A New Way of Treating Binge Eating
By Andrew Neufeld, MC RCC
At Alongside You, we help clients from all over Metro Vancouver deal with various types of eating disorders. Whether it is through the services offered by our in-house Registered Dietitian or through therapies offered by our team of experienced counsellors, we’ve got the answers to many questions on the topic of eating disorders and related health issues.
Defining Binge Eating Disorder (BED)
First of all, it is important to define what binge eating is and what it is not. This way, if you are suffering from this condition, you can get the proper help you need to get back to healthy eating habits. Binge eating is not simply emotional eating. Binge eating is done to sooth oneself during a period of emotional dysregulation or other stressors. While certain emotional states can cause binge eating, not all situations where emotional eating is involved would lead to binge eating. Binge Eating Disorder (BED) is one of the newest eating disorders recognized by the DSM5
The formal criteria for diagnosis of Binge Eating Disorder, from the DSM5 are:
- Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
- The binge eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal.
- Eating until feeling uncomfortably full.
- Eating large amounts of food when not feeling physically hungry.
- Eating alone because of feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
- Marked distress regarding binge eating is present.
- The binge eating occurs, on average, at least once a week for 3 months.
- The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
We’re very happy that BED is getting the recognition it deserves as a separate diagnostic category for many reasons, not the least of which is that it is gaining more recognition as a specific condition. Further, it will hopefully help in finding more methods of treatment, as well as accessing funding for clients and treatments because now it has its own DSM5 classification.
We offer a number of services aimed at eating disorders, and BED specifically, including our Registered Dietetics, Individual, Couples, and Family Therapy, Neurofeedback, and Therapeutic Yoga but I want to highlight one specific modality today that has great efficacy with eating disorders: Dialectical Behaviour Therapy.
A Ray of Hope – Dialectical Behaviour Therapy
Dialectical Behaviour Therapy (DBT) was originally created to help people who were struggling with chronic suicidal thoughts and attempts. However, that was not the sole reason Dr Marsha Linehan developed this method of therapy. The main goal of DBT can be summarized in just one sentence: “To have a life worth living.”
DBT places importance on understanding and working with various emotions. As part of the DBT model, we believe that the problematic behaviours in question are results of the inability to manage strong emotions. To treat binge eating, it is important to address the emotions in play. This is where DBT can truly shine.
The four pillars of DBT can help people struggling with binge eating in the following profound ways:
- Mindfulness: People with binge eating disorders often find it hard to stay in the moment. It can “trigger” people when they connect emotions with food. Some people are not aware of what exactly triggers their binge eating symptoms (chain analysis can also help with this). Since it is difficult to treat anything without being aware of what exactly it is, mindfulness skills become extremely important when it comes to managing binge eating disorders. One of the skills taught is the concept of mindful eating, which makes the eating experience intentional, rather than making eating a reaction or means to calm emotional turmoil.
- Interpersonal Effectiveness: People suffering from binge eating disorders often find it difficult to assert their needs and to say no. This could be due to fear of rejections and feeling of shame. When we do not have proper boundaries, feel taken for granted or feel we are treated like a doormat, we experience negative emotions that lead to ineffective behaviours. Interpersonal effectiveness helps us ask for what we need in relationships and how to say no to others for the right reasons.
- Emotional Regulation: As described above, people who have binge eating disorders often have problems dealing with their emotions. Instead of suppressing or getting rid of their emotions, this skill set helps people reduce their vulnerability to negative emotions, as well as connecting with positive emotions.
- Distress Tolerance: This set of skills help people who are going through crises, in this case binge eating. It helps steer people away from actions that would worsen their current situations. Through Crisis Survival Skills and Reality Acceptance Skills, sufferers of binge eating disorders learn to tolerate their distress and make lasting changes in their lives.
If you feel that you are struggling with binge eating, it is important to seek help. A properly designed DBT program can help people who have binge eating disorders to stop binging. They will gain insights and learn skills to regulate their emotions and eliminate the habit of using eating to deal with problems.
At the individual therapy and group therapy programs at Alongside You, our clients get to learn the role binge eating play in their lives. In turn, they can put the newly learned skills in place to handle challenges life throws at them. They find harmful behaviours, such as binge eating, no longer useful to them when it comes to regulating emotions.
If you would like to learn more about the connection between food, diet, eating and mental health, please contact your registered dietitian. Your counsellor and dietitian can also work together as your team of family health advisors – they can come alongside you to create the most optimal health plan for you and your family.
If you have any questions, please call 604-283-7827 and reach Andrew Neufeld MC, RCC at extension 701 or Annie Tsang RD at extension 712.
If you are interested in joining a DBT program or individual therapy program to treat potential binge eating disorders, please call 604-283-7827 and reach Kelly Williams at extension 710. We will begin by identifying any symptoms of potential problematic eating. Then we will direct you to the most appropriate program that will help you turn around the situation.