Binge Eating Disorder

Treatment Overview

Treatment for binge eating disorder includes counselling and sometimes medicine. Goals in treating binge eating often include:

• Reducing your number of eating binges.
• Developing healthy eating and exercise habits.
• Dealing with shame or guilt about your eating disorder.
• Developing a healthy view of yourself and your body.
• Getting treatment for other conditions that you also might have, such as depression, anxiety, or health problems related to being overweight.

Most people with binge eating disorder need treatment, but many people who have an eating disorder try to keep it secret or deny that they have a problem. Some might join weight management programs to lose weight but do not seek treatment for binging or for mental health problems related to the condition. It often is a family member or friend who convinces the person to seek treatment.

If you think that you or someone you know might have an eating disorder, talk to your doctor. Signs of an eating disorder that needs treatment include binges, concern or embarrassment about eating behaviours, secretive eating habits, preoccupation with weight or body image, or an unhealthy body weight because of eating problems.

Counselling

Several types of counselling can be useful in treating eating disorders.

• Cognitive-behavioural therapy (CBT). This type of therapy can help you control the urge to binge, especially when combined with nutritional counselling and a weight-reduction program.¹ CBT often deals with learning how to eat a balanced diet, because this is important to recovery. Developing more regular eating habits can help reduce binging.
• Interpersonal therapy. This type of therapy can help you examine any connection between your relationships and your symptoms of binge eating.
• Dialectical behaviour therapy. This approach focuses on helping you manage emotions. By coping better with life's challenges and your emotions, the binging behaviours may decrease. This type of therapy helps reduce binging that is related to stress.⁵
• Group counselling. This can be used to enhance individual therapy. Speaking with other people who have this condition often can be helpful.
• Family therapy. Sometimes family members unknowingly interfere with a loved one's recovery. Family therapy can help family members learn about the disorder, get support, and eventually focus on dealing with other family issues. Family therapy often is used as a part of treatment for teenagers who have binge eating disorder. This type of therapy can help reduce binging that is triggered by stress, tension, or relationship problems.⁴

Medicine

Antidepressants sometimes are used in the treatment of binge eating disorder. Treatment with antidepressants can help reduce episodes of binging. It is useful in treating the depression that often occurs along with binge eating disorder.⁶

Sibutramine (Meridia) is a medicine that reduces appetite. It appears to be effective in helping people with binge eating disorder. Combined with a low-calorie diet, this drug can help people lose weight, and it also might help people stop binging.⁷

Topiramate (Topamax), which is a medicine used to treat seizures, is sometimes used to reduce the urge to binge and to promote weight loss in those who are overweight because of binge eating disorder.⁸

What To Think About

Medicines and counselling may help you quit binging and lose excess weight. But this will take some time and patience. Some people find that they still have trouble losing excess weight, even after they stop binging. Talk to your doctor about what results are realistic to expect from treatment.

Advisories. Health Canada and the U.S. Food and Drug Administration (FDA) have issued advisories to patients, families, and health professionals to closely watch for warning signs of suicide in children and adults who are taking antidepressants. This is especially important at the beginning of treatment or when doses are changed.

Health Canada and the FDA also advise that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviours in children, who might be less able to control their impulsivity as much as adults and therefore might be at greater risk for suicidal impulses. It is not recommended that people taking antidepressants stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. If concerns arise, contact a health professional.

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Author:	Jeannette Curtis Douglas Dana	Last Updated: November 16, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine W. Stewart Agras, MD - Psychiatry Andrew Swan, MD, CCFP, FCFP - Family Medicine
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