How to treat binge eating disorder

Binge eating disorder is more common than we ever thought, with up to 30% of some populations showing signs of binge eating. The condition occurs more commonly in women and in people who are overweight or obese. What are the treatment options?


(a) The first goal
Therapists stress that treating Binge Eating Disorder requires a team-based approach. Teams consisting of a physician, psychiatrist/psychologist and a dietitian should work together to help patients overcome their physical and psychological problems, which are believed to be at the root of this disorder.

To start off with, the goal of treatment is to eliminate binge eating and normalise eating patterns. The experts agree that it is more important to first eliminate excessive, rapid food intake during binges, before giving attention to weight-loss or other dietary changes. If the patient can achieve control over his/her food intake and start eating a balanced diet, then some degree of weight-loss may well follow.

(b) Introduction of exercise
Once the patient has normalised his/her eating patterns, exercise can be introduced to help patients improve their physical and psychological fitness. Exercise not only stimulates body metabolism, thus promoting weight-loss, but it also increases serotonin levels in the brain.

Most of the pharmaceutical products which have been used to treat Binge Eating Disorder are serotonin-uptake inhibitors. Exercise is, therefore, a non-chemical way of increasing the levels of the chemical serotonin in the brain to improve mood and prevent overeating.

(c) Cognitive behaviour therapy
Cognitive behaviour therapy which concentrates on education, keeping track of food intake, replacing false beliefs and ideas about food and body image with rational ideas and teaching patients to take control of their lives and their food intake, is regarded as an excellent option.

In one study with obese binge eating patients, 16 weeks of cognitive behaviour therapy reduced binge eating by 81%. Another study, found that 67% of patients improved after receiving cognitive behaviour therapy.

(d) Pharmacological interventions
For those patients with Binge Eating Disorder who do not improve with cognitive behaviour therapy or individual psychotherapy, the use of so-called serotonin uptake inhibitors can be useful. Drugs such as fluoxetine and fluvoxamine have achieved significant reductions in binge eating in studies conducted with patients suffering from Binge Eating Disorder.

Drug treatment of this disorder should always be closely monitored by the prescribing physician.

Are you suffering from Binge Eating Disorder?
To decide if you have Binge Eating Disorder and need help, check the following list of characteristics symptoms:
(1) Have you indulged in two or more episodes of binge eating per week for 6 or more months?
(2) Do you feel that you have 'no control' over your binge eating?
(3) Do you eat faster than normal?
(4) Do you eat very large quantities of food even when you are not hungry?
(5) Do you eat alone to avoid embarrassment?
(6) Do you eat until you feel uncomfortable and fit to burst?
(7) Do you feel disgusted with yourself after an eating binge?
(8) Do you feel guilty or depressed after an eating binge?
(9) Do you never use purging, fasting, or exercise to decrease your weight?

If you answer "yes" to three or more of the questions, then you should seek professional help immediately. - (Dr I.V. van Heerden, DietDoc)

Have a question for DietDoc?

More on eating disorders

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