In my last post, I discussed the addition of binge eating disorder (BED) to the recently revised fifth edition of the Diagnostic and Statistical Manual (DSM), the go-to resource mental health professionals use to diagnose and treat mental disorders. The eating disorders treatment community is hopeful that this new recognition of BED as a valid, diagnosable illness will help the general public better understand the seriousness of BED and seek help as appropriate, while the health care professionals from whom individuals seek help will be able to better identify the illness and provide — or refer patients to — effective treatment.
As a starting point for raising BED awareness among the health care community and general public alike, below are four important facts about BED.
1. There is a cultural tendency to minimize BED. “Binge eating” has seemingly become a popular culture catchphrase of sorts used to describe occasional overeating, even though BED is a very real, serious condition. People with BED feel something they do not want to feel — anger, sadness, boredom, stress or guilt — and they have learned to cover up those feelings through food. Binge eating behaviors can sometimes be accompanied by compensatory behaviors, including vomiting, over-exercise or the use of laxatives or diuretics; however, these behaviors are generally insufficient to wholly offset the calories consumed during the bingeing sessions. In addition, BED is commonly accompanied by an unhealthy preoccupation with body image and size. Despite this seriousness, the general public tends to minimize BED as a bad habit or something that can be fixed by simply eating less or losing weight.
2. BED is commonly misdiagnosed. Due to misunderstanding of BED by the general public and health care community alike, individuals struggling with BED are commonly (and inaccurately) referred to weight-loss programs/clinics or gastric bypass surgeons to address their “weight issue.” In reality, they need BED treatment to address the biological/psychological/sociological issues underlying their unhealthy relationship with food, eating and body image. Similarly, BED is often overlooked in individuals who are of normal weight due to the widespread misperception that sufferers of BED must be overweight.
3. BED can have serious medical and psychiatric comorbid conditions. Eating disorders are complex illnesses that often present alongside serious medical and psychiatric conditions. In many cases of eating disorders comorbidities, the two diagnoses are intertwined in some way, with one illness having contributed to the development of the other condition. BED is commonly associated with medical complications including obesity, high cholesterol, high blood pressure, heart disease and Type 2 diabetes. Common psychiatric complications of BED include anxiety, depression, bipolar disorder and substance abuse. Interestingly, while health plans routinely cover treatment for these medical complications associated with BED, many health plans do not yet cover comprehensive treatment for the eating disorder itself.
4. Specialized treatment for BED is available. The individuals suffering from BED have developed behavior patterns that adversely impact their physical and emotional health, personal relationships and professional, educational or familial obligations. Cognitive behavioral therapy (CBT) is often used to help patients identify underlying causes for their binge eating and learn new habits, while values identification can also help patients align their behaviors and relationship with food with the things in life that are important to them. Due to the medical and psychiatric comorbidities that commonly present alongside BED, many eating disorders treatment programs will offer some degree of medical support to help patients restore physical health in addition to a therapeutic program to address emotional and socio-cultural elements of the illness. Nutrition education and supervised meals are also important components of BED treatment and recovery, helping patients to understand what a balanced diet looks like, how to properly plate and portion food and enjoy the social aspect of meals.
Visit EatingRecoveryCenter.com to learn more about qualified treatment options for anorexia, bulimia, binge eating disorder and eating disorder not otherwise specified.
For more by Kenneth L. Weiner, M.D., FAED, CEDS, click here.
For more on eating disorders, click here.
If you’re struggling with an eating disorder, call the National Eating Disorders helpline at 1-800-931-2237.