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Binge Eating and Emotion-Focused Therapy


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Binge Eating Disorder (BED) is the most commonly occurring eating disorder in the United States and sadly the most under recognized [1]. Individuals suffering from BED can often feel alone, wondering what is wrong with them and why they cannot stop the constant cycle of binge eating.

Due to feeling their behaviors are wrong or will be judged, many suffering from BED are deterred from asking for help. Clearly, an open conversation needs to be started. This conversation needs to include an understanding of what BED is and the options for treating BED. Now is the time to break the stigma around BED and open the doors to treatment.

What is Binge Eating Disorder (BED)?

Binge Eating Disorder (BED) is a severe but treatable eating disorder. An individual suffering from BED may experience recurrent episodes of eating large amounts of food, sometimes eating very quickly and/or until they experience pain or discomfort [2].

Individuals will often describe binge eating episodes as feeling out of control or unable to stop. BED also comes with experiencing intense guilt and/or shame after binge eating episodes. BED is not associated with the use of other disordered eating habits including behaviors such as restriction, purging, and/or abuse of laxatives [1].

What Current Treatments Exist for BED?

Binge Eating Disorder (BED) is newly recognized as a formal eating disorder in the DSM-5. Since BED is now a DSM diagnosis, those suffering from BED can receive eating disorder treatment covered by their insurance. This is an important step to bringing awareness to BED, which is again the most under recognized eating disorder [1].

Current treatment strategies for BED have focused on cognitive-behavioral therapy (CBT) as a primary form of treatment. Secondary treatment options include interpersonal therapy (IPT) and dialectical behavior therapy (DBT)[3].

In order to expand and individualize treatment options, we must ask what are the options beyond the standard of treatment for BED? Experts believe the experience of negative emotions acts as a predictor of binge eating episodes for those suffering from BED; therefore, treatment options should be focused on the role emotions play with BED [3].

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What is Emotion-Focused Therapy (EFT)?

Emotion-focused therapy (EFT) stems from the thought that human emotions can be used to achieve and maintain fulfilling, meaningful lives. EFT explores the notion that emotions are directly connected to our identity, and these emotions guide the choices we make. EFT assumes that individuals may avoid experiencing negative emotions to prevent feeling pain; therefore, EFT teaches that disconnecting from emotion can result in the inability to understand the emotion and the message it’s attempting to provide [4].

Through EFT an individual can learn to reconnect to and bring awareness to their emotions. Patients will explore where emotions are rooted, the impact emotions have on day-to-day functioning, and the influence emotions have on their thoughts and behaviors. Awareness of these aspects allows one to hear what the body is trying to communicate and value the experience of emotions [4].

Can EFT be used to Effectively Treat BED?

A recent study explored the practicality of EFT in treating BED. This study was prompted by the current limited treatment options available. One of the most accurate predictors of binge eating episodes is the experience of negative emotions. Keeping this in mind, a treatment focused on the role of emotions may be a better avenue for treating BED [3].

This initial study evaluated the practicality of EFT by measuring the treatment dropout rate, binge episodes and days, and binge eating psychopathology outcomes. The treatment involved 12 weekly one-hour EFT sessions over a 3-month period with a therapist trained in EFT. Participants were split into two groups; one group started EFT immediately, while the other group was placed on an EFT waitlist. This design was used to determine the effectiveness of treatment length [3].

The study revealed EFT resulted in a lower dropout rate compared to other forms of treatment including CBT, which remember is the most common treatment for BED. Those who remained in the trial showed a significant decrease from pre to post-therapy in binge episodes, binge episode days and binge eating psychopathology. When looking at post-therapy compared to 3-month follow-up, there was no significant difference. These findings suggest that participates were able to maintain treatment improvements over at least a 3-month period [3].

Overall, EFT shows promising results as a treatment option. This was one of the first known studies exploring EFT as a treatment option, and further studies are needed to validate the effectiveness of EFT as a treatment option [3]. Those suffering from BED can benefit from understanding the relationship between emotions and binge eating episodes. Effectively experiencing emotions will work to challenge the automatic response to use food as a coping mechanism.


Resources:

[1] Binge Eating Disorder. (n.d.). NEDA. Retrieved May 1, 2021, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed [2] Dingemans, A., Danner, U., & Parks, M. (2017). Emotion Regulation in Binge Eating Disorder: A Review. Nutrients, 9(11), 1274. https://doi.org/10.3390/nu9111274 [3] Glisenti, K., Strodl, E., King, R., & Greenberg, L. (2021). The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial. Journal of Eating Disorders, 9(1), 1–15. https://doi.org/10.1186/s40337-020-00358-5 [4] GoodTherapy Editor Team. (2018, June 22). Emotion-Focused Therapy. Good Therapy. https://www.goodtherapy.org/learn-about-therapy/types/emotion-focused-therapy


About the Author:

Bio

Raylene Hungate, RD/N, LD/N is a registered dietitian dedicated to providing the utmost care and support to those struggling with mental health. As a supporter of the Health at Every Size movement and the idea that all foods fit, she is passionate about helping others explore a life full of nourishment and bursting with flavor.

As an eating disorder dietitian, Raylene works not only in Private Practice, but also as a dietitian for an eating disorder treatment center in Los Angeles, California. She finds great joy in guiding others through an empowering journey of self-discovery and healing.


The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published May 12, 2021 on EatingDisorderHope.com
Reviewed & Approved on May 12, 2021, by Jacquelyn Ekern MS, LPC



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