specialists are more likely first to treat weight control
issues with drugs, diet, and nutrition counseling in
order to reduce the health risks of obesity-related dis-
eases. Although there are no drugs specifically
approved by the United States Food and Drug
Administration for treating binge-eating disorder,
the FDA has approved selective serotonin reuptake
inhibitors (SSRIs) such as fluoxetine (Prozac) and
sertraline (Zoloft) for the treatment of bulimia. Buli-
mia also involves binge-eating behavior. These medi-
cations increase serotonin levels in the brain and are
thought to affect the body’s sense of fullness. They are
used whether or not the patient shows signs of depres-
sion. SSRIs are often prescribed for people with binge-
eating disorder. Appetitive suppressants are also
sometimes prescribed to help control binge eating.
Treatment is most successful when group therapy
occurs in conjunction with psychotherapy (see Thera-
pies below).Nutrition/Dietetic concerns
People with binge-eating disorder understand that
their eating pattern is abnormal and unhealthy. Nutri-
tion counseling and meal planning can help bring
weight under control, but they do not address the
inability to control the impulse to binge. Nutrition
counseling needs to be part of a broader treatment
program that includes psychotherapy and possibly
drug therapy.Therapy
Psychologists are more likely to approach the
problem of binge eating by using therapy that helps
the individual change his or her behavior and by treat-
ing emotional and psychological problems that cause
it. For them, treating obesity is secondary to treating
the behavior and the thought patterns that cause it.
Psychologists tend to think that once the individual
understands and can control bingeing behavior, obe-
sity will be easier to treat.
Some types of psychotherapy that have been suc-
cessful in treating people with binge-eating disorder
are listed below.
Cognitive behavior therapy (CBT) is designed to
confront and then change the individual’s thoughts
and feelings about his or her body and behaviors
toward food, but it does not address why those
thoughts or feelings exist. Strategies to maintain
self-control may be explored. This therapy is rela-
tively short-term.
Interpersonal therapy is short-term therapy that
helps the individual identify specific issues and prob-lems in relationships. The individual may be asked to
look at his or her family and personal history to try
to recognize problem areas and to work toward
resolving them.
Dialectical behavior therapy consists of structured
private and group sessions in which the therapist
and patient(s) work at reducing behaviors that inter-
fere with quality of live, finding alternate solutions to
current problem situations, and learning to regulate
emotions.
Family therapy is helpful in treating children who are
binge eaters. It teaches strategies to reduce conflict,
disorder, and stress that may be factors in triggering
binge eating.
Some people with binge-eating disorder find self-
help groups and structured weight-loss programs
useful, while others do not.Prognosis
There is no clear prognosis for binge eating disor-
der. Since stress often triggers bingeing, relapses are
apt to occur in response to stressful life events. Some
individuals find that simply seeking help improves
their control over binge eating. For example, some
studies have found that receiving a placebo is as effec-
tive as receiving medication. This is one reason why
some parts of the medical community refuse to accept
binge eating as a genuine disorder. Many studies
are underway to test different approaches to treating
binge eating. Individuals interested in participating
in a clinical trial at no cost can find a list of
studies currently enrolling volunteers at<http://www
.clinicaltrials.gov>Prevention
Since binge eating is difficult to detect, it is also
difficult to prevent. Some prevention strategies are
listed below.
Parent should not obsess about their weight, appear-
ance, and diet in front of their children.
Do not tease people about their body shapes or
compare them to others.
Make it clear that family members are loved and
accepted as they are.
Try to eat meals together as a family whenever pos-
sible; avoid eating alone.
Avoid using food for comfort in times of stress.
Monitoring negative self-talk; practice positive self-
talk
Spend time doing something enjoyable every day
Stay busy, but not overly busyBinge eating