Binge eating disorder (BED) is one of the latest eating disorders officially acknowledged in the DSM5. Before this 2013 new revision, binge eating disorder was listed as a subtype of EDNOS currently known as OSFED. The alteration is significant because a few insurance companies will not provide cover for Binge disorder treatment without a DSM diagnosis. [1]
The diagnosis is classified under the DSM-IV-TR category of eating disorders otherwise specified [2]
although clinical professionals constantly view it as a distinct clinical occurrence. Individuals are classified under DSM-IV-TR Binge eating disorder if they suffer from binge eating without recurring compensatory behaviors two or more days every week for more than 6 months. The change to DSM-5 class identifies a different BED diagnosis that lessens the regularity of occurrence of binge eating days to one time every week and the duration factor to the previous three months. Here, the focus also shifts from days of binge eating to binge episodes. [3]
Registered dieticians (RDs) have an exclusive contribution to make in the discovery, evaluation, and treatment of binge eating disorders. This responsibility calls for a higher level of training and clinical judgment for all registered dieticians that care for binge eaters as protection for patients with EDs. [4]
A therapeutic eating plan for binge eating disorder recovery
Nutrition Therapy; Initial Assessment involves the following considerations:
• Allergies
• Religious dietary requirements
• Patients desired weight
• Binge foods
• Food rules
• Food recall
• Food shopping and preparing information
• Eating environment
It as well includes the following:
· accessing your medical history
There are various treatment methods devised for binge eating. One aspect of the treatments is centered on nutritional rehabilitation or medical nutrition therapy with a registered dietitian. This is a treatment of binge eating disorder together with associated medical conditions. It makes use of specific dietary recommendations and diet therapy counseling. Medical nutrition therapy is a significant part of binge eating disorder treatment because binge eating is commonly associated with anomalous and destructive eating habits.
Dietitian Support
For proper dietary planning, a registered dietician should be part of your team of care professionals. Depending on the seriousness of your binge eating episodes and associated symptoms, your treatment with a registered dietician can be conducted under different clinical settings.
Your registered dietitian will partner with you and your other health care team to find a lasting solution to your problems. Several registered dietitians will work together with your medical team to establish any medical conditions that can be treated with nutrition therapy.
At your first appointment, you will normally receive recommendations that will guide you towards making a few therapeutic steps with your diet and nutrition. [8]
It is better to work with dietitians who are specialized in eating disorder treatment because they have expert knowledge that will guide you towards taking steps that can assist you to conquer your abnormal feeding habits. They can as well help you with challenges with food and stabilize your eating behaviors. They can, for instance, incorporate any food that triggers your binge eating episode into your dietary treatment plan. However, they can assist you to control your intake by specifying an individualized customized mealtime plan.
Counseling
As part of your medical nutrition therapy, you will receive counseling from a dietitian. This will assist you to understand potential emotional or psychological connections to your feeding habits and behaviors. Although a dietitian is not a therapist, a dietitian is very critical to your treatment plan and can complement the work of your therapist or counselor. Thus, collaborative care is very essential to your recovery process of binge eating disorder. [9, 10]
The link between food addiction and binge eating
Binge eating disorder is connected to food addiction due to their related symptoms like compulsive and excessive eating. Thus, the knowledge of the relationship between food addiction and BED may be useful for discovering the mechanisms behind the initiation, continuance, deterrence, and treatment of challenging eating behaviors. [11]
A study found that serious pre-dieting makes the individual to be inclined to post-treatment abstinence after CBT [12]. Nevertheless, patients who engage in unpolluted dietary control (DR) and dietary control-negative effect (DRNA) subtypes exhibit little prognostic soundness [13].
The DRNA subtype is linked to better regularity of binge eating post-treatment compared to the DR subtype. This implies that people who show high levels of dietary control and negative influence are the more rigorous and treatment-resistant subtype of BED [14, 15].
Depending on the seriousness of the illness, age of the patient, and place of treatment, RDs will have differing levels of task. The American Psychiatric Association (APA) has formulated management guidelines for degrees of care, depending on the degree of seriousness of binge eating disorder. The APA guideline is made up of significant physical and psychological markers that show different stages of infirmity.
The distinctive role of RDs is their immense knowledge of foods, food science, and the part foods play in the health and wellbeing of people. RDs are capable of evaluating diets and making changes depending on the person’s state of health, physical activity, food choices, and religious beliefs. They are as well able to evaluate if the food beliefs and eating behaviors of an individual can be classified as normal or abnormal. [4]
The nutrition assessment usually involves various components depending on the levels of illness and the treatment plan; it can be inpatient, intensive outpatient, or less intensive outpatient treatment plan.
Inpatient, residential and intensive outpatient treatment plans are commonly made up of specific practices and standard codes of behaviors and will require the registered dietician to carry out various assessment tasks.
A full nutrition evaluation shows the present dietary intake of binge eaters; current eating prototypes, food-related history, deficiencies of nutrients, supplement intake, the possibility of refeeding syndrome, beliefs about food, and physical activity patterns. [4]
The treatment plan must provide room for patients to tell their stories. The therapists must be able to listen attentively to them to make it easier for therapists to have an in-depth knowledge of their situation.
Estimating characteristic eating patterns
To estimate the binge eater’s eating patterns, therapists need to make the following inquiries from the patient; inquire about occasions when the patient binge eat, investigate the influence of holidays or family get-together on food intake, and find out information regarding food rules and rituals that may be affecting the person including the level of calories counting, numbers of calories, strict food patterns, extreme feeding habit or omitted food groups.
After the nutrition assessment is completed, the RD can determine a nutrition diagnosis following the Nutrition Care guidelines. [4].
