Psych Central

Treatment for Binge Eating

By Toby Goldsmith, M.D.
25 Nov 2001

Psychotherapy

Psychotherapy can involve a significant time and financial commitment. You are worth it! Particularly if you are struggling with other issues (sexual abuse, depression, substance use, relationship problems) psychotherapy can be very helpful in addressing not only your disordered eating, but also your overall emotional health and happiness.

  • Cognitive-behavioral therapy includes standard elements of behavioral treatment with a focus on identifying and altering dysfunctional thought patterns, attitudes and beliefs which may trigger and perpetuate binge eating disorder.

  • Interpersonal psychotherapy focuses on relationship difficulties, self-esteem, assertiveness, social skills and coping strategies.

Monitoring your intake of food is an important component, along with identifying triggers and developing alternative reactions to them. For some people with binge eating disorder, learning the size of a normal portion is an important part of the process.

Exercise is important. Remember that a person cannot binge eat while exercising. Exercise also is a wonderful way to relieve stress and anxiety! Learning how to eat again is part of the process. One must come to understand the sensations of hunger and satiety again.

Coming to accept one's larger body. Many binge eaters do not necessarily return to a BMI of 25 or less. Part of their psychotherapy entails helping them come to terms with their shape and regaining self-confidence. Because of their size, many people with binge eating disorder have avoided social situations. Therapy can help them assert themselves in those situations again.

Medication

Unlike depression or panic disorder, there is no specific medication that is used to treat binge eating disorder. First and foremost, the doctor will prescribe medication that will treat any medical problems that may be related to your weight. But there may be some medications that will decrease your desire to eat.

  • Antidepressants -- Many patients who also have depression may respond to antidepressants. Antidepressants like Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil) and the older antidepressant Desipramine (Norpramin) may help the binge eater have more control over her appetite and recognize when she is hungry.

  • Topiramate (Topamax) -- There is evidence that this anticonvulsant which is also used (off-lablel) in bipolar disorder helps control appetite and helps people lose weight. There is currently a controlled study evaluating the efficacy of this medication in binge eating disorder.

  • Weight loss medicines -- In studies of typical weight loss medicines (which are currently not on the market), people with binge eating disorder did lose weight. However, after the medication was stopped, their episodes of binge eating returned to pretreatment levels. It appears that these medicines are just not a panacea.

Self-Help Programs and Books

There are a variety of materials available. Some people are able to make significant gains in this way. Other people require the structure of groups or more supervised treatment in order to recover fully. Overeaters Anonymous, a 12-step program, is a group run by consumers that many people find valuable.

Last reviewed: By John M. Grohol, Psy.D. on 9 Oct 2013
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