Binge Eating Disorder—Which Afflicts More Than Anorexia Or Bulimia Combined—Gets New Treatment Guidelines

Topline

Although binge eating disorder affects millions of Americans—considerably more than bulimia or anorexia—very few seek treatment, though updated assessment and treatment guidelines aim to fix that.

Key Facts

News Peg

The American Psychiatric Association updated its guidelines for eating disorder treatment and assessment. It recommends psychiatric assessment should include updated bloodwork, basic physical and psychosocial evaluations, a complete metabolic panel and any other individual-based assessment. It also offered specific recommendations for BED, anorexia and bulimia nervosa. For BED patients, the APA suggests treatment with either individual or group disorder-based cognitive behavioral therapy. It also advises those who seek treatment with medication to take antidepressants or lisdexamfetamine if psychotherapy alone doesn’t work.

Crucial Quote

“Many patients who enter treatment tell me that they don’t belong because they are not ‘small enough’ or aren’t actively trying to lose weight,” Dr. Nicole Garber, the chief medical officer for the eating disorder treatment program Alsana, told Forbes. “Most people with an eating disorder have normal-size to larger-size bodies. This stereotype can prevent people from seeking care and treatment because, to them, they don’t match the image of those with an eating disorder.”

Characteristics Of Binge Eating Disorder

Binge eating occurs at least once a week over the span of at least three months. According to the National Eating Disorders Association, episodes are associated with three or more of the following: eating until uncomfortably full, feeling guilty, disgusted or depressed afterwards, eating faster than normal, eating a lot of food even when the feeling of hunger isn’t present and eating alone because of the embarrassment of how much food is consumed. Signs of BED include hoarding food in odd places, the fear of eating in public, frequent body checking for appearance changes, stomach cramps or other gastrointestinal issues (i.e. acid reflux, constipation, etc.), weight fluctuations and the development of food rituals, like excessive chewing or only eating a specific food group. BED is diagnosed via questions on medical history and symptoms from a physician—bloodwork, urine samples or tests for other health problems may be conducted.

Treatment Options

According to the Office on Women’s Health, treatment plans for BED include medication, nutritional counseling, psychotherapy or a combination of the three. Doctors may prescribe either antidepressants or lisdexamfetamine (a class of central nervous system medications, which alters the amount of natural substances in the brain). A registered dietitian can provide nutritional counseling via a detailed meal plan, weight trend monitoring, assistance with grocery shopping and an assessment, which analyzes each individual’s needs. Psychotherapy is used to help patients change any harmful behaviors or thoughts, and focuses on how feelings impact what the patient does (i.e. how stress or work affects a binge). This treatment can be done either individually or in group sessions.

Weight Loss Medication And Binge Eating

A report found glucagon-like peptide 1 (GLP-1) receptor agonists like Ozempic, Wegovy, Mounjaro and Saxenda may be successful in treating BED. Many people with BED also take weight loss drugs to treat their obesity. Wegovy and Saxenda are approved by the Food and Drug Administration for weight loss, and diabetes drugs Ozempic and Mounjaro are prescribed for off-label weight loss management. Studies done on Ozempic and Wegovy found patients gain significant amounts of weight after they stop taking the medication. If BED isn’t addressed while taking these medications, weight gain after stopping is very likely. Model and TikToker Remi Bader shared she lost a significant amount of weight while taking Ozempic, which curbed her cravings. However, she stopped taking the medication and resumed binge eating, which resulted in her gaining “double the weight back.”

Further Reading

Diabetes Drug Mounjaro Expected To Be Approved For Weight Loss Soon: What To Know And How It Compares To Similar Drugs (Forbes)

What To Know About Ozempic: The Diabetes Drug Becomes A Viral Weight Loss Hit (Elon Musk Boasts Using It) Creating A Shortage (Forbes)

APA releases new guidelines for assessment, treatment of eating disorders (Healio)

Model Remi Bader says she tried weight-loss drug semaglutide, but gained all her weight back when she quit (Insider)