Binge-eating disorder

Diagnosis

To diagnose binge-eating disorder, your healthcare professional may recommend a mental health evaluation. This includes talking about your feelings and eating habits with a mental health professional. Look for a mental health professional with expertise in treating eating disorders.

Your healthcare professional also may want you to have other tests to check for health problems that can be caused by binge-eating disorder. These may include high cholesterol, high blood pressure, heart problems, diabetes, GERD, poor nutrition, electrolyte imbalances and some sleep-related breathing disorders. Tests may include:

• A physical exam. With your permission, the exam may include getting your weight.
• Blood and urine tests.
• A visit with a sleep disorder specialist.

Treatment

The goal for treatment of binge-eating disorder is to have healthy, regular eating habits. Because binge eating often involves shame, poor body self-image and other negative emotions, treatment also addresses these and related mental health conditions, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating.

Treatment of binge-eating disorder may be done by a team of specialists. The team can include doctors and other healthcare professionals, mental health professionals, and dietitians, all with experience in eating disorders.

Talk therapy

Talk therapy, also called psychotherapy, can help you learn how to exchange unhealthy habits for healthy ones and reduce binge eating. Talk therapy may be in individual or group sessions. Examples of types of talk therapy that can help binge-eating disorder include:

• Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge eating, such as negative feelings about your body or a depressed mood. CBT also may give you a better sense of control over your behavior and help you gain healthy-eating patterns. A form of CBT called enhanced CBT (CBT-E) is specifically designed to treat eating disorders.
• Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating.
• Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.

Medications

Lisdexamfetamine dimesylate (Vyvanse) is a medicine for attention-deficit/hyperactivity disorder (ADHD). This is the first medicine approved by the U.S. Food and Drug Administration to treat moderate to severe binge-eating disorder, but only in adults. Because it's a stimulant, this medicine can be habit-forming and misused. Common side effects include dry mouth and problems sleeping, but more-serious side effects can happen.

Examples of other types of medicine that may help reduce symptoms of binge-eating disorder include certain medicines used to control seizures and certain antidepressants.

Lifestyle and home remedies

Along with getting professional help, you can take these self-care steps as part of your treatment plan:

• Stay with your treatment. Don't skip therapy sessions. If you have a meal plan, do your best to stay with it. Don't let setbacks keep you from continuing treatment.
• Stay away from dieting. Trying to diet can trigger more binge eating, leading to a vicious cycle that's hard to break.
• Eat regularly. For example, eat every 2 to 3 hours to try to break the restrict-then-binge cycle.
• Plan ahead for triggering situations. Being around certain foods can trigger eating binges for some people. Plan what to do when you're around foods that are tempting.
• Get the right nutrients. Just because you may be eating a lot during binges doesn't mean you're eating the kinds of food that have all the nutrients you need. Ask your healthcare professional if you need to adjust your diet to get essential vitamins and minerals.
• Stay connected. Don't isolate yourself from caring family members and friends who want to see you get healthy. Surround yourself with people who have your best interests at heart.
• Get active. Ask your healthcare professional what kind of physical activity is best for you.

Alternative medicine

Most dietary supplements and herbal products designed to lessen the appetite or aid in weight loss are not effective and may be misused by people with eating disorders. Natural doesn't always mean safe. Some weight-loss supplements or herbs can have serious side effects and dangerously interact with other medicines.

Before you use any dietary supplements or herbs, talk about the possible benefits and risks with your healthcare professional.

Coping and support

Living with an eating disorder can be difficult. Here are some tips to help you cope:

• Treat yourself with care. Living with and treating an eating disorder is very hard. Often other people don't understand what you're going through. Be kind to yourself, even if you're not successful with the treatment plan right away. Try to find communities where people are able to support your efforts.
• Identify situations that may trigger problem eating behavior. Identifying these triggers can help you develop a plan of action to deal with them.
• Look for positive role models. Find role models who don't accidentally add to your body dissatisfaction and pressure to eat in unhealthy ways. Remind yourself that the models, actors and influencers showcased in the media or on social media often don't represent healthy, realistic bodies.
• Look for a trusted relative or friend. Find someone you can talk with about what's going on.
• Find healthy ways to take care of yourself. Do something just for fun or to relax, such as yoga, meditation or a walk.
• Consider writing in a journal about your feelings and behaviors. Journaling can make you more aware of your feelings and actions, and how they're related.
• Visit trusted internet sites. Examples of organizations that offer support for people affected by eating disorders include the National Eating Disorders Association (NEDA). Families Empowered And Supporting Treatment for Eating Disorders (F.E.A.S.T.) offers support to families.

Get support

If you have binge-eating disorder, you and your family may find support groups helpful for encouragement, hope and advice on coping. Support group members can understand what you're going through because they've been there themselves. Ask your healthcare professional or mental health professional about finding a group in your area.

Preparing for your appointment

Here's some information to help you get ready for your appointment. Think about asking a family member or friend to go with you. Someone who goes with you can help you remember key points and, with your permission, give extra information about your situation.

What you can do

Before your appointment make a list of:

• Symptoms. Include any that may not seem related to the reason for your appointment.
• Key personal information. Include any major stresses or recent life changes.
• All medicines you're taking. Include any herbs, vitamins or other supplements, and the doses.
• A typical day's eating. Make a list of what you eat over a few days to help your healthcare professional or mental health professional understand your eating habits.
• Questions to ask your healthcare professional or mental health professional.

Questions to ask may include:

• What treatments are available, and which do you suggest?
• If medicine is a part of treatment, is a generic drug available?
• Are there any brochures or other printed material I can have? What websites do you recommend?

Feel free to ask other questions during your appointment.

What to expect from your doctor

Your healthcare professional or mental health professional is likely to ask you questions, such as:

• What does your typical daily food intake look like?
• Do you eat much larger than usual amounts of food or eat until you're uncomfortably full?
• Do you feel that your eating is out of control?
• Have you tried to lose weight? If so, how?
• Do you think about food often?
• Do you eat even when you're full or not hungry?
• Do you ever eat in secret?
• Do you feel depressed, ashamed or guilty about your eating?
• Do you ever make yourself vomit to get rid of food you've eaten?
• Are you concerned about your weight?
• Are you physically active? What types of physical activity or exercise do you do and how often?

Be ready to answer questions so you have time to discuss what's is most important to you.