Binge eating disorder is the most common eating disorder in the U.S., with estimates that it impacts 3.5% of women and 2% of men.[i] Unfortunately, binge eating disorder is commonly misunderstood and many individuals who are struggling do not seek treatment. In fact, binge eating disorder wasn’t even a formal diagnosis until it was recently added in the DSM-5.
It’s important to note that if you are a therapist who is not trained in working with eating disorders, that you reach out for supervision, consultation, and/or clinical training on the topic. If you are not interested in working with this population, it’s critical that you refer the individual out to a specialist. Eating disorders are complex mental illnesses, which can be deadly. Thus, it is crucial that psychotherapists treating eating disorders are knowledgeable about evidence-based treatments.
The following are three tips for helping patients with binge eating disorder to recover and go on to live meaningful and productive lives.
1. Help them to make peace with their binging.
Patients that I’ve worked with who are struggling with binge eating disorder often report feeling a sense of shame, embarrassment and guilt, surrounding their binging. Thus, a crucial first step is to provide them with some psychoeducation surrounding how binging is often a natural and adaptive bodily response to real or perceived deprivation. Our bodies evolved to ensure our survival as a species and it makes sense that physical and/or emotional restriction can trigger subsequent binging episodes.
Additionally, it’s helpful to share with clients that binging is helping them to get their needs met. Binging behaviors may be a way that a patient is coping with past trauma, unpleasant emotions or a history of food insecurity. It’s important for clients to be compassionate with themselves and to work to explore their binging from a place of curiosity and nonjudgment. “Beating themselves up” for binging will likely only serve to perpetuate the behavior and cause them to feel even worse.
2. Explore their triggers and the function of their binging.
I also help my patients to explore the situations and thoughts that often trigger their binging. This technique can be a helpful way for them to begin to see the function of their binging and to work to come up with some more life-affirming ways of meeting their needs.
I express to clients that binging is a way that they are meeting their needs-and that their needs are valid. It is important for them to come up with some healthy coping strategies and other ways to get their needs met, which support their recovery.
Additionally, it’s important that they work to be compassionate with themselves throughout the recovery process. The healing process is typically not linear and can take time. However, it’s definitely well-worth the effort.
3. Support a non-diet and weight-neutral approach.
Dieting, a focus on weight loss, and food rules, all serve to perpetuate binge eating disorder. Therefore, as a clinician and recovery coach, I work from a health at every size and intuitive eating framework.
In my viewpoint, it’s simply unethical to treat patients with binge eating disorder with a diet or “weight-loss” approach. There is no research to suggest that this approach is an effective long-term solution and there is evidence that dieting and the pursuit of weight-loss can be incredibly harmful to those in recovery.
I express to my clients that it is natural for them to grieve the false beliefs that the diet-industry works to perpetuate. However, ultimately when they are able to give up the scale and “food rules,” they often express feeling a great deal of relief.
There is Hope
Full recovery from binge eating disorder is completely possible. I’ve watched my clients make amazing changes in their lives and discover a newfound sense of empowerment and freedom. It’s so important to express to our clients that there is hope for recovery.
Lastly, it’s so important to use a team approach when treating clients with eating disorders. A treatment team could include a therapist, a registered dietitian, a psychiatrist, a physician and a recovery coach. Eating disorders are complex and multifaceted illnesses and working with a multidisciplinary team is recommended.
With access to proper treatment and support, individuals with binge eating disorder can recover and lead productive and meaningful lives.
[i] Binge eating disorder. (n.d.) Retrieved from: https://www.nationaleatingdisorders.org/binge-eating-disorder