Binge Eating Disorder (BED) is more common than most people realize. In a culture obsessed with appearance, internalizing feelings of shame about body size and shape are all too common. The stereotypes and weight stigma associated with BED have a severe impact on both physical and mental health. To make matters worse, the multi-billion dollar weight loss industry works to further idealize the need to look a certain way and fosters patterns of disordered eating. The need for evidence-based treatments is key to effective, lasting BED recovery. Not only this, but finding an innovative treatment program that understands weight is not a defining characteristic of BED matters!
“It takes COURAGE to engage, STRENGTH to speak the truth, and HOPE to push through. Life is a lot better when people come together to battle the eating disorder rather than each other.” – Emily Estes, RD
As a clinician treating the full continuum of eating disorders, I have learned the following from my BED patients:
- BED shows a greater likelihood of remission than other eating disorders.
- Patients with BED respond more positively to specialty treatments (e.g., CBT) in terms of reduction of eating disorder behaviors.
- BED is not a choice. No one would choose the shame, discomfort, and depression that comes with BED.
- BED is a neurobiological condition that involves mind and body.
- Risk factors for BED include: genetics, a history of trauma, and a culture that idealizes thinness.
- Recovery does not include weight suppression.
Appropriate treatment of BED is NOT about weight loss. Intervention aimed at weight loss in BED patients shows less weight loss overall, more rapid weight regain, and higher attrition from treatment. Individuals struggling with BED may be those living in a larger body or they may be straight size. It is important to remember that an individual’s size is not going to tell us if the person has an eating disorder. My treatment focus for patients with BED includes the following:
- Identification of the adaptive function of binge eating.
- The development of skills to interrupt binge eating.
- Understanding how weight stigma contributes to the development of BED.
- Understanding how internalized weight stigma leads to unhealthy efforts to change body weight/size/shape and to make oneself worthy of love and self-love.
- The establishment of a healthy and even “joyful” relationship with food through nutritional rehabilitation. Patients need to learn to eat enough to let their bodies regulate and be fully nourished.
My ultimate goal is to help individuals with BED to heal their relationships with food and their bodies. My patients come to me with shame and self-loathing. It takes so much courage to take this brave leap to seek treatment and relief from the psychological and physical distress caused by a culture of weight stigma and, very often, a consequent eating disorder.
“Restricting calories is never a good idea for your health. Restricting negative thoughts should be the new “diet” trend.” – Rebecca McConville
Dr. Tamara Pryor, Executive Clinical Director and Director of Research at EDCare, has been privileged to work in the field of eating disorders for the past 30 years. Dr. Pryor has published research examining personality disorders, substance abuse, sexual functioning, and the neurobiology of the eating disordered individual. She has presented nationally and internationally, and she co-authored a prevention curriculum, as well as authored 4 chapters in a textbook on Eating Disorders and Substance Abuse. Dr. Pryor is a member of the Eating Disorder Research Society, a Fellow of the Academy of Eating Disorders and serves on the Board of Directors of the National Eating Disorders Association.