Binge Eating Disorder Treatment: Is Mainstream Or Alternative Your Best Bet For Getting Better

 

Binge eating disorder affects both women and men of all ages including children, adolescents and adult. It affects people of all races, levels of education and financial status. Binge eating is the most common eating disorder in adults. Binge eating disorder can arise in normal-weight, overweight, or obese individuals. A projected 3.5 percent of women, 2 percent of men, and 30 percent to 40 percent of trying to lose weight can be clinically diagnosed with binge eating disorder [1]. There are periods when people over overeat while reacting to stress, nervousness, or other life occurrences, yet those are not eating disorders.

What is Binge eating disorder?

Binge eating disorder is an existing medical condition that is characterized by the habit of eating huge quantities of food within a short period [2] and this is often followed by feelings of anguish, misery, guilt and sadness; yet they are unable to manage the urge. It was recognized as a different eating disorder in 2013; however binge eating disorder (BED) is not disconnected from anorexia nervosa and bulimia nervosa, the other two types of eating disorder [3]. The symptoms of binge eating are also unconnected to those of anorexia nervosa and bulimia nervosa. The occurrence of BED in adults is more than the combination of occurrences in anorexia and bulimia.

 

Individuals with BED exhibit higher general and specific psychopathology than individuals without any form of eating disorder. [4] Binge Eating Disorder (BED) is the most widespread eating disorder in the United States. The percentages of women who suffer from binge eating disorder are two times as much more than the percentage of men who suffer from it in the US.

 

A national survey suggests that binge eating disorder affects roughly 2.8 million US adults. It occurs at a related rate across non-Latin speaking white (1.4%), Latin speaking white (2.1%), Asian (1.2%), and African American (1.5%) adults in the US. [5]

Effects of BED

Persons with binge-eating disorder have a model of recurring binge eating often in response to their mood alterations. Individuals affected by Binge Eating Disorder (BED) have a lower quality of life and state of well-being compared to other overweight people without the BED. [6]

 

Properly documented scientific evidences (James 2001; Linna et al. 2013; Stewart et al. 1990) show that eating disorders (EDs) are connected to female infertility. Despite these previous research linking infertility and reproductive health issues among women with EDs ,Study conducted by Claudia Geist, [7] Department of Sociology, University of Utah show that  women youngsters who experienced EDs or Disordered eating behaviors (DEBs) in early life were more likely to have three or more children in early adulthood irrespective of the differences in their delinquency, sexual behaviors or risk taking abilities. [8]

Causes of Binge Eating Disorder

Although research has not discovered exact causes of binge eating disorder, a lot of factors are considered to play a joint role in BED. The amalgamation of these causes and risk factors differs from individual to individual.

A lot of studies showed that there is a directly proportional relationship between negative mood states and binge eating habit and that binge eating disorder increases with increase in the individual’s negative mood. [9]

 

Another scientific study showed that the seriousness and the degree of negative feeling could be gainfully utilized to predict the beginning of a binge period. And although it is most possible for binge disorder to set in when the individual is most moody, it takes lesser time to occur when the individual is at the highest levels of negative mood. [10]

 

It is, therefore, necessary to mediate at moderate levels before it gets to the extreme as there is possibility of binge disorder setting in at that stage. Interfering at this moderate level creates enough time to prevent the binge episode. [11, 10] Those suffering from binge eating disorder can access psychological and medical remedies.

Treatments for Binge Eating disorder

·        Main stream medical and pharmaceutical treatments

·        Alternative medical treatments or psychotherapeutic treatments

Psychotherapeutic Treatments for Binge Eating disorder

·        Interpersonal psychotherapy (IPT) or full cognitive behavior therapy

·        Behavioral weight loss treatment (BWL)

·        Guided self-help cognitive behavior therapy (CBTgsh)

·        Mindfulness training

·        CBT-BWL Chronological treatment approach

·        Enhanced cognitive Behavioral therapy

·        Multimodal treatment model

·        Dialectical behavior therapy (DBT)

Cognitive Behavior Therapy and Guided self-help cognitive behavior therapy (CBTgsh)

Guided self-help cognitive behavior therapy is usually proposed first for treating majority of BED patients. The IPT is recommended for BED patients with poor self-image and excessive eating disorder. [12]

IPT and CBTgsh are more efficient alternative treatment for binge eating disorder than BWL. BWL also help to reduce binge eating disorder but the effect is short-term as revealed in a scientific study [13] that tested if BED patients need extra therapy outside BWL and if IPT is more efficient than BWL or CBTgsh.

A study that investigated short-term and long-term effects of rapid response between IPT, CBTgsh and BWL treatments for binge eating disorder (BED) found that CBTgsh and IPT are similarly effective for speedy and non-speedy responding patients and that IPT could be a second alternative treatment for non-speedy response after CBTgsh. [14]

Mindfulness training

Studies on mindfulness training as a treatment for eating disorders shows that mindfulness, eating behaviors, and psychosocial characteristics are interconnected and those mindfulness trainings are more efficient treatments for eating disorders among clinical populations than among the general population. [15]

 

The comparative poor effect of mindfulness among non-clinical population may be an indication that the factors affecting eating behavior in clinical population and non-clinical populations are divergent.

 

Although, anybody can experience emotional eating, stress and mindlessness; the degree of this experience may be very minor compared to that suffered by those with a clinically proven eating disorder.

CBT-BWL Chronological treatment approach

A study that compared CBT-BWL and a chronological treatment approach in which CBT is first offered to BED patients first before BWL (CBT-BWL) showed that Cognitive– behavioral therapy (CBT) yielded noteworthy reductions in binge eating than BWL while BWL yielded notably more percentage of BMI loss during treatment. [16, 17]

 

Similar to other studies, it does not support the usefulness of chronological CBT-BWL treatment approach but support BWL as an alternative BED treatment to CBT and emphasizes on the significance of restraining from binge eating for weight loss.

BWL is recommended as an alternative effective treatment for binge eating disorder and related eating issues in patients with mild binge eating disorder. BWL constantly produces short-term weight loss but there is less evidence of lasting weight loss effects of BWL. [18]

Enhanced cognitive Behavioral therapy (CBT-E)

Fairburn developed enhanced CBT (CBT-E) for eating disorders and researches show that CBT-E may be more efficient in the treatment of bulimia nervosa and the other eating Disorder than CBT but the effect on BED is yet to be investigated. [19]

Multimodal treatment model

The multimodal treatment model is based on the belief that eating disorders do not have one particular cause or a predictable pathway. The treatment begins with dieting and controlled eating behavior. Frequently, the dieting is to make the individual lose weight and look smarter or it may be as a result of an after effect of a severe stress or physical illness. [20]

 

The seriousness of illness and the type of eating disorder the patients have would determine the line of treatment that would be recommended. The clue for a treatment strategy is usually developed from the patients ‘hospitalization through day programs to rigorous outpatient and group therapies.

 

Dialectical behavior therapy (DBT)

Another research on psychological treatments for BED investigated CBT, interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL) and other treatments supported the effectiveness of CBT and IPT for the treatment of BED and additionally showed that DBT is a possible treatment for BED, but supplementary research is essential to determine its long term effect. [21]

Medical treatment of Binge Eating Disorder (BED)

Lately, the medication produced by Shire Inc. known as Vyvanse (Lisdexamfetamine dimesylate or LDX was approved as the first medication for binge-eating disorder of patients. The medication is already used for ADHD. It was approved as a treatment for binge-eating disorder in relation to five studies that showed that Vyvanse drug lessens symptoms through a levelheaded and well-designed path of clinical testing. [22] 

The side effects of mediation

·        Dry mouth

·        Headache

·        Insomnia

·        Minimal increase in pulse

·        Minor boost in blood pressure

The side effects affected only ten percent of the research population.

 

The drug is usually recommended as a multi-disciplinary treatment strategy rather than just a treatment by itself alone. It is usually used together with Cognitive-Behavioral Therapy (CBT) by a psychologist and through management of eating habits provided by dietician.

 

Also, as a result of the side effects, doctors who prescribe the medication ought to monitor the patient for useful signs like weight, pulse, and blood pressure. A significant conflict of interest in these five researches was that they were all sponsored by Shire, Inc.

 

Further researches are ongoing to determine the long-term effectiveness of the drug’s efficacy for treatment of binge-eating disorder and its safety.

Conclusion:

The two best psychological therapies for BED are CBT and IPT. They are recommended especially for patients with the full range of BED patients with overweight issues. They additionally improve other eating disorder psychopathology and related general psychopathology like depression.  [23]

 

However, Cognitive– behavioral therapy (CBT) is the best established and preferred treatment for binge-eating disorder (BED) because:

 

·        It is cost effective, focused driven and involves a brief process

·        It is carried out through a pre-planned structure which makes it easy to deliver disseminate than the other comparatively longer therapies with multiple components.

·        It could be provided by a lot of psychotherapists than the more complicated and time-consuming therapies that need much more clinical expertise to carry out like the CBT-E and IPT.

Pharmacological treatment plays a significant role in the treatment of BED but data are still limited to small samples studies and short period of follow-ups. The bariatric surgery which is frequently recommended for overweight patients may as well help patients with Binge Eating Disorder but additional research is required to confirm the efficacy.

Combination of various treatment options concurrently does not show any significant improvement but developing chronological treatments, with more precise treatments for non-responders appears to yield much fruit. [24]

 

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