Supporting a Loved one with Binge-eating Disorder
What is binge-eating?
A binge episode is defined as an experience of eating while feeling a loss of control -- as though you cannot stop, even if you wanted. The amount eaten is viewed as excessive, and the individual may eat faster than usual and/or beyond the point of physical comfort. A hallmark of a typical binge episode is that it occurs in secret. Distress in the form of shame, guilt, and secrecy often accompany binge episodes and can create conflict with loved ones.
What causes and maintains binge episodes?
The cause is hard to pinpoint and is likely multifaceted, but once the pattern is established, there is a typical ‘maintenance mechanism’ that involves thoughts, feelings and behavior. For one reason or another, people set rules about how to eat and what to eat. While these rules might be set up to help people think less about appearance or weight, they wind up thinking more about it. Increased dietary restraint in the form of strict dieting and/or rigid rules about eating can lead to binge eating. Individuals tend to feel guilt and shame about this cycle and it can often lead to decreased self-esteem. Sometimes, these episodes get cued by particular stressors, including arguments with loved ones, pressure at work, and life transitions.
Cognitive Behavioral Therapy for Binge-eating (CBT-E)
CBT-E is an evidence based, effective treatment for binge-eating disorder. It is a present-focused, strategy-based therapy. The primary goal of this treatment is to decrease or eliminate binge episodes. CBT-E focuses on helping the individual eat flexibly without restricting foods from their diet. The treatment focuses on both problematic behaviors and unhelpful, sometimes distorted beliefs that contribute to the binge eating cycle. CBT-E aims to stabilize weight but does not target weight loss. It does so by helping to normalize the eating pattern, strategizing about how to cope with stressors that lead to binge eating episodes, and challenging underlying problematic thoughts. Towards the end of treatment, a CBT-E therapist can help the individual think through the potential goal of weight loss and evaluate potential benefits and risk in maintaining a secure recovery from binge-eating disorder.
How can you help?
Talking about food using neutral language and avoiding discussions about weight can be helpful. Try not to point out what your loved one is and is not eating. Ask them how they want to feel supported and how you can encourage them as they undergo this treatment. As your loved one finds other ways of dealing with stress through therapy, help support them in utilizing these techniques.
To learn more about binge-eating disorder and ways you can help, you can check out the below resources:
The Feed Blog run by the Columbia Center for Eating Disorders
This blog was originally published by the Columbia Center for Eating Disorders on The Feed Blog.
