What Is Your Relationship With Food?
In this statement about Food and You each word is capitalized for a reason, because each word carries equal weight in this type of disorder we will be discussing.
Common concerns of my patients are:
“I cant stop myself from eating the entire bag of chips!”
“I eat alone because I feel embarrassed about the quantity I can consume!”
“I hide food from my family, because they will not approve of it!”
“I have weird cravings for this food which I cant seem to overcome it no matter what I do!”
‘’I feel ashamed and disgusted after I have eaten so much and such bad food that I keep on repeating it and sabotaging myself.”
“I have been very good so far, I have lost a bunch of weight by restraining myself from my bad habits and cravings, but I am scared that I will not be able to keep up with it for too long!”
“I am good at losing weight but I put it back on very quickly and then I resort to binging and purging to keep the balance!”
When talking to people at their initial consultation it is important that a behavioral questionnaire is given to them along with some private time (which can mean at home) to complete it. It can become one of the most powerful tools in your toolbox to help the patient. There are more people than you think in the US with food and mood related disorders. Binge Eating Disorder happens to be the most common one out of the lot. Binge Eating Disorder also known as BED has only been recognized as recently as 2013 in the DSM-5.
What is BED:
According to nationaleatingdisorders.org Binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.
The diagnostic criteria for BED are very specific, it is episodic, about at least one a week in a three-month period. The patient eats unusually large amounts of food till they feel uncomfortably full, and there is a feeling of being totally out of control about their binging. They feel disgusted, depressed and upset with themselves; they hide from others and also hide food for later. Unlike in Anorexia Nervosa or Bulimia, purging after eating is not a usual association with BED. This disorder has consequences of weight gain, weight cycling, poor self-image and feelings of disgust, depression and guilt, gastrointestinal problems like constipation and acid reflux and lack of concentration.
Good News About Binge Eating Disorder:
This is a treatable eating disorder leading to a good life style. The goal of the treatment is to reduce the frequency of binging and learning to make better choices of food and activity.
BED is successfully treated if all modalities are utilized namely behavioral therapy and medication. Behavioral therapy can be; Cognitive Behavioral therapy, Interpersonal Therapy and Dialectical Behavioral Therapy depending upon the assessment by a specialist. There are medications like Topiramate, anti- depressants which have shown promise in the treatment of the disorder and they must be used along with above mentioned behavioral therapy. However lately Vyvanse, a drug used in disorders like ADHD has been approved by the FDA for treatment of Binge Eating disorder as an adjunct to behavioral therapy. The weight loss treatments like Gastric Sleeve or even weight loss programs are not recommended to patients with BED until their disorder is treated and under control. The weight loss treatment should always be done at a medical weight loss center under direct supervision of a medical doctor.
No matter what the eating disorder or cause of psychological distress to the body, having support of the family, doctor’s office, friends and support groups all seem to help the patients on their journeys.
Sources:
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633