Everyone overindulges in food from time to time, but people with binge eating disorder regularly overeat large amounts of food quickly with no control over what or how much they eat. These binge eating episodes happen at least once a week for at least three months.
There is no cure for binge eating disorder, and for many, it’s a chronic (long-term) condition. However, effective treatment options can help you manage the condition. The goal of treatment is to change any eating habits, thoughts, and feelings that play a part in your binge eating.
Psychotherapy is the main form of treatment. Some people use medication to control the condition, as well as behavioral weight loss strategies or intuitive eating techniques.
Although relapsing does occur at times, most people get better or are better able to manage binge eating disorder with treatment.
The first-line treatment for binge eating disorder is typically therapy. A few types of therapy are considered effective in managing binge eating disorder, including cognitive behavioral therapy, interpersonal therapy, and dialectical behavioral therapy.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) focuses on helping people recognize their thoughts and feelings and becoming aware of how these impact behaviors. CBT encourages people to create plans for behavior change. CBT for binge eating disorder involves creating healthful eating routines, becoming more mindful of eating habits, and learning techniques for self-control and problem-solving.
Interpersonal Therapy
Interpersonal therapy for binge eating disorder involves an exploration of interpersonal stressors and triggers. The goal of the therapy is to learn to recognize interpersonal triggers for binging, manage issues like decreased self-esteem and perfectionism, and make positive modifications in your relationships with other people.
Dialectical Behavioral Therapy (DBT)
Dialectical behavioral therapy (DBT) helps people develop self-regulation skills when it comes to binge eating. You might focus on becoming more mindful of your binge eating triggers and learn emotional regulation skills and other practical approaches to manage binge behaviors.
People with binge eating disorder sometimes benefit from medications that help manage hunger and urges as well as treat mental health issues that contribute to their binge eating. Prescription medications are typically used after therapy has been tried and may be used in conjunction with therapy.
Vyvanse
Vyvanse (lisdexamfetamine) is the first and only medication approved by the United States Food and Drug Administration (FDA) to treat binge eating disorder. It’s a central nervous system stimulant medication that can suppress appetite.
Side effects include dry mouth, trouble sleeping, racing heart, jitters, headaches, and constipation. Vyvanse can be habit-forming and may be abused, so it’s important to take this medication under the careful watch of a healthcare provider.
Antidepressants
Antidepressants are often used off-label (meaning they’re used to treat a condition for which they’re not officially FDA-approved) to treat binge eating disorder. In fact, the American Psychiatric Association recommended antidepressants to treat binge eating disorder.
Selective serotonin reuptake inhibitors (SSRIs) are usually the type of antidepressant recommended. SSRIs include Zoloft (sertraline), Prozac (fluoxetine), Lexapro (escitalopram), Celexa (citalopram), and Luvox (fluvoxamine).
Side effects of antidepressants include nausea, weight gain, low sex drive, and fatigue.
Anti-Seizure Medications
Anti-seizure medications are sometimes used off-label to treat binge eating disorder. Topiramate (sold under brand names like Eprontia and Topamax) is the most commonly prescribed. It’s approved to treat seizures and prevent migraine but also may be helpful for people with binge eating disorder because the drug decreases appetite.
Side effects of topiramate can include numbness in extremities, nausea, fatigue, dizziness, vision issues, memory issues, and anxiety.
Behavioral weight loss involves strategies aimed at helping people with binge eating disorder experience fewer episodes of binging and lose weight. Techniques employed include increasing physical activities, learning about nutrition, focusing on nutritious foods, and reducing caloric intake.
While this method may be helpful to some people, others find the focus on weight loss and calorie restriction unhelpful. Some people find the treatment approach leads to body image issues and stress, both of which may trigger further binging episodes.
Some people find that taking a more intuitive approach to eating can help manage their binge eating disorder.
Intuitive eating involves becoming more attuned to your hunger signals, only eating when you feel hungry and stopping when you are full. For many, learning to become more in tune with their true hunger helps decrease binging episodes.
Intuitive eating also embraces body positivity—feeling healthy and happy in your body rather than focusing on a number on the scale.
Intuitive eating can decrease stress around food, eating, and body image, which can be helpful in treatment.
Binge eating disorder isn’t life-threatening on its own, but it can lead to other medical conditions that may be serious.
If left untreated, binge eating disorder can lead to excessive weight gain, metabolic issues like type 2 diabetes, heart disease, and even certain cancers. People with the condition are more likely to experience depression, anxiety, and suicidal ideation. Issues with sleep, digestion, and joint or muscle pain are also possible.
Untreated binge eating disorder can also lead to other eating disorders, like bulimia and anorexia. Some people with binge eating disorder may also abuse substances like drugs and alcohol.
The condition can make it hard to function well in social situations and day-to-day life, but treatment can help. Some people can stay symptom-free after treatment. Others may relapse at times but improve again with treatment.
Binge eating disorder can be a life-long journey for many people, and support is key.
Support may come from a licensed therapist or counselor, a healthcare provider, friends, family, or even others who live with binge eating disorder. The most holistic approach to treatment involves a team of medical professionals, including a primary care provider, dietitian, counselor, psychiatrist, and your support system.
Lifestyle modifications aren’t usually enough to treat the condition, but a healthy lifestyle can help you maintain positive eating habits and avoid relapses. Lifestyle tips for binge eating disorder include:
- Engage in regular exercise or movement
- Manage stress
- Eat regularly and don’t skip meals
- Eat well-balanced, satisfying meals
- Recognize binge eating triggers
- Recognize signs you may be relapsing
