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How is binge-eating disorder (BED) treated?

When left untreated, binge eating disorder (BED) can get worse over time and result in a very poor quality of life.

Treatments include specific types of cognitive behavioral therapy (CBT) and interpersonal therapy, as well as medications including certain antidepressants including selective serotonin reuptake inhibitors (SSRIs) and anticonvulsants, such as topiramate.

This content originally appeared on HealthyWomen.org.
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A number of treatment options exist to address both the symptoms and causes of binge-eating disorder. Possible treatments include psychotherapy, drugs, behavioral therapy, and self-help techniques. A qualified medical professional can work with you to devise a course of action best suited to your needs.

Various psychotherapy methods can be used to treat the feelings of shame and self-esteem so often linked to binge-eating disorder. Cognitive Behavioral Therapy (CBT) is one such method, which can help a person learn to manage negative thought patterns and behaviors. Medications may also be useful in aiding effective weight management and treating conditions such as depression. Some people with binge-eating disorder find various self-help techniques to be of use, such as group therapy and self-help books.

Dr. Robert S. Johnson, MD
Psychiatrist (Therapist)
CBT (cognitive behavioral therapy), combined with medication, has been shown to be an effective treatment for binge eating. Medications commonly used with this type of talk therapy include Prozac or another selective serotonin reuptake inhibitor, Topamax and Vyvanse.
Brooke Randolph
Marriage & Family Therapy Specialist
In the treatment of binge eating disorder, there is debate over whether it is best to treat self-esteem, depression, irrational thoughts, or obesity first. Eating regular, healthy meals and snacks to prevent hunger, removing tempting junk food or binge triggers, and learning new techniques to manage stress may all be important in overcoming binge eating disorder. Groups may also be important to address isolation and self-esteem concerns.
Psychotherapy appears to be more effective than behavioral weight loss therapy and more effective than medications for the treatment of binge eating disorder. Types of psychotherapy include:
  • Cognitive behavioral therapy (CBT)
  • Interpersonal therapy
  • Dialectical behavioral therapy
CBT has the advantage of being available in self-help formats. The addition of medications to psychotherapy has not proven beneficial except for the use of topiramate, an anti-epileptic drug. Another class of medication, selective serotonin reuptake inhibitors, or SSRIs, is effective for treatment of binge eating disorder and should be considered if psychotherapy is not an option. For obese patients for whom psychotherapy is not an option, behavioral weight loss therapy and/or a medication (SSRI or topiramate) can be considered.
Mrs. Marjorie Nolan Cohn
Nutrition & Dietetics Specialist

BED often causes obesity however, treatment for obesity is not the same thing as seeking treatment for BED. Obesity is a medical condition, where BED is a psychological condition. And while obesity is often a result of BED and they need to be treated together, there are aspects of treatment that are distinct, especially when obesity related disease is concerned. For example, intuitive eating is commonly promoted as a practice in the treatment of all eating disorders, BED in particular. “Intuitive eating” an approach to eating that teaches you how to create a healthy relationship with your food, mind, and body by distinguishing between physical and emotional feelings. In intuitive eating food is not labeled good or bad, and no foods are forbidden. For many people struggling with BED the idea of being able to eat something that is considered forbidden, like cookies or other sweets, can be very empowering and a relief to the all or nothing mentality associated with BED. However, if someone with BED is obese and has insulin dependent type 2 diabetes, having cookies or other sweets (even in moderation) may be hazardous to health as it will affect blood sugar and requires insulin adjustment. In this case there is a necessary balance between what is medically required for health (such as no sweets) and what is mentally beneficial. In this situation the necessary dietary restrictions of type 2 diabetes may very well play right into the BED mentality of all or nothing thus perpetuating BED.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.