Binge eating disorders, triggers and treatments.
That's what I'm going to talk about today.
I'm Dr. Tracey Marks, a psychiatrist
and I publish weekly videos
on mental health education and self-improvement.
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This video is based on a viewer question by T.
And the question is:
Hi, I enjoy your videos.
I find them, as you say, educational
which is much appreciated.
I would like to see a video
that talks about binge eating disorder, please.
Thanks, T. for this question.
I'll start out by talking about
what binge eating disorder is.
It's not the same as bulimia
which involves eating large quantities of food
and then using things to purge the food
such as over-exercising, vomiting, or using laxatives.
Binge eating disorder is a newly defined disorder
and the criteria is as follows:
Eating a massive amount of food in a short period of time,
like over a couple of hours, and this would be more
than what an average person would eat.
While you're doing this you feel out of control
like you just can't stop eating.
So this is different from sitting down at a picnic
and packing your stomach because the ribs are really good
or eating a lot at Thanksgiving.
This eating behavior has to occur
at least once a week for period of three months.
Also while you're eating,
you must have at least three of these five things going on:
you can eat much faster than normal,
you feel uncomfortably full,
you eat large amounts of food
even though you're not really hungry,
you eat alone because you're ashamed
of how much you're eating,
and then after you eat
you feel disgusted, depressed or guilty.
On a severity scale,
binge eating disorder is considered mild
if you have one to two binge eating episodes a week.
It's moderate if it happens four to five times a week,
severe if it's eight to 13 times a week
and extreme if you have 14 or more
binge eating episodes a week.
But all you need is one episode a week
for three months to be considered having the disorder.
There's lots of factors that play into
how someone develops an eating disorder,
but there has been research linking specific emotions
that trigger the binge episodes
in binge eating disorder or BED.
Binge eating disorder episodes have been shown
to be triggered by sadness, anger and frustration.
In fact in some studies, anger and frustration
were stronger triggers than sadness and depression.
In one study,
and these study references will be in the description,
frustration was broken down more specifically
to be emotions like discouragement,
guilt, irritation, inadequacy, and resentment,
just to name a few.
If you notice all of these emotions tend to be associated
with some kind of interpersonal interaction
and this is important
because one of the recommended treatments
for binge eating disorder
is a specific therapy called interpersonal therapy.
But regardless of the trigger and the emotions with BED,
you're unable to tolerate dealing
with the negative emotions in a healthy way
and eating becomes the coping mechanism.
The eating may provide some temporary relief,
but it doesn't last that long
because it's quickly followed by guilt and shame.
And it's no surprise that the kinds of foods
that people binge on are the high sugar and high fat foods.
These foods themselves can make you feel good
by giving you spikes in energy.
People just don't binge on celery
because it doesn't make you feel the same way.
Another finding from research that I thought was interesting
is that people with BED are less
emotionally aware of their feelings.
And what that means is that you experience
a negative emotion and can't always link
that emotion to a specific feeling.
For example, as far as emotions go,
there are big differences between feeling insulted
versus misunderstood versus invalidated versus ignored.
And all of those are negative emotions,
but each of these have a difference cause and significance.
For example, let's say I make you feel bad about yourself.
It may not feel as bad to you if you think I heard you,
but just didn't understand what you were saying
versus I heard you, but I don't really care what you think.
Misunderstanding isn't necessarily a personal attack.
But for any given interaction
if you can't make this kind of distinction,
you can just walk away feeling bad and attacked.
Then, you don't know how to process your emotion
and you rid yourself of that negative feeling by eating.
Why does eating become the coping mechanism?
Without getting too deep here,
I'll say that your mouth
is a very intimate part of your body.
You speak out of it to express yourself,
you kiss people to show affection,
beginning with your first day of life,
you're fed through it to sustain your life.
This dynamic plays in to why putting something in your mouth
becomes what would be considered
a primitive coping mechanism
to deal with the internal distress.
And in this case, primitive means
it's one of those basic, primal needs.
Okay so how do we treat binge eating disorder?
The main treatment for binge eating disorder
is therapy with or without medication.
The evidence-based treatments for BED
are cognitive behavior therapy, interpersonal therapy,
cognitive behavior therapy, guided self-help
and dialectical behavior therapy for eating disorders.
Cognitive behavior therapy addresses binge eating
that results from over-restricting your diet
and over-focusing on your body image.
So the therapy encourages better eating behaviors
and it works on your self-image.
Cognitive behavior therapy guided self-help
is a way to do this kind of therapy
on your own without a therapist.
I put a reference in the description
of a manual that can be used for guided self-help
called Overcoming Binge Eating Disorder
by Christopher Fairburn.
This one and others like it
can be very useful in helping you walk through the exercises
in a similar way that a therapist would.
Interpersonal therapy helps you identify
the negative emotions that you have
stemming from a relationship.
And this doesn't have to be a close relationship,
it could be a relationship with a coworker or a classmate.
But the idea behind it
is that you have these negative interactions
that produce emotions that you have trouble coping with
and then you use eating to cope.
In the therapy, the therapist can also recognize
any difficulties you may have
with identifying the correct emotion.
This treatment, of course,
requires a therapist to guide you through it.
And then there's dialectical behavioral therapy
for binge eating disorder.
Dialectical behavior therapy
was developed for borderline personality disorder.
And there's four modules to DBT:
mindfulness, distress tolerance, emotion regulation,
and interpersonal effectiveness.
DBT really addresses the emotions
that trigger the overeating and help you identify them,
tolerate them and find other ways to cope with them.
With DBT there's some overlap
with the interpersonal therapy,
but it's less focused on feelings
that come from your personal interactions with people.
As for medications,
the antidepressants that fall
into the selective serotonin reuptake inhibitor category
have been shown to help some.
However, the side effects from some of these medications
like weight gain can be counterproductive.
Another medication that's been FDA approved
for the treatment of BED is Vyvanse.
Vyvanse is a stimulant that we use to treat ADHD.
We don't know exactly how it helps
with binge eating disorder, but it has been shown
to reduce the binges or the cravings
and result in some weight loss.
That's binge eating disorder.
Thanks for watching and leave a comment,
as you can see some of these videos are generated
from viewer comments and questions.
See you next time.
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♪ Nothin' y'all can say ♪
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