Binge Eating Disorder Treatment
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by Lizabeth Wesely-Casella
Binge eating disorder (B.E.D.) is first and foremost a mental health issue. It is treatable using various therapies and modalities and recently a medication has come to market to add another tool to the toolbox. But make no mistake, even with these options, B.E.D. is not easy to overcome and we are far from understanding all of the complexities surrounding the disorder. Like all eating disorders, it is a very personal experience that can be impacted by myriad factors including trauma, genetics, environment, social cues and cultural beliefs. Any or all of these combined with fragile mental health can lead to disordered eating, unhealthy food relationships and poor body image.
It’s worth noting that eating disorders have the highest mortality rate of all mental health diseases[i] – a low estimate of the death rate is 10 percent and that’s due in part to faulty reporting. If a person with an eating disorder succumbs to organ failure, often times the eating disorder is not listed as having caused the death even though it directly contributed.
So it’s fair to say that a person with B.E.D. is likely to be sensitive to the ubiquitous messages that directly connect worth and health with body size and shape. In fact, that person is likely to assume that seeking treatment for B.E.D. will result in significant weight-loss – and that’s simply not true.
Though weight changes may occur, the point of seeking treatment is not to find another way to diet. Treatment is designed to address the underlying reasons for the food use; stress, poor coping skills, inability to prioritize self, body shame, low self esteem, and of course the repeated feelings of failure for having dieted and then weight cycled; having promised never to binge again only to succumb due to self imposed pressure.
With a qualified treatment provider, ideally a B.E.D. specialist, individuals who are struggling learn that food is not the enemy. That bingeing has less to do with food than with unmet needs. A therapist trained to treat B.E.D. will never suggest putting their client on a diet because it is counterproductive to building the healthy food relationships that our bodies (and minds) need. A good B.E.D. therapist will assist in identifying emotions and disconnecting them from frenzied consumption.
There are many types of therapy; cognitive behavioral (CBT), dialectical behavioral (DBT) family systems and more. There are also distinct certifications and credentials for eating disorders treatment providers including Certified Eating Disorders Specialist (CEDS), and Fellow, Academy for Eating Disorders (FAED). When looking for the right type of therapist, familiarize yourself with what these treatment styles and subspecialties mean in order to narrow your search for what best fits your needs.
In addition to therapy, the traditional and most holistic approach to treating B.E.D., a new medication has been approved by the FDA for use with B.E.D. patients. The drug is called Vyvanse and it is a mild stimulant, available by prescription only. It is a product from Shire plc pharmaceutical company and it’s the impetus for the binge eating disorder awareness campaign found here www.bingeeatingdisorder.com, which includes personal stories and tennis great Monica Seles as the spokesperson. Both the Binge Eating Disorder Association (BEDA) and the National Eating Disorder Association (NEDA) are working in partnership to highlight both the campaign and the need to bring awareness for BED as a treatable disorder.
For many with B.E.D., the idea of having a medication to support their therapy is a welcome weapon in their arsenal, however, for others who have not yet begun their deep work with a treatment provider, the idea of a stimulant may conflate the purpose of getting help with the idea of losing weight. Both the treatment community and Shire plc alike are clear that all forms of treatment must be designed to treat the disorder and stop the binge activities, they must not be weight-focused or in any way promote dieting.
Chevese Turner, Founder and CEO of the Binge Eating Disorder Association (BEDA) puts it this way, “As the leader of an organization designed to support a community of people who suffer from a binge eating disorder, I believe it is helpful to have multiple treatment tools available. There is no magic bullet that will work for every person and in fact, multiple therapies may be necessary. What is right for one person may not always be right to aid the recovery of another. Having a tool like Vyvanse provides an additional possibility for those who, in consultation with their specialized eating disorder treatment team, may try it as a part of their approach to recovery”.
BEDA is the sole organization focused on supporting people with BED and the providers who care for them. To learn more about B.E.D. or to become a BEDA member, please visit www.bedaonline.com or call 855-855-BEDA (2332).
The bottom line is that B.E.D. is a mental health issue that may impact weight and body size, and that treating the disorder may or may not change the shape of the body. The goal of treatment is to provide relief from the eating disorder, not to lose weight or ‘get in shape’. When working on recovery, the body’s cues to eat when hungry and stop when satiated will fall in line as will improved coping skills and interest in self-care. Those are the goals for treatment and those are the changes that truly improve daily life. To live a life of sound mental health and stability fulfills the promises that diets simply can’t – a healthy mind is not equivalent to a smaller size of pants.
If you feel as though you are out of control around food, that you are fixated and isolating, that you are ashamed to eat around other people and that you hate your body, you may want to speak with your doctor about screening for binge eating disorder. If you need support finding a B.E.D. specialist who can help you, reach out to BEDA through the contact information above. There is no reason to suffer a single day longer; there is help for you, and it comes in many forms.
About the Author:
Lizabeth Wesely-Casella is a weight stigma prevention advocate and a binge eating disorder (BED) expert. She works in Washington, DC as a coalition builder and speaker addressing the impact of size discrimination on communities and industry and the profound effect that weightism has on individuals with eating disorders, especially BED.
As a speaker, Lizabeth blends science, humor, and cultural wisdom to engage her audience, creating a clear understanding of the disconnect between health and body shape and underscoring that shape and size do not reflect personal value or character. She also connects the dots between weight discrimination as a civil rights issue and the negative consequences to our economy, education, and workforce.
Lizabeth’s advocacy has afforded her opportunities to speak in the Senate, on film, and in radio. Her advocacy work has positively influenced program design from college campuses to the White House including the Let’s Move! initiative. Lizabeth lives in Washington DC with her loving husband and delightfully spoiled dog Noodle.
Disclaimer: This blog post does not reflect the views of the OAC, the National Board of Directors or staff. The OAC does not endorse or support any merchandise, program or hyperlink mentioned in this blog post.
1. Arcelus J, et al. Mortality rates in patients with anorexia nervosa and other eating disorders. Archives of General Psychiatry, 68(7):724-731.