End Binge Eating Now

End Binge Eating Disorder

In this ebook youll learn the seven factors that may contribute to the development of Binge Eating Disorder according to the latest research and how they affect you. The five ways you can achieve a healthy, positive body image right now even if you are at your lowest point (page 102).Why dieting is a Big no-no if you are a binge eater and what steps to take so that you never have to diet again (page 43). How you can implement one single thing into your life and see profound changes in all areas of you life (page 73) How the media plays a major roll in your thinking even leading you to binge, and how you can get in control so that the media has no influence on your life (page 60). The simple three-step process enables you to finally stop jumping on the diet of the month train, while still losing weight (page 37). The easy to follow four-week plan that enabled me to see results almost instantly and how you can do the same (page 114). How your daily routine may be adding fuel to your binge eating and the simple changes that you can make to see immediate results. How to overcome your fear- yes, even positive changes in your life can spring up some new fears.A little known technique that will not only help you overcome binge eating, but it will also put you on the fast track of living the life you have always imagined. More here...

End Binge Eating Disorder Summary


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Contents: Ebook
Author: Kristin Gerstley
Official Website: endbingeeatingnow.com
Price: $29.97

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My End Binge Eating Disorder Review

Highly Recommended

I usually find books written on this category hard to understand and full of jargon. But the author was capable of presenting advanced techniques in an extremely easy to understand language.

All the modules inside this e-book are very detailed and explanatory, there is nothing as comprehensive as this guide.

Loss of control and binge eating in children and adolescents

Full-syndrome binge eating disorder (BED) is rarely diagnosed among children and adolescents. Yet episodes of loss of control (LOC) eating are often reported by youth (Tanofsky-Kraff et al. 2004). As described more fully in the first part of this chapter, when children and adolescents report experiencing an inability to stop eating once started, the eating can be characterized as a LOC episode, which can occur irrespective of amount of food consumed. In other words, children experience LOC with or without consuming an unambiguously large amount of food, so including both large episodes of binge eating and not large episodes. Given the psychological (e.g. depressive symptoms), social (difficult relationships), and health (obesity) problems associated with LOC eating in youth (see the first part of this chapter), it is crucial for clinicians to assess for the presence of LOC eating and to implement interventions focused on reducing LOC eating and associated problems, such as excessive...

Have had a problem with binge eating Does this mean I am not a candidate for bariatric surgery

The short answer to this question is that gastric bypass surgery may actually be thought of as a treatment for binge eating. Binge eating disorder (BED) has been reported in as many as 68 percent of people undergoing gastric bypass surgery. Interestingly, some people who think they have BED really do not. In order to meet the strict definition of BED, episodes of binge eating must occur at least two days a week for a period of about six months. In addition to consuming large amounts of food over a period of about two hours, binge eaters describe a sense of loss of control. In other words they cannot stop themselves, nor do they feel in control of what or how much they are consuming.

B Treatment of Obese Individuals with Binge Eating Disorder

If a patient suffers from binge eating disorder (BED), consideration can be given to referring the patient to a health professional who specializes in BED treatment. Behavioral approaches to BED associated with obesity have been derived from cognitive behavior therapy (CBT) used to treat bulimia nervosa. 227 Among the techniques are self-monitoring of eating patterns, encouraging regular patterns of eating (three meals a day plus planned snacks), cognitive restructuring, and relapse prevention strategies. 581

Professionally Assisted Self Help Treatment for Binge Eating Disorder Primary Focus

To our knowledge, the most frequently evaluated self-help program for the treatment of BED has been Fairburn's Overcoming Binge Eating (Fair-burn, 1995). In 1997, Wells, Garvin, Dohm, and Striegel-Moore conducted an uncontrolled study to evaluate the feasibility of providing a self-help plus telephone guidance program for BED. The duration of the program was 3 months. For the self-help component, all women received Overcoming Binge Eating. Participants were instructed to complete daily self-monitoring logs. For the telephone guidance component, participants received 30-minute telephone sessions weekly for the first month and every other week for the following 2 months. Telephone sessions, conducted by a psychology graduate student, focused on the participants' progress with the self-help program. Reductions were observed on the Eating Disorder Examination Questionnaire (Beglin & Fairburn, 1992) total score and in the frequency of binge eating. Compliance with the program sessions...

Assessment of Binge Eating

A binge episode is defined as the consumption of a large amount of food within a discrete period of time, accompanied by a sense of loss of control over eating. Researchers and clinicians have agreed that loss of control involves the subjective feeling that one cannot stop eating or control what or how much is being eaten. However, there has been much less agreement about the size and duration of a binge eating episode. Specifically, there is no consensus as to what constitutes a large amount of food, and the duration of binge eating episodes can vary widely, sometimes continuing throughout an entire day. Many individuals have difficulty delineating binges into discrete episodes but can more readily recall whether a binge occurred or not on a given day. Thus, the BED diagnosis is made based on binge 'days' rather than 'episodes.' Similarly, many observers have concluded that the loss of control, rather than the amount of food ingested during a binge (i.e., a 'large' amount), is the...

Clinicians Guide to Binge Eating Disorder

Incidence of Binge Eating Disorder (BED) appears to be on the increase. Treating it and overcoming it is all the more difficult, especially for those living in a culture that has an intense body image focus. A Clinician's Guide to Binge Eating Disorder educates the reader about its triggers and behaviors, and describes steps to treat it and resume a full and productive life. Evidence-based research outcomes provide the framework and foundation for this book. First-person case studies bring application of this science to life to help close the gap between research and treatment care, and the importance of clinicians developing a therapeutic relationship as a healing tool with their client is discussed, recognizing that medical and psychological dimensions are inextricably intertwined.

Binge Eating

Binge eating disorder (BED), also known as compulsive overeating, has been designated as a psychiatric disorder requiring further study by the American Psychiatric Association. Like bulimics, individuals suffering from binge eating disorder indulge in regular episodes of gorging, but unlike bulimics, they do not purge afterward. Binges are accompanied by a similar sense of guilt, embarrassment, and loss of self-control seen among bulimics. Because of the tremendous number of calories consumed, many people with BED are overweight or obese, and as a result they are more prone to complications such as high blood pressure, diabetes, high cholesterol, and heart disease.

Myra Altman Denise E Wilfley Juliette M lacovino Heather L Waldron and Dana M Gredysa

BED is associated with significant functional impairment (Rieger et al. 2005), but prognosis is good with appropriate therapeutic intervention. Specialist treatments for BED, such as cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT), which directly address binge eating and related psychopathology, are associated with robust short- and long-term binge abstinence rates. CBT and IPT have been found to produce superior outcomes as compared to pharmaco-therapy (Devlin et al. 2005), and generalist treatments such as behavioral weight loss (BWL) (Grilo et al. 2011 Wilson et al. 2010) and supportive psychotherapy (Kenardy et al. 2002). The rationale of CBT for BED is based on the restraint model of binge eating. This model posits that problematic eating patterns and concerns about shape and weight result in extreme dietary restriction (Wilfley 2002). This promotes a dysfunctional pattern in which patients alternate between dietary restraint and binge eating (see Figure...

Alison E Field and Kendrin R Sonneville

Binge eating disorder (BED) is more common than bulimia nervosa (BN) and anorexia nervosa (AN). Although the prevalence of BED is higher in women than men, the gender difference in prevalence is smaller than that for BN and AN (Hudson et al. 2007 Swanson et al. 2011). Despite the higher incidence of BED, public health efforts and targeted prevention programs focused on preventing the onset of binge eating are lacking. As such, greater attention to eating disorder prevention is warranted. Relatively little is known about the risk factors for binge eating disorder. Most studies have been cross sectional, had treatment-seeking samples, or used a broader outcome definition (i.e., binge eating, disordered eating, etc.). Nevertheless, a handful of risk factors have been identified. In treatment seeking samples the binge eating onset, as well as the risk factors, must be recalled, and so this type of research is highly susceptible to recall bias. Moreover, since only the minority of people...

Michael J Devlin Stephen A Wonderlich B Timothy Walsh and James E Mitchell

I've been struggling for more than 20 years with a terrible binge eating problem. You may remember me - I called your clinic back in 1990, and you had nothing to offer me. I'm still having exactly the same problems that I was having back then. Has anything gotten better in the meantime so long. I'm happy to say that the situation has indeed improved. For starters, we now have a name for what you have. It's called binge eating disorder, or BED, and we've developed a number of different treatment approaches, including different forms of psychotherapy, medication, and even self-help approaches. We'll need to meet with you to find out exactly what your goals are and what type of approach would be most helpful. Studies of the psychopathology characterizing BED have significantly clarified the nature of this relatively new eating disorder. We have acquired a clearer understanding of the nature of binge eating, the importance of loss of control of eating, and the...

Cynthia M Bulik and Sara E Trace

Eating disorders like anorexia nervosa and bulimia nervosa, but this was the first I had heard about BED. To be honest, I couldn't believe there was a name for what I was experiencing The therapist explained that my description of both my mother and me sounded like binge eating. She said it was not uncommon for these things to run in families and that genetic factors might be involved. She has helped me completely rewrite my own script about what was going on. I had thought I was a bad person who had no willpower, but now I have a better understanding of what this is, and I have hope that it is treatable. I have kept seeing my therapist and we have worked on both depression and BED. I have also used my experience to help educate my adult children about BED. My son has always been a stress eater, so I let him know about my BED and the successes I have had with treatment. The role of genetic factors in the development of eating disorders, including binge eating disorder (BED), has...

Kay E Segal Sarah E Altman Jessica A Weissman Debra L Safer and Eunice Y Chen

For years, I struggled with my weight, often fluctuating between starvation and binge-eating. This was only one of many problems I faced. I also self-injured, abused alcohol, ruined relationships, and even attempted suicide a few times in my younger years. Often the way I felt after a binge would cause me to cut myself as a punishment for losing control. My therapists usually gave up on me. My family often only made things worse, having been a source of physical and emotional abuse since childhood. At some point, I began to understand that all of these destructive ways to cope stemmed from my inability to manage my emotions this made sense given my traumatic history. I was just trying to feel better or different, or to numb these terrible feelings. Dialectical Behavior Therapy (DBT) represents an example of one of the new-wave behavior therapies that integrate mindfulness practice into the treatment of Binge Eating Disorder (BED), e.g. acceptance commitment therapy (Lillis et al....

Kelly C Berg and Carol B Peterson

I am a nurse manager at a local hospital, am married, and have two adolescent boys, ages 13 and 17. I'm seeking treatment for binge eating (BE), which occurs several times a week. As a child I would sneak food from my family's kitchen and hoard it in my bedroom. I would come home from school and binge in my room by myself. In typical episodes I would eat half a bag of brown sugar or a box of cookies. My BE has fluctuated in severity since childhood, with the worst periods occurring during college, my late twenties, and currently. My binge episodes usually occur in the evenings after dinner, when alone in the kitchen cleaning up and watching Tv. In a typical BE episode I eat two pints of ice cream or 30 to 50 snack crackers and experience a sense of loss of control, particularly a feeling of being unable to resist eating the food that I know is in the kitchen. I have struggled with being overweight since adolescence and have made multiple attempts at weight loss, including structured...

Debra L Franko Meghan E Lovering and Heather Thompson Brenner

I am a 24-year-old Latina woman who recently graduated from college with a degree in biology. I am the eldest of four children and have always felt much pressure to succeed academically. I began binge eating once a month at age 16 to help cope with the stress from school and feelings of isolation. I felt out of control during these episodes, eating eat any junk food I could find, alone in my bedroom. After binging, I felt incredibly embarrassed looking at all the food wrappers and hid them under my bed in an old trunk, a gift from my grandmother. I gained 30 pounds during my junior and senior year of high school and, feeling very depressed and isolated, I missed out on important events like the prom. I have tried many times to lose weight, but have never been able to stick with it. I have a good relationship with my parents but struggle with them at times because they think that I look fine even though I don't feel that way. These days I am distracted by my body size and shape and my...

Jonathan Mond Anita Star and Phillipa

I'm a 32-year-old secretary working at a solicitor's office. I've been overweight since adolescence, but in recent years this problem has increased to the point where I'm severely obese, with a BMI well in excess of 40 kg m2. Over the years, I've tried a number of diet and healthy eating plans, but have never been able to adhere to the recommendations for any length of time. I live alone, have a strained relationship with my family and have few friends that I feel I can rely on. Generally, my diet is regular in that I eat three meals a day and these meals contain a wide variety of foods. However, to help cope with my feelings of isolation, I treat myself with luxury foods such as chocolate, cheesecake, and ice-cream. Because this sort of eating is linked to my emotions, rather than level of hunger, it can occur at any time. When I get home from work I often go to the fridge for a small snack trouble is, after eating the snack I'm unable to stop eating and continue to consume a large...

Marney A White and Loren M Gianini

This case study demonstrates several important themes in understanding patients who struggle with binge eating disorder (BED). Most notably, BED is frequently associated with substantial weight gain, which can lead to obesity and various physical and psychological health problems. This chapter will focus on complications that arise due to concurrent obesity in BED, and will describe treatment approaches for the obese patient with BED. Discussion of the clinical features and treatment of BED must also consider obesity, since many people who suffer from this illness are obese (American Psychiatric Association 2000). Binge eating is strongly associated with increased obesity (Spitzer et al. 1992 Telch et al. 1988). Consequently, the health risks associated with obesity are relevant to most individuals with BED. Both BED and obesity are associated with a variety of medical complications, including non-insulin dependent diabetes mellitus, hypertension, and heart disease (Bray 1998 Bulik...

Scott Engel and James E Mitchell

I have been quite overweight all of my life. I was teased about my weight in grade school and in high school. Besides eating too much most of the time I also went on eating binges several times a week, when I would consume very large amounts of food, such as one or two pizzas or a quart of ice cream. During these times I felt driven , like I couldn't stop myself until the food was gone. I was very embarrassed by this and because of that I would isolate myself at home when no one else was around to do much of my eating. My parents worried about my weight and started encouraging me to diet during adolescence but nothing really seemed to work. I tried low-calorie diets, low-carbohydrate diets, low-fat diets, and just about everything else. I had a book shelf devoted just to self-help diet books. In my 20s my weight continued to increase and by the time I turned 30 I weighed about 300 pounds at 5'5 tall. My doctor was always telling me how I would develop health problems if I didn't lose...

Trisha M Karr Heather Simonich and Stephen A Wonderlich

I have tried countless diets over the years - some more successful than others. Regardless of my weight, I've always hated the way my body looks. The continual dieting is also accompanied by frequent binge eating. I also struggle with depression and have a history of drinking problems. I have had numerous relationship problems in my three marriages. I have gone to many therapists for help with my eating, but nothing has worked for me. As a child, my grandfather and an uncle sexually abused me, and I sometimes wonder if this trauma is connected to my eating problems. I have never told anyone and no one has ever really asked. I am not sure I will ever feel better. This chapter provides a brief overview of clinically relevant information about childhood trauma, which most commonly takes the form of child abuse and neglect. We will synthesize a small but growing body of research on the relationship of childhood trauma and binge eating disorder (BED). This overview will cover data...

Chevese Turner

A radio interviewer asked me if it is true that a majority of Americans have binge eating disorder. Surely , the interviewer speculated, if we have an obesity epidemic in our country and around the world, then binge eating disorder must be rampant. Another common conversation takes place during Binge Eating Disorder Association (BEDA) outreach and educational work. People usually say something like this I definitely have an eating disorder. I eat too much and love food. I am an emotional eater and I need to stop. They usually goes on to inquire how BEDA can help them stop overeating and usually there is a request to suggest a diet and exercise regime that will result in permanent weight loss. Borrowing from former US President Bill Clinton's 1992 campaign slogan, It's the Economy, Stupid , the title of this section is meant to bring attention to the fact that far too often we hear and read information about binge eating disorder that is conflated with obesity. Binge eating disorder is...

Marian Tanofsky Kraff

Loss of control (LOC) while eating refers to the sense that one cannot control what or how much one is eating (American Psychiatric Association 2000), and may or may not be accompanied by the consumption of unambiguously large amounts of food (i.e., binge eating). LOC eating is among the most commonly reported eating disorder behaviors in children and adolescents (Goldschmidt, Aspen et al. 2008). Youth reporting LOC eating often present with psychosocial impairments (Glasofer et al. 2006 Goldschmidt, Jones et al. 2008 Tanofsky-Kraff et al. 2004) as well as obesity and excess body fat (Tanofsky-Kraff et al. 2004). Moreover, pediatric LOC eating predicts the onset of full-syndrome eating disorders (Stice et al. 2009 Tanofsky-Kraff et al. 2011). LOC eating is therefore a clinically significant behavior with considerable public health implications. While LOC eating often develops in childhood, there is a paucity of research in pediatric populations. Therefore, it is important to develop a...

Lynn Grefe

With the addition of Binge Eating Disorder (BED) to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Illnesses (DSM-5) (American Psychiatric Association 2012), I am cautiously reminded of that kind of misinformed thinking which dangerously conflates two very different issues. We as a field face the challenge of showing the distinction between a serious mental disorder diagnosis of BED, and the much-debated weighty problems of an obesity epidemic (our society's words, not mine). The distinction is a whole lot more than lipstick, with many people already confusing a mental health problem with a weight status. To increase understanding for BED we must expand our public education efforts to the same levels as offered for other eating disorders. NEDA has created a Binge Eating Disorder Task Force to include top clinicians and experts, and also families and sufferers. The goals of this task force are to identify how NEDA can develop the best possible resource base and...

Amy Pershing

Binge Eating Disorder (BED) has myriad causal factors. Biology, genetics, weight stigma and weight-related bullying, cultural pressures to be thin, a history of trauma, and family dynamics may all play a part. We know, too, that the specific combination of these factors varies a lot from person to person. Clinically we see some specific psychological factors that present with particular frequency in the adult population of patients with BED. Problematic attachment styles and an inability to set and maintain appropriate relational boundaries are often of particular concern. Somatic disconnection and dissociative behavior is also common especially for survivors of abuse, powerful feelings of shame may elicit use of food to disconnect. In these cases, BED is often a powerfully protective mechanism, and one that patients quite wisely do not give up easily. weight obsession, a decrease in overeating binge eating, and a more peaceful relationship with food and one's physical body. To date,...

Carrie Arnold

When someone with binge eating disorder (BED) presents for treatment, he or she often feel guilty and ashamed. The binge eating has probably resulted in weight gain. The person's eating behaviors feel out of control. He or she is filled with self-loathing and desperate to stop stuffing him or herself on a regular basis. Anxiety and depression frequently accompany BED, too. As a result, the patient feels isolation and despair. Basic psychoeducation about the prevalence of BED and the common feelings that accompany binge eating can help to relieve some of those negative feelings. One in thirty-five Americans has BED (Bulik 2009). Over half of all people with BED have a mood disorder (Grilo et al. 2009). Out-of-control eating is actually a hallmark of a binge, which makes these feelings normal and even expected for someone with BED. Ditto for the weight gain. Knowing that lots of other people understand these tumultuous feelings can be a powerful tool against isolation and despair...

Scott Crow

I'm a 45-year-old woman who presented for treatment of BED at a multi-disciplinary eating disorder treatment program. I began engaging in episodes of binge eating in the seventh grade. About three times a week I eat a large amount of food with loss of control, usually in secret. I don't have a history of purging, except for brief experimentation when I started college. I have begun psychotherapy sessions and have been working with a dietician about two months prior to this latest medication evaluation. I feel my relationship with food has improved substantially, and the amount of time I spend thinking about eating, weight, and shape-related issues has diminished somewhat. The frequency of eating binges has gone from four or five times a week down to three a week, but I believe this has plateaued. I'm interested in considering medication to try to get my binge eating under better control, and I want to lose at least 50lbs (my current height is 5'5 and my current weight is 212lbs for a...

What other factors are used to determine if a person is a good candidate for bariatric surgery

With regard to emotional health, people with a history of anorexia nervosa are generally not considered good candidates for this surgery. Likewise, uncontrolled bulimia (self-induced vomiting, typically following binge eating) is generally a contraindication for bariatric surgery. If you have had an eating disorder in the past but have been well controlled for a long time, your doctor may consider you a good candidate.

Psychosocial Treatments

Treatments for binge eating have been adapted from those that have been shown to be effective in reducing binge eating among individuals with BN. The majority of the research on psychosocial treatments has supported two structured, focused, short-term psychotherapies CBT and interpersonal psychotherapy (IPT) both of which have been shown to be more effective than no treatment in decreasing the frequency of binge eating and improving the psychopathology associated with binge eating. In addition, the use of DBT shows promise as an alternative treatment for BED. Cognitive behavioral therapy CBT has been the most extensively studied treatment for individuals with binge eating. CBT for BED is based on the assumption that binge eating is maintained in the context of ongoing dietary restraint, weight concerns, negative emotions, and low self-esteem. Treatment focuses first on normalizing eating and then on the identification and restructuring of maladaptive thoughts and beliefs, particularly...

Selection of Treatment for Specific Patients

Eating disorder and obesity history A history of early onset of binge eating, binge eating in the absence of obesity, or obesity in combination with numerous bouts of weight loss and regain over time ('yo-yo' dieting) suggests a course of psychosocial treatment. Such patients can be reassured that significant improvements in the aberrant eating and eating disorders psychopathology associated with BED can be obtained without weight loss. On the other hand, clinical experience suggests that patients who report adult onset of binge eating and obesity, and do not have a history of marked weight fluctuations, may be more likely to benefit from a behavioral weight control approach. Behavioral weight control may also be indicated for patients who remain overweight after a trial of eating disorders treatment. Although behavioral weight control appears to be beneficial on average, it is important for each individual to evaluate the likelihood that he or she will be able to sustain lifelong...

Dialectical Behavior Therapy

Linehan, Armstrong, Suarez, Allmon, and Heard (1991) reported the first randomized controlled trial (RCT) of DBT. Since then, DBT has generated by far the greatest number of studies of any psychosocial treatment for BPD (reviewed by Robins & Chapman, 2004). In addition to a number of uncontrolled studies, there are now four RCTs of standard DBT for BPD, as well as two RCTs of adaptations of DBT for BPD or suicidal behavior two RCTs of an adaptation of DBT for patients with BPD and comorbid substance abuse and two nonrandomized but controlled trials of adaptations of DBT, one for suicidal adolescents and one for inpatients with BPD. There have also been two RCTs of DBT adaptations for eating disorders (binge-eating disorder and bulimia) and two RCTs of adaptations for older adult depressed patients, with or without comorbid personality disorders. In all, 11 RCTs of standard DBT, or close adaptations of it, have all reported beneficial effects.

Psychological Complications

Dieting efforts correlate positively with the prevalence of eating disorders, particularly binge eating. A correlation of eating disorders with abuse of drugs and alcohol has been shown. In strictly dieting female college freshmen who were not alcohol abusers at baseline, the frequency of alcohol abuse was reported to increase after 1 year compared to nondieters.

Nonergotderived dopamine agonists

There are three newer fully-synthetic dopamine agonists that are not derived from ergot. The three drugs include ropinirole, pramipexole, and rotigotine. As of July 2011, rotigotine is not approved by the FDA for use for RLS in the USA. These nonergot agents are not associated with valvular heart disease but have been associated with impulse control disorders including pathological gambling, compulsive overeating, hypersexuality, and pyschosis. There is increasing recognition that patients treated with these agents should be monitored for impulse control disorders.

Psychological Consequences

Among obese people were the topic of a literature review that reported that weight cycling was not associated with depression or other psychopathology or depressogenic cognitive styles. It was observed, however, that weight cycling was associated with decreased perceptions of health and well-being, decreased eating self-efficacy, and weak increases in binge eating severity. Subsequently, it was concluded that an individual's perception of being a weight cycler may be more related to psychological problems than the actual number of pounds lost and regained over time. In 2000, the National Task Force on the Prevention and Treatment of Obesity concluded that concerns that dieting induces eating disorders or other psychological dysfunction in overweight and obese adults are generally not supported by empirical studies. This is in contrast to the wide belief that dieting is a necessary precursor for subsequent development of eating disorders.

Dieting and Weight Loss

Normal weight who gain and lose weight throughout their lives. Because of the societal appearance standards for women and girls, they are at particular risk for the side effects of weight cycling. Additionally, the reduced calorie intake can cause dieters to receive inadequate nutrients such as calcium, thus increasing their risk for osteoporosis and related injury (NEDA, 2005b). Psychologically, dieting can lead to eating disorders such as binge eating, depression, and lowered self-esteem (Darby, Hay, Mond, Rodgers, & Owen, 2006 Grilo, & Masheb, 2000 NEDA, 2005b). However, the National Task Force on the Prevention and Treatment of Obesity's (2000) review of the literature suggests that these concerns have been exaggerated and makes the point that, such concerns should not preclude attempts to reduce caloric intake and increase physical activity to achieve modest weight loss or prevent additional weight gain (p. 2581).

Dietary Management

Education is essential to ensure that people understand why they are being asked to abandon what are some of the only coping mechanisms they have. They feel anxious that by giving up the pattern of dieting, binge eating, and purging they will gain excessive amounts of weight. These fears are very real and failure to address them with sensitivity can sabotage any attempt to control the disorder. This is

D Colin Drummond John Strang

Nervosa has been recognized by the American Psychiatric Association as an autonomous eating disorder. The term bulimia means ''an extreme hunger,'' but the word is most commonly understood to refer to Bulimia Nervosa. It is characterized by recurrent episodes of binge eating followed by such regular activities as self-induced vomiting, excessive use of laxatives and or diuretics, fasting or dieting, and vigorous exercise all of which are directed at weight control. A characteristic feature in the bulimic patient is a persistent concern with weight and body shape. Other psychiatric disorders can accompany bulimia, particularly major depression. The full syndrome affects 1 to 3 percent of the adolescent and young adult female population, but many more experience subclinical variants of the disorder. Bulimia nervosa does occur in males, but such incidence is rare. Parallels between bulimia nervosa and substance abuse have been drawn based on an ADDICTION model, a self-psychology model,...

Behavior Modification

Research is now directed towards finding ways of improving the results of such programs in terms of long-term weight loss maintenance. An increased focus on weight-maintaining behavior rather than weight loss, a stronger emphasis on increasing activity and exercise, and better relapse strategies are being evaluated. Targeting the needs of specific subgroups, for example those with binge eating disorders or dysfunctional family circumstances, is another way in which behavioral therapy may be improved.

Bronchopneumonia See pneumonia

As with anorexia, bulimia typically begins during adolescence and occurs most often among girls. Girls with bulimia deny their hunger and restrict their food intake for several days or weeks at a time, but sooner or later, they begin to eat and cannot stop eating until they have stuffed themselves. Experts think this overeating compensates for the prior calorie restriction. Binge eating may also be related to problems with feeling satisfied after Even bulimia patients at normal weight can severely damage their bodies by frequent binge eating and purging. In rare instances, binge eating causes the stomach to rupture purging may lead to heart failure because of loss of vital minerals, such as potassium. constant vomiting causes other less deadly, but serious problems the acid in vomit wears down the outer layer of the teeth, the esophagus becomes inflamed, and glands near the cheeks become swollen. As with anorexia, bulimia may lead to irregular menstrual periods. counseling may last...

Self Help Bibliotherapy for Eating Disorders

In 1993, Schmidt, Tiller, and Treasure evaluated a CBT-based self-help handbook with women with BN. Participants were assessed 4-6 weeks after the onset of treatment. The intervention was found to be effective in reducing bulimic symptoms and increasing nutritional knowledge. Participants significantly reduced binge eating and purging behavior but their weight and shape attitudes did not change significantly during treatment. Carter and colleagues (2003) extended the findings of previous studies by comparing the self-help treatment condition to two control conditions, an attention-placebo control and a standard wait-list control (WL). Women who met criteria for BN were randomly assigned to one of three conditions for 8 weeks (a) unguided CBT self-help (b) attention-placebo control or (c) wait-list control. The duration of the self-help treatment was 2 months. Women in the CBT self-help condition received Overcoming Binge Eating (Fairburn, 1995). The attention-placebo group was...

Box 10 Assess Reasons for Failure to Lose Weight

Failure to achieve weight loss should prompt the practitioner to investigate energy intake (dietary recall including alcohol intake, daily intake logs), energy expenditure (physical activity diary), attendance at behavior therapy group meetings, recent negative life events, family and societal pressures, or evidence of detrimental psychiatric problems (depression, binge eating disorder). If attempts to lose weight have failed, and the BMI is 40, surgical therapy should be considered.

Types of Self Help Programs

Self-help programs for eating disorders are offered in a variety of formats. The most common format is bibliotherapy. Hundreds of self-help books on eating disorders have been published. The approaches range from empirically validated CBT (e.g., Overcoming Binge Eating Fairburn, 1995) to religiously oriented (e.g., Loving Your Body Embracing Your True Beauty in Christ Newman, 2002) to those using the popular For Dummies series format (Anorexia & Bulimia for Dummies Beck, 2004). Didactic interventions that provide general information and education are routinely published in magazines and also are available on numerous Web sites. Williams (2003) reported finding approximately 218,000 hits for self-help and eating disorders in August 2002. A hybrid form of self-help with limited professional guidance also is available. This format typically follows a structured format that unfolds over time. The majority of structured self-help programs take a socio-cognitive or CBT approach that is,...

Conclusion and Recommendations

How should the clinician interpret these findings The clinician may feel confident recommending these self-help interventions in the first step of a stepped-care approach to treating eating disorders. Some of the self-help interventions, such as Fairburn's (1995) book Overcoming Binge Eating are easily accessible. It is important that the clinician maintain some oversight over the patient's treatment, however, to ensure adherence to the self-help protocol and advancement to a more intensive treatment if the self-help approach is not effective. Given the brief nature of most structured interventions, it is likely that follow-up in 2 months is sufficient to determine whether the intervention is helpful. Although unstructured and unmoderated self-help groups for eating disorders are widely available and widely used by women with eating disorders, there does not appear to be sufficient empirical evidence from controlled studies of the effectiveness of these groups to warrant unqualified...

Behavioral Weight Control

Because the majority of individuals with BED are also overweight and want to lose weight, and because obesity is associated with significant medical and psychosocial consequences, weight loss is a potentially important outcome in the treatment of BED. Numerous studies have documented that calorie restriction does not exacerbate binge eating in BED patients. Indeed, participation in behavioral weight control programs that focus on calorie restriction, provide education about sound nutritional principles, and promote physical activity may decrease binge eating and improve mood in BED patients. Therefore, concerns about the

L Psychosocial Aspects of Overweight and Obesity

A number of reviews have been published on the psychosocial aspects of obesity. 124-128 183 The specific topics that will be reviewed here include social stigmatization, psychopathology, binge eating, and body image perceptions. higher (indicating clinical depression) on the Beck Depression Inventory. Focusing on depression was considered an important component of the weight loss program. Another study compared obese people who had not sought treatment to an obese group that had sought treatment in a professional, hospital-based program, and to normal weight controls. 215 Again, obese individuals seeking treatment reported more psy-chopathology and binge eating compared to the other groups. Both obese groups reported more symptoms of distress than did normal weight controls. The authors suggest that the obese population is not a homogenous group, and thus, may not respond in the same way to standardized treatment programs. In particular, obese individuals seeking treatment in clinic...

Hierarchy of Constraints

See also Appetite Physiological and Neurobiological Aspects Psychobiological and Behavioral Aspects. Eating Disorders Anorexia Nervosa Bulimia Nervosa Binge Eating. Energy Balance Adaptation. Hunger. Obesity Definition, Etiology and Assessment. Religious Customs, Influence on Diet. Socio-economic Status.

Prevalence and Risk Factors

More diverse, affecting relatively more men and minority groups than BN or anorexia nervosa. Furthermore, binge eating is more prevalent among obese individuals in both clinical and community samples. It is estimated that up to one-third of individuals who present for treatment in university-based weight control clinics report significant binge eating. In order to improve our understanding of how multiple factors interact to determine the onset and maintenance of binge eating, prospective risk factor studies including males and females of different racial groups are needed. As suggested previously, biological (e.g., obesity), psychological (e.g., negative self-evaluation), and social (e.g., exposure to repeated negative comments about shape, weight, or eating) factors have been implicated in the patho-genesis of binge eating. Emergent research also has linked binge eating in a small proportion of individuals to a mutation in MC4R, a candidate gene for the control of eating behavior....

Assisted Self Help Treatment for Eating Disorders

Several treatment studies examined the feasibility and effectiveness of guided self-help programs for the bulimic spectrum eating disorders, namely BN, binge eating disorder (BED), and EDNOS, with binge eating identified as the key feature but occurring at a subthreshold level. In the following sections, we review findings from these studies. See Table 8.1 for a summary of structured self-help interventions for the treatment of eating disorders. Table 8.1 Summary of Structured Self-Help Interventions for Bulimia Nervosa and Binge Eating Disorder Note. SH self help, WL wait-list, BN bulimia nervosa, BED binge eating disorder, EDNOS eating disorders not otherwise specified, BF binge frequency, CBT cognitive-behavior therapy. Uncontrolled SH using Overcoming Binge Eating and 30-minute phone sessions Randomized to three groups WL SH using Overcoming Binge Eating (12 weeks SH plus six to eight 23-minute sessions with lay facilitator Of the seven participants who completed post-measures, 3...

Professionally Assisted Self Help Treatment for Bulimia Nervosa

Using a similar approach, Cooper and colleagues (Cooper, Coker, & Fleming 1994) conducted an uncontrolled study to evaluate the effectiveness of a supervised CBT-based self-help manual for women with BN. For 4-6 months, participants completed the CBT manual, Bulimia Nervosa and Binge Eating A Guide to Recovery (Cooper, 1993) and received guidance from a social worker with no previous specialist training in the treatment of eating disorders. Guidance included 20- to 30-minute sessions for support and encouragement to continue applying the strategies in the self-help manual. At post-assessment, half of the participants had discontinued binge eating and self-induced vomiting. On average, the frequency of binge eating decreased by 85 and self-induced vomiting was reduced by 88 . Improvement on other key features including body shape and weight dissatisfaction and dietary restraint were also noted. In 1996, Cooper, Coker, and Fleming reported similar results using their structured...

B Comparison of Behavior Therapy Strategies

Another study examined the effect of extending cognitive behavior therapy for 3 months in addition to the initial 3 months of therapy for obese patients with binge eating disorder, and found that extended cognitive behavior therapy improved binge eating behavior, although not weight. 494 A pilot study of women with type 2 diabetes compared a 16-week group-behavioral weight loss program to the same group, but with three individualized motivational interviewing sessions added. Both groups demonstrated significant weight loss with the motivational group losing 5.5 kg (12.1 lb) on average and the standard behavioral group losing 4.5 kg (9.9 lb) there were no differences between the two. However, those in the motivational interviewing group demonstrated better attendance at meetings (attending on average 13.3 meetings versus 8.9 meetings), had significantly better glucose control, and recorded blood glucose and food diaries more frequently 489 than did members of the standard behavioral...

After the diet

Now that the (temporary) diet is over, he goes off his diet. Few people have the desire or willpower to stay on low calories for long. On a strict calorie and or food-restricted diet, almost everyone falls of the wagon sooner or later. After a long period of low calories, his body tricks him into binge eating by triggering severe cravings and hunger.


Binge eating is strongly associated with both obesity and psychiatric disorder. It is well documented that obesity is linked to adverse medical and psychosocial outcomes. Preliminary findings also suggest that BED may be associated with poor health, independent of the effects of comorbid psychopathology or comorbid obesity. Severity of binge eating is positively associated with degree of overweight. Additionally, there are important differences between overweight individuals with and without BED. BED patients report earlier onset of obesity, along with a history of more severe obesity, dieting, and weight fluctuations. When compared with equally overweight individuals without binge eating problems, BED patients report considerably less 'restraint' or control overeating, lower self-esteem, more fear of weight gain, more preoccupation with food, and higher body dissatisfaction. Individuals with BED endorse high rates of psychiatric symptoms and disorders. For example, when compared to...


Antidepressant treatment Because of their efficacy in ameliorating binge eating and purge behaviors in BN, antidepressants have been used in the treatment of BED. Early research comparing tricyclic anti-depressants, such as desipramine and imipramine, to placebo showed greater reductions in binge eating among obese binge eaters treated with the drug than with a placebo. Recently, several selective serotonin reuptake inhibitors (e.g., fluoxetine) have been shown to be associated with moderate reductions in binge eating in BED patients. Moreover, the effects of antidepressant treatment on binge eating are independent of any effects on mood. Antidepressant treatment also may be useful in treating depression associated with BED and has been associated with weight loss among obese binge eaters. Antidepressant treatment also may enhance dietary restraint or improve compliance with a weight loss program. Thus, it seems possible that longer term antidepressant treatment may be useful in...

Bulimia nervosa

The term bulimia nervosa literally means 'the hunger of an ox'. It is only since the 1970s that it has been recognised by the medical community. Sufferers are caught in a cycle of eating huge quantities of food (binge eating) and then getting rid of that food by vomiting, taking laxatives and diuretics, excessive exercising or a combination of any of these. It is thought that male sufferers are more likely to exercise excessively to get rid of the calories, whilst female sufferers are more likely to vomit.

Other Disorders

The DSM-IV includes two eating disorders. Anorexia nervosa is characterized mainly by refusal to maintain even minimally normal body weight, symptoms of intense fear of gaining weight even though underweight, and disturbance in the perception or experience of one's body weight or shape. The second disorder, bulimia nervosa, is diagnosed when individuals engage repeatedly in binge eating alternating with inappropriate methods to prevent weight gain. Eating disorder symptoms and associated behaviors can also be measured with questionnaires. Eating disorders tend to be more prevalent in industrialized countries and are relatively rare, with prevalence estimates typically fewer than 2 percent, nearly all girls. Onset is typically around adolescence and may be associated with a stressful event. Causes are likely to include a combination of biological, family, and sociocultural factors as well as individual psychological characteristics of the child. Treatment, often resisted, requires...

Eating Disturbances

An eating disturbance shares many similar characteristics with eating disorders, but is less severe in scope. As a result, many abnormal dietary patterns and behaviors, such as binge eating, excessive exercising, weight cycling, and chronic dieting may involve many of the same attitudes and impulses as eating disorders, though they do not meet the clinical criteria for diagnosis.

Chronic Dieting

Many individuals with eating disorders report habitual dieting prior to the onset of their illness. Repeated dieting during adolescence increases the risk of eating disorders, with some patients reporting attempts at weight loss as early as age nine. The incidence of eating disorders may be as much as incidence number of new cases reported eight times greater among girls with a history of dieting, with the initiation each year of a weight loss regimen often marking the onset of the eating disorder itself. Dietary restriction may result in alterations in brain chemistry that can further increase anorexic tendencies, while hunger resulting from caloric restriction can set off binge eating, thus establishing a pattern. While most healthy individuals who attempt to lose weight can stop at any given time, depression and major life stresses in combination with habitual dieting can predispose others to develop an eating disorder. see also Addiction, Food Anorexia Nervosa Bulimia Nervosa...


There are various types of eating disorders, each with its own physical, psychological, and behavioral manifestations. They are classified into four distinct diagnostic categories by the American Psychiatric Association anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. This illness has two subtypes the restricting type, in which weight loss is achieved solely via reduction in food intake, and the binge eating purging type, in which anorexic behavior is accompanied by recurrent episodes of binge eating or purging. To qualify for a clinical diagnosis of bulimia nervosa, binge eating and related compensatory behaviors must take place at least two times a week for a minimum of three months. Sufferers are classified into one of two subtypes the purging type, which employs laxatives, diuretics, or self-induced vomiting to compensate for bingeing, or the nonpurging type, which relies on behaviors such as excessive exercising or fasting to...

Helmet Standards

Binge eating disorder An eating disorder that resembles bulimia but without the vomiting (purging). Girls with binge eating disorder feel that they lose control of themselves when eating, gorging themselves with huge amounts of food until they are uncomfortably full. Usually, they have more problem losing weight and keeping it off than do girls with anorexia or bulimia. In fact, most girls with the disorder are obese and have a history of weight fluctuations. About 3 percent of all teenage girls develop binge eating disorder.


While weight gain in children is certainly a concern in the context of a growing obesity epidemic, perhaps of more concern is the possible link between the early onset of dieting and the development of eating disorders in children and adolescents. A 1987 study of bulimia and binge-eating behavior in school-age populations found that, of 126 school children surveyed, 53 percent reported engaging in some form of binge behavior. While not directly linked to dieting behaviors, the prevalence of binge-eating was found to be closely associated with unwanted thoughts about food (Lakin and McClellan 1987). The predominance of young people at risk for bulimic behavior was also found to be high in a 1999 study of unhealthy eating behaviors in adolescents (Martin 1999). Studies have also shown that rates of anorexia amongst preadolescent girls have been increasing every decade since the 1950s (Inoko 2005 Emans 2000 American Academy of Pediatrics 2003). These studies and others demonstrate that...

Treatment Modalities

In the case of anorexia, these medications are most effective if employed after successful weight restoration is achieved, at which time they can be useful for relapse prevention and the treatment of coexisting psychiatric conditions. SSRIs are also used in preventing binge relapses among bulimics, although their effectiveness ceases once the medication is discontinued. Although antidepressants have also been employed in the treatment of binge eating disorder, outcomes have not been sufficiently positive to warrant recommendations for their use.

Eating Disorders

Eating disorders affect 3-5 million in the US 86 are diagnosed before the age of 20 and up to 11 of high-school students are affected. More than 90 are female, 95 Caucasian, and 75 have an onset in adolescence. Eating disorders are probably the most frequent causes of undernutrition in adolescents in developed countries, but only a relatively small percentage meet the full Diagnostic and Statistical Manual (DSM) IV criteria for anorexia nervosa (see Table 6), while most cases fall into the more general category eating disorder NOS (not otherwise specified). Bulimia, binge eating, and or purging are probably much more common than full-blown anorexia nervosa, with some estimates of up to 20-30 of college women in the US, and often occur surreptitiously without telltale weight loss. Lifetime prevalence estimates range from 0.5 to 3 for anorexia nervosa and 1-19 for bulimia. So far eating disorders are considered rare in developing countries, but prevalence often increases dramatically...

Anorexia Nervosa

A clinical diagnosis of anorexia nervosa necessitates body weight less than 85 percent of average for weight and height. Subtypes of this disorder include the binge eating purging type (bingeing and purging are present) or the restricting type (bingeing and purging are absent). see also Addiction, Food Body Image Bulimia Nervosa Eating Disorders Eating Disturbances.

Nutritional Findings

A key feature of bulimia nervosa is the extreme dietary restraint that is exhibited in between episodes of binge eating. Such behavior has been described as all or nothing, so that on a good day the sufferer may describe consuming a very low-energy diet, whereas a bad day will consist of several episodes of uncontrolled eating. This will be accompanied by the purging behaviors previously described. To sustain binge eating episodes, the person with bulimia nervosa may spend hundreds of pounds on food, selecting foods normally avoided during periods of dietary restraint which are easy to eat and subsequently remove from the body. To them, it is this overeating that is seen as the basic problem, not the dietary restraint that precedes it. Yet, it is this dietary restraint that drives the disorder. When not binge eating, it is common for patients to avoid eating for long periods, with 80 reporting consumption of one meal a day or less. While restricting their intake, they will consume...

Diagnostic Criteria

The behavior at the center of the disorder, binge eating, has been progressively redefined. A priority has been to separate binge eating from mere indulgence and everyday overeating. Accordingly, two features of a true binge have been identified consumption of unusually large amounts of food and an aversive sense of lack of control over eating. The size of binges varies but is typically between 1000-2000 kcal. and prevalence but has increased the numbers of those with atypical eating disorders. Failing to exhibit one or more of the key diagnostic features, such as an insufficient frequency of binge eating, is classified variously as atypical, partial syndrome or 'eating disorders not otherwise specified' (EDNOS). It is also useful to note that the diagnostic criteria for another eating disorder, binge eating disorder (BED), are included in DSM-IV, albeit for research purposes. The key difference between BED and bulimia nervosa is the absence of the extreme compensatory behaviors that...

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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