Therapy For Binge Eating Disorder: Steps Your Therapist Will Take To Help You Recover

Binge eating disorder (BED) was publicly acknowledged as an official diagnosis in the fifth publication of the Diagnostic and Statistical Manual of Mental Disorders [1, 2] by the American Psychiatric Association [3] in 2013. Binge eating is not just all about food. It involves similar sections of the brain that is connected with neurotransmitters and many other similar symptoms [4]. Series of research show that psychotherapy is more effective binge eating disorder treatment than medical or pharmacological interventions. [5, 6]

The purposes of psychological treatment of Binge eating disorder are to reduce the risk associated with binge eating, enhance positive weight gain and encourage healthy eating. [7] Psychological treatment is made up of a succession of therapeutic sessions in which a healthcare provider works with a patient individually, in a group of related patients or together with their family to assist patients to manage their binge eating issues.

The most frequently used psychotherapeutic treatments for binge eating disorder are:

Self-help

Self-help may be proposed to you as your first line of treatment. Your General Practitioner or other healthcare experts may guide you on how to go about it. If you have a minor binge eating disorder issue, self help may be able to help you to resolve the issue and get back to normal. In some instances, you may not require any additional form of treatment to overcome your issue with binge eating. If you have a more serious and unrelenting binge eating disorder, you may be referred to go for the following psychological treatments: [8]

·        Cognitive analytic therapy (CAT)

·        Cognitive behaviour therapy for binge eating disorder (CBT-BED)

·        Interpersonal psychotherapy (IPT)

·        Modified dialectical behaviour therapy (DBT).

Cognitive analytic therapy (CAT)

Cognitive analytic therapy is a psychological treatment for BED where a therapist works with binge eaters to assist them to make constructive alterations in their lives, and improve their well-being. CAT therapy involves investigations of involuntary motivations that lead to binge eating. [8]

Cognitive behavioral therapy (CBT) - (CBT-BED) is an adapted form of CBT

Cognitive behaviour therapy (CBT) is a psychological therapy that is structured to assist individuals make connections between their thoughts, feelings, actions, their present or past symptoms and to re-examine their views and beliefs. CBT may assist individuals to manage with problems that can activate binge-eating episodes, like negative feelings about self or depression. It can also help you to control your behavior and normalize your eating patterns. [8,9]

CBT ought to incorporate at least one of the following:

(1) Examination of thoughts, feelings or behaviour regarding BED symptom;

(2) Being assisted to make use of various ways of dealing with the symptom;

(3) Stress reduction

Interpersonal psychotherapy (IPT)

Interpersonal psychotherapy (IPT) is a form of therapy that centers on helping you to identify and tackle your relationships problems with other people. The purpose is to perk up your interpersonal skills which include the way to relate with people like family members, friends and colleagues. This may minimize binge eating that's set off by poor relationships and bad communication skills. [8, 9]

Dialectical behaviour therapy (DBT):

This is a psychological therapy that can assist binge eaters to learn behavioral skills to assist them to cope with stress, normalize their emotions and boost their relationships with others, all of which in turn curb the urge to binge eat. This is a composite and rigorous psychological treatment that was formally structured for individuals with borderline personality disorder but a simplified and modified version has been created for patients of Binge eating disorder.  It basically involves steps that help binge eater to boost their ability to control their emotions and normally carried out through 20 group sessions of two hours every week.  [8]

What to expect from a BED counselor or psychotherapist

There is currently no legislation that specifies the level of training a counselor or therapist must have before treating people with BED. Nevertheless, the National Institute for Health and Care Excellence has formulated a collection of clinical guidelines that provides advice on the forms of psychological treatment, medication and services available BED. [9]

Steps taken by therapists to help binger eaters recover

Step 1:

It is highly essential to start the treatment well. This is especially so because research found that the degree of success attained early in treatment is a great indication of how successful the whole treatment would be. [10]. This first step of intensive treatment is structured to achieve first therapeutic impetus and is composed of roughly 8 sessions conducted two times every 4 weeks. This first treatment step is aims to obtain a custom-made formulation using the individuals’ specific case to offer instruction about the treatment and the disorder, and to initiate and execute two significant processes: mutual “weekly weight checking” and “standard eating.” The improvements recorded in this first stage of treatment form the bases on which other alterations are structured. [11]

Step 2:

This step is succinct but very significant. It is an intermediary stage that is commonly completed through two appointments once a week for two weeks. At this stage, you continue with what you were introduce into in the first step and most importantly evaluate with your therapist how far you have done so far. The main intention is to discover issues that still need to be attended to as well as discover anything that is posing impediment to change.

Given the result of the assessment, a revision of the formulated treatment procedure may be introduced if deemed essential. At this stage, the treatment plan of stage three is structured. The assessment is aimed to achieve different intentions. If the assessment shows that the patients are improving, they are commended and further reinforced to make more positive changes.  If the opposite is the case, the reason for the poor performance should be understood and handled. If the reason for poor performance is any of the following; clinical perfectionism, low self-esteem or relationship difficulties, it shows that the individual needs a more extensive treatment version. [11]

Step 3:

This step is the most essential part of the treatment. The purpose of this step of treatment is to tackle what is causing the individual to engage in binge eating disorder. The method to be used and the order of tackling these issues depend on the part played by that factor in sustaining the psychopathology of the patient. It is commonly completed within 8 weeks sessions. [12, 11]

The following are issues that are usually addressed in step 3:

·        Boosting the significance of other area s for self-appraisal

·        Tackling body inspection and evasion

·        Tackling the feeling of fatness

·        Investigating the origins of overvaluation

·        Tackling Dietary regulations

·        Handling event-depended alterations in eating pattern

·        Dealing with the issues of Clinical Perfectionism, Low Self-esteem, and Interpersonal issues [13]

o   Dealing with clinical perfectionism-The psychopathology of clinical perfectionism is related to that of eating disorder.[14]

o   Tackling of issues that relate to low self-esteem

o   Taking care of what is causing interpersonal issues to the patient. [11]

 

Step four:

This is the last step that your therapist will take. It endures that your treatment is conclusive. At this stage the main focus is to ensure that the successes that have been made during the course of the treatment are maintained to minimize the possibility of the patient going back to the old habit. It basically involves three appointments roughly two weeks spaced out. At this stage, the patient is encouraged to stop monitoring the self and start weighing at home in preparation for the termination of the treatment.

To increase the possibility of the patient maintaining the habit cultivated during the training period, the therapist and patient mutually formulated a customized structure to be followed by the patient in the subsequent few months till when the patient will return for a post treatment assessment which normally fall within 20 weeks after the treatment or more.

Basically, this appointment involves re-checking of the patient’s body, training for food avoidance, and maybe additional training on problem solving. Additionally, patients are advised to keep up with their efforts to create fresh interests and activities. [11]