This article originally appeared in The National Psychologist, February 4, 2020
Binge eating disorder (BED) is the most common eating disorder among adults in the U.S. . More than 8% of American adults meet some or all the criteria for binge eating disorder at some point in life. That’s more than all other eating disorders combined.
Despite the need for treatment, binge eating disorder is very resistant to therapy. Cognitive-behavioral therapy (CBT) has proved to be the most effective form of treatment. But, even that approach has demonstrated remission rates of only 40 percent to 60 percent. This means about half who seek CBT treatment for BED do not benefit.
CBT and Binge Eating
CBT emphasizes interventions for binge eating that focus on stopping unwanted behavior. Yet, research has shown dieting to be a causal factor in the development of binge eating disorder. For a patient, interventions to stop the behavior may feel like restrictive eating. This may play a role in limiting the effectiveness of CBT.
The causes of binge eating are assumed to be a mix of social, psychological, and physical factors. These create a predisposition to the behavior. Binge episodes are then triggered by various emotional experiences that cause distress. Food is a way of coping with those negative feelings.
But, if we view binge eating as a response to an emotional threat, the focus can shift from the behavior to the cause. Identifying this threat can help the clinician use strategies to address it, reduce it, and end it. Thus, rendering the need for a response unnecessary.
My Approach to Binge Eating Disorder Treatment
I’ve spent the past 15 years working with many emotional eaters. I find the perception of being controlled is a root cause of a reactive binge response. Especially as it applies to dieting pressure. It serves as a way of rejecting that control.
Although this behavior is unwanted, it can feel almost impossible to resist. I help my patients challenge their perceptions of this belief. With support, they have been able to stop emotional eating in a very short time.
The core to this approach is understanding acceptance and self-determination are in tension with each other.
To belong, we adapt to the wishes of others, giving up a degree of autonomy. To be autonomous, we act according to our wishes, without regard to the judgment of others. We try to find an acceptable balance between them while still satisfying each need.
The social pressure to diet is emotionally compelling as a way to feel accepted by others. But, dieting usually requires self-denial. This creates an imbalance that favors belonging at the expense of autonomy.
Such a tradeoff will always feel unfair. Especially when weight loss results are affected after repeated episodes of emotional eating. This creates a need to restore balance by rejecting the perceived control. As a result, we decide to eat those forbidden foods in defiance.
Binge Eating and Control
Understanding binge eating as a way to correct imbalances between emotional needs allows the therapist to identify a cause-and-effect relationship so they can address it in a more effective way. By ending the idea of control and supporting patient autonomy, the unwanted response becomes needless. As a result, there’s nothing to rebel against.
The focus of sessions shifts from suppressing the binge eating impulse to regain a sense of having control over choices. Clients start viewing all foods as “on the menu” and then following their preferences. So, patients feel free to choose what they want.
Knowing that they can have anything they want eliminates the urge to want everything. I’ve found this approach results in more successful, sustainable outcomes in a shorter time.
Begin Binge Eating Disorder Treatment in Chicago, IL
Binge eating isn’t something you should have to tackle alone. Our caring therapists can help you change your relationship with food from our Chicago, IL-based practice. To start treatment in Chicago or via online therapy, follow these steps:
- Contact Equipoise Teletherapy
- Meet with a caring therapist
- Start enjoying your relationship with food
Other Services Offered at Equipoise Teletherapy
Binge eating disorder treatment is not the only service offered at our Chicago, IL-based teletherapy practice. Other mental health services offered include therapy for emotional eating, depression treatment, and anxiety treatment. We also offer counseling for addiction, nutrition counseling, and counseling for unwanted behaviors. Learn more about our practice, or read our blog to learn more!