Binge-Eating Disorder DSM-5 307.51 (F50.8)
DSM-5 Category: Feeding and Eating Disorders
Of the multiple eating disorders, binge eating is typified by compulsive overeating. Suffers are helpless to control their behavior and will continue to eat long after their appetite has been sated; or when they are not even hungry. It is unique from other eating and food issues as there are no consequent episodes of purging (Halmi,2010). Too, there are no tell-tale weight parameters; victims may be within normal weight recommendations for their age and height; they may be slightly overweight or even obese.
The new DSM 5 shows that Binge-Eating Disorder (BED) has been given its own classification. In their estimation binge eating is recurring episodes of greater food intake than necessary in an abbreviated time frame and with an accompanying lack of self-control (American Psychiatric Association, 2013). Onset of the disorder has been traced to late adolescence or early adulthood (Treasure, 2014); and there is a co-morbidity of psychological and self-esteem matters; differentiating it from overeating as well. Finally, episodes of binge-eating may last several hours; or may occur multiple times throughout the day.
Symptoms of Binge-Eating Disorder
There is an array of emotional and/or behavioral symptoms associated with binge-eating disorder. They may include sentiments of self-loathing or personal shame in light of an inability to control eating habits; consuming unusually large amounts of food rapidly and even after one is uncomfortably full; refusing to eat in the company of others and being anxious and/or depressed. Without medical intervention persons with binge-eating disorder will often embrace the notion of dieting after an episode; only to return to the destructive eating patterns.
Diagnosing any type of eating disorder is particularly challenging because it is often accompanied by secrecy, denial and outright shame. When a patient seeks the expertise of a medical professional the physician should be on guard for a number of diagnostic features specific to binge-eating versus other forms of eating disorders. However, there is currently no diagnostic tool to confirm that a patient is suffering from BED. Therefore most physicians will make this diagnosis through a process of elimination of other similar disorders; and or by ruling out the existence of alternative physical ailments after which a referral to a mental health professional may be called for. These experts are trained in identifying this form of mental disease.
Psychologist-based Treatment for Binge-Eating Disorder
Now that the DSM 5 has formally classified binge eating as a separate disorder, a renewed focus on psychologist based treatments is expected. There are currently a variety of interventions for binge-eating disorder that have shown great promise in helping sufferers gain control of this problem. In particular, one study offers a breadth of empirical research to support the use of multiple psychology based therapies including dialectical behavior therapy (DBT), behavioral weight loss (BWL), cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT) (Iacovino, Gredysa, Altman, & Wilfley, 2012). There are other treatments that may warrant further study in the future but the aforementioned therapies are currently the most widely adopted.
Cognitive behavioral therapy is the most widely employed and reveal a greater success at curbing binging while improving the rate of abstinence. Too, a form of CBT labeled guided self help has been a cost-effective approach to binge eating. Interpersonal psychotherapy (IPT) helps the patient trace uncover the sociological root causes of binge eating while determining how and why they turned to this behavior as a coping mechanism.
Overall, psychologist based treatments are designed to target binge habits; promote regular eating patterns and moderate dietary restraint using a variety of problem-solving strategies. Therapists support patients by encouraging the development of realistic weight loss and eating control goals throughout the weight loss process while helping a patient get to the underlying emotional and psychological causes that predicated the self-destructive behavior. Finally, as noted in the DSM 5; comorbid comorbidities may run the gamut of a variety of disorders including hypertension, bipolar disease, personality disorders, and diabetes. In light of this it is imperative that a full medical workup precede psychotherapy treatment.
Pharmacological Treatment for Binge-Eating Disorder
There is a growing body of research to support pharmacotherapy as an alternative treatment for BED. Rationale for such includes the results of studies that reveal patients benefit from the dual application of both psychologist and pharmacological treatment and data that confirms certain classes of medication can help patients better control their behaviors (McElroy, Guerdjikova , Mori, & O’Melia, 2012). These medications include anticonvulsants, antidepressants and anti-obesity medication. It is believed that anticonvulsants such as Zonisamide suppress the appetite while selective serotonin reuptake inhibitor (SSRI) antidepressants such as Fluoxetine, Fluvoxamine can help reduce the incidence of binge eating. Anti-obesity medications are also known as weight loss drugs; the only one with FDA approval to date is Xenical; however there are many over-the-counter medications that promise to suppress appetites, regulate weight and alter caloric consumption. Although research is ongoing in the field; there is currently nothing to indicate the consequences of pharmacology interventions for binge-eating disorder long-term.
The prognosis for those who suffer from binge-eating disorder is actually very hopeful if the condition is recognized and addressed. Mental health professionals trained in the treatment of this disorder claim a high success rate. The most important component is a patient who is willing to follow the advice of a both the physician and psychologist while displaying an authentic commitment to changing one’s habits and behaviors. The greatest challenge will be to lose weight at a healthy pace while adopting new lifestyle habits.
Functioning with Binge-Eating Disorder
Binge-eating does not have to control an individual’s life. The first step in bringing this disorder under control is to seek medical and therapeutic help. A full physical work-up by a professional will set the stage for adopting healthier eating and exercise habits that will put a patient on the road to weight loss and better lifestyle choices. It is important to remember that weight loss takes time and keeping a positive mental outlook helps to guarantee success. To ensure the ability to function with this disorder over the long-term seek psychotherapeutic support that will help you recognize and avoid your compulsive eating triggers.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Halmi, K..(2010). Binge-Eating Disorder: Clinical foundations and treatment.The journal of clinical psychiatry. Vol. 71; Iss. 4.
Iacovino, J.; Gredysa, D.; Altman, M. & Wilfley, D. (2012). Psychological Treatments for Binge Eating Disorder. Curr Psychiatry Rep. 2012 August; 14(4): 432–446.
McElroy, S.; Guerdjikova , A. Mori, N. & O’Melia, A. (2012). Pharmacological management of binge eating disorder: current and emerging treatment options. Ther Clin Risk Manag; 8: 219–241.
Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry;68(7):714–723.
Treasure, J. (2014). The time is right to launch large-scale controlled treatment effectiveness studies of early-onset binge eating disorders and bulimia nervosa in student populations. Epidemiology and psychiatric sciences; Vol. 23, Iss. 1.
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