healing process, toward health and inner peace. Contact me today!