Binge eating disorder can be deadly

By Jamie Long, Psy.D.
September 1, 2009



Research suggests that eating disorders are the deadliest of all mental health disorders. Currently, Binge Eating Disorder (BED) or compulsive overeating is not officially a diagnostic category listed in the DSM-IV-TR. Therefore, patients struggling with binge eating disorder or “BED” may typically be classified under Eating Disorder NOS, which is the most commonly diagnosed eating disorder.

BED is a devastating psychological disease which can often result in obesity. According to CBS News, obesity affects more than 26 percent of Americans. It is important to note that not all patients diagnosed with a binge eating disorder are obese and some patients may be of normal weight or only slightly overweight.

BED is characterized by recurrent binge eating without the regular use of compensatory behaviors to counteract the binge and occurs almost twice as often in women. As a psychologist, one can recognize a patient struggling with binge eating disorder if the patient reports:

  • Eating past the point of becoming uncomfortably full
  • Binging accompanied with a feeling of “frenzy” or being out of control
  • Guilt and shame after binge eating
  • Often eating in the absence of others

Binge Eating Disorder left untreated can be fatal. BED can potentially lead to heart disease, diabetes, high blood pressure, high cholesterol and other medical issues. Some research suggests that BED is as costly to treat as Obsessive Compulsive Disorder. BED can be considered an addictive, destructive behavioral cycle. Treatment by a skilled psychologist or other clinician is crucial.

Another critical factor when considering treatment is recommending an appropriate level of care. The intensity of the disorder indicates the level of care from which the patient will most benefit. Some patients may respond to treatment with an outpatient therapist and/or a support group. Others may require a higher level of care such as an intensive outpatient program, a day program or partial hospitalization, residential or inpatient hospitalization.

Due to the complex nature of BED, a “treatment team” approach may best benefit the individual struggling with this disorder. If your client struggles with a severe or complex binge eating disorder, I strongly recommend working with other professionals. This can easily be accomplished on an outpatient level as well as an inpatient level of care.

A comprehensive treatment team could consist of: a psychologist, a family therapist, a nutritionist, a psychiatrist and a primary care physician. There is debate and difference of opinion about the best treatment approach for binge eating disorders. Therefore, I recommend considering a treatment approach that will best match the individual needs of your client.

Recommended treatment modalities:

  • Cognitive Behavioral Therapy
  • Insight-oriented therapies
  • Group Therapy
  • Nutritional Therapy
  • Medical Consultation

A psychologist who is not trained in treatment of binge eating disorder could consider referring a patient to an eating disorder specialist. If you are a psychologist interested in treating this common eating disorder, you may want to obtain specialized training. One may obtain training via supervision by a seasoned eating disorder specialist or by attending an eating disorder educational seminar (e.g., CEU class, conference, etc.). If you are a doctoral candidate or student, consider obtaining training during your practicum or internship year. Ideally, training at an eating disorder facility would prepare a trainee well for treating BED.

In an eating disorder facility, you are likely to work with other disciplines that will offer their perspective on recovery and help educate you to a new treatment approach of BED. If training in an eating disorder facility is not an option, comparable training exposure could be obtained in a variety of other settings. For example, university counseling centers often treat eating disorders. In fact, eating disorders are the third most commonly treated mental issue in universities. Hospitals or community mental health facilities also often treat binge eating disorders.

Eating disorders rarely travel alone meaning that they often are accompanied with a co-occurring mental disorder. Psychologists may be skilled in treating a co-morbid disorder, thus making them a good match for the binge eating patient. Common associated disorders with BED are:

If you are skilled in treating in one or more of the above psychological issues, you may be well on your way to effectively treating an individual struggling with binge eating. A clinician skilled in both treatment of eating disorders and trauma, for example, will be attractive to a client searching for an effective therapist.

In conclusion, Binge Eating Disorder is a catastrophic and life threatening psychological illness. The disease affects many Americans and there is a significant need for skilled specialists to treat this disorder.

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Jamie Long, Psy.D., is a licensed clinical psychologist practicing in Fort Lauderdale, Fla. She has specialty experience in the treatment of eating disorders, depression, anxiety, trauma, and other associated disorders. She is also on the staff at the Renfrew Center in Coconut Creek, Fla. She may be reached at jamielong@mail.com.

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