Bulimia nerwicowa nieograniczona

Bulimia nerwicowa nieograniczona
Leczenie

Bulimia nerwicowa nieograniczona (BED) to poważne zaburzenie odżywiania wymagające wielodyscyplinarnego podejścia terapeutycznego, obejmującego psychoterapię, farmakoterapię oraz wsparcie dietetyczne i rodzinne. Podstawą leczenia są terapie psychologiczne, w szczególności terapia poznawczo-behawioralna (CBT) oraz jej ulepszona forma CBT-E, które wykazują najwyższą skuteczność w redukcji napadów objadania się i poprawie kontroli nad zachowaniami żywieniowymi. Alternatywnie stosuje się terapię interpersonalną (IPT) oraz dialektyczno-behawioralną (DBT), które również przynoszą korzyści, choć efekty IPT pojawiają się wolniej. Samopomoc z przewodnikiem CBT (CBTgsh) jest rekomendowana jako pierwszy krok leczenia, szczególnie w systemach o ograniczonym dostępie do specjalistów. Farmakoterapia, obejmująca selektywne inhibitory wychwytu zwrotnego serotoniny (SSRI) oraz lisdeksamfetaminę (jedyny lek zatwierdzony przez FDA do leczenia BED), stanowi opcję u pacjentów niepoddających się psychoterapii lub preferujących leczenie farmakologiczne. Topiramat i inne leki są badane, jednak ich stosowanie ogranicza profil działań niepożądanych.

Leczenie bulimii nerwicowej nieograniczonej

Terapia psychologiczna
Samopomoc z przewodnikiem
Farmakoterapia
Wielodyscyplinarne podejście do leczenia
Skuteczność różnych metod leczenia

Wnioski i zalecenia

Kolejne rozdziały

Leczenie bulimii nerwicowej nieograniczonej

Bulimia nerwicowa nieograniczona (zaburzenie z napadami objadania się, binge eating disorder – BED) to poważne zaburzenie odżywiania, które wymaga kompleksowego podejścia terapeutycznego. Celem leczenia jest przywrócenie zdrowych, regularnych nawyków żywieniowych, zmniejszenie częstotliwości napadów objadania się oraz poprawa stanu emocjonalnego pacjenta. Skuteczne leczenie zaburzenia z napadami objadania się zazwyczaj wymaga zespołu specjalistów, w tym lekarzy, specjalistów zdrowia psychicznego i dietetyków, z których wszyscy posiadają doświadczenie w leczeniu zaburzeń odżywiania.¹

Terapia psychologiczna

Psychoterapia jest podstawą leczenia zaburzenia z napadami objadania się. Badania wskazują, że jest to najskuteczniejsza metoda terapeutyczna, zwłaszcza dla pacjentów z wyższym poziomem psychopatologii związanej z zaburzeniami odżywiania oraz ogólnej psychopatologii.² Do najczęściej stosowanych form terapii psychologicznej należą:

Terapia poznawczo-behawioralna (CBT)

Terapia poznawczo-behawioralna (CBT) jest najlepiej zbadaną i udokumentowaną metodą leczenia bulimii nerwicowej nieograniczonej. CBT pomaga pacjentom lepiej radzić sobie z czynnikami wyzwalającymi napady objadania się, takimi jak negatywne uczucia związane z własnym ciałem czy obniżony nastrój. Daje ona pacjentom większe poczucie kontroli nad ich zachowaniem i pomaga w kształtowaniu zdrowych wzorców żywieniowych.³ Specjalna forma CBT zwana ulepszoną CBT (CBT-E) została specjalnie zaprojektowana do leczenia zaburzeń odżywiania i wykazuje szczególną skuteczność.⁴

Meta-analizy dostarczyły silnych dowodów na to, że CBT prowadzona przez terapeutę zmniejsza częstotliwość napadów objadania się i zwiększa abstynencję od nich. Wyniki badań pokazują, że zarówno indywidualne, jak i grupowe formy CBT są związane ze znacznie wyższymi wskaźnikami abstynencji w porównaniu z brakiem leczenia, terapią wspierającą i behawioralnym leczeniem odchudzającym.⁵⁶

Terapia interpersonalna (IPT)

Terapia interpersonalna (IPT) skupia się na problemach interpersonalnych, funkcjach i rolach w relacjach międzyludzkich.⁷ Model interpersonalny napadów objadania się zakłada, że problemy społeczne tworzą środowisko, w którym rozwija się i utrzymuje objadanie jako mechanizm radzenia sobie, służący zmniejszeniu negatywnego afektu w odpowiedzi na niesatysfakcjonujące interakcje społeczne.⁸

IPT koncentruje się na identyfikacji i rozwiązywaniu konkretnych problemów interpersonalnych wpływających obecnie na pacjenta. Terapia jest prowadzona w formacie grupowym lub indywidualnym i obejmuje około dwadzieścia cotygodniowych sesji.⁹ Badania wykazały, że IPT jest skuteczną alternatywą dla CBT w leczeniu BED, chociaż uzyskanie rezultatów może trwać dłużej, a wskaźnik powodzenia jest niższy niż w przypadku CBT-E.¹⁰

Terapia dialektyczno-behawioralna (DBT)

Terapia dialektyczno-behawioralna (DBT) wywodzi się z terapii poznawczo-behawioralnej, ale jest specjalnie dostosowana dla osób, które doświadczają emocji bardzo intensywnie. Koncentruje się najpierw na akceptacji tych uczuć i nauce życia z nimi, a następnie na pracy nad zmianą zachowań.¹¹

Modyfikacja DBT w leczeniu BED opiera się na modelu regulacji afektu napadów objadania się, który zakłada, że objadanie się występuje w odpowiedzi na nieznośne doświadczenia emocjonalne, gdy bardziej adaptacyjne mechanizmy radzenia sobie nie są dostępne. Zakłada się, że angażowanie się w napady objadania się zapewnia tymczasową ulgę od negatywnego afektu, wzmacniając to zachowanie.¹²

Terapia DBT pomaga pacjentom nauczyć się umiejętności behawioralnych, które pomagają radzić sobie ze stresem, zarządzać emocjami i poprawiać relacje z innymi. Umiejętności te zmniejszają chęć objadania się.¹³ Badania wykazały, że DBT może być pomocna w zmniejszaniu napadów objadania się, ponieważ pomaga redukować nagłe, intensywne fale emocji.¹⁴

Samopomoc z przewodnikiem

Samopomoc z przewodnikiem CBT (CBTgsh) odpowiada na potrzebę szeroko dostępnych terapii dla BED. Takie leczenie jest tanie i wymaga minimalnej opieki specjalistycznej. Większość programów CBTgsh zapewnia uczestnikom podręcznik do samodzielnej pomocy „Overcoming Binge Eating” autorstwa Christophera Fairburna, a także regularne krótkie spotkania z terapeutą.¹⁵

Podobnie jak tradycyjna CBT, samopomoc z przewodnikiem zwalcza napady objadania się poprzez promowanie regularnych wzorców żywieniowych i umiarkowanego ograniczenia dietetycznego poprzez samomonitorowanie i strategie rozwiązywania problemów.¹⁶

Wytyczne brytyjskiego NICE zalecają ukierunkowaną na napady objadania się samopomoc z przewodnikiem jako pierwszy krok w leczeniu. Jeśli samopomoc z przewodnikiem nie jest odpowiednia dla pacjenta, zaleca się grupową CBT skupioną na zaburzeniach odżywiania.¹⁷

Farmakoterapia

Leczenie farmakologiczne może być zastosowane jako leczenie pierwszego rzutu u pacjentów, którzy nie mają dostępu do psychoterapii, odmawiają jej lub preferują leki. Według American Psychiatric Association zaleca się rozpoczęcie od selektywnych inhibitorów wychwytu zwrotnego serotoniny (SSRI) lub lisdeksamfetaminy.¹⁸ Oto główne opcje farmakologiczne:

Lisdeksamfetamina

Lisdeksamfetamina (Vyvanse) jest jedynym lekiem zatwierdzonym przez FDA do leczenia umiarkowanego do ciężkiego BED u dorosłych.¹⁹²⁰ Jest to stymulant zwykle przepisywany na ADHD, który pomaga zmniejszyć liczbę epizodów objadania się.²¹

Meta-analizy dostarczyły silnych dowodów, że lisdeksamfetamina zwiększa abstynencję od napadów objadania się.²² Według stanu na lipiec 2024 r., lisdeksamfetamina jest jedyną farmakoterapią zatwierdzoną przez USFDA i TGA w leczeniu BED.²³

Leki przeciwdepresyjne

Selektywne inhibitory wychwytu zwrotnego serotoniny (SSRI) mogą być pomocne w zmniejszaniu niektórych objawów BED.²⁴ Meta-analizy dostarczyły silnych dowodów, że leki przeciwdepresyjne drugiej generacji zwiększają abstynencję od napadów objadania się, zmniejszają ich częstotliwość oraz redukują obsesje i kompulsje związane z jedzeniem.²⁵

Badania wykazały, że fluoksetyna, fluwoksamina, citalopram i sertralina mogą być skuteczne w leczeniu BED.²⁶ Leki przeciwdepresyjne nie powinny być jednak oferowane jako jedyne leczenie bulimii nerwicowej nieograniczonej, ale mogą być stosowane w połączeniu z terapią lub leczeniem samopomocowym, aby pomóc w zarządzaniu innymi współistniejącymi stanami.²⁷

Inne leki

Topiramat (Topamax), lek przeciwpadaczkowy, może również pomagać w leczeniu BED, ale jego stosowanie jest ograniczone ze względu na profil działań niepożądanych, które mogą obejmować problemy z pamięcią, mrowienie w palcach rąk i stóp, problemy z mówieniem i sedację.²⁸

W trzech podwójnie ślepych, kontrolowanych placebo badaniach wykazano, że topiramat jest bardziej skuteczny niż placebo w leczeniu BED.²⁹ Inne leki badane w leczeniu BED to zonisamid, akamprozat, orlistat, atomoksetyna i duloksetyna.³⁰

Niedawno opublikowane w formie abstraktu badanie z randomizacją sugeruje, że donosowy nalokson może zmniejszać czas spędzony na napadach objadania się.³¹

Wielodyscyplinarne podejście do leczenia

Leczenie bulimii nerwicowej nieograniczonej najczęściej wymaga wielodyscyplinarnego podejścia, które uwzględnia aspekty medyczne, psychologiczne, żywieniowe i społeczne.³² Oto kluczowe elementy kompleksowego leczenia:

Poradnictwo żywieniowe

Poradnictwo żywieniowe jest istotnym elementem leczenia BED. Dietetycy pomagają pacjentom opracować zrównoważone plany posiłków, normalizować relację z jedzeniem i osiągnąć zdrową wagę.³³ Edukacja żywieniowa obejmuje informacje o różnych składnikach odżywczych i ich znaczeniu dla organizmu.³⁴

Należy podkreślić, że podczas leczenia nie zaleca się stosowania diet odchudzających, ponieważ może to utrudniać zaprzestanie napadów objadania się.³⁵ Zarówno wytyczne NICE, jak i SIGN stanowią, że terapie psychologiczne w leczeniu BED nie mają na celu doprowadzenia do utraty wagi ani się na niej nie koncentrują.³⁶

Terapia rodzinna

Wsparcie rodziny jest bardzo ważne dla powodzenia leczenia. Pomaga członkom rodziny zrozumieć zaburzenie odżywiania i rozpoznać jego oznaki i objawy, aby mogli lepiej wspierać pacjenta.³⁷

Terapię rodzinną należy rozważyć, gdy dynamika rodzinna odgrywa znaczącą rolę jako czynnik wyzwalający napady objadania się, szczególnie u dzieci i młodszych nastolatków.³⁸ Terapia oparta na rodzinie (FBT) jest popularną metodą leczenia zaburzeń odżywiania, szczególnie w terapii skoncentrowanej na nastolatkach.³⁹

Poziomy opieki

Leczenie BED może odbywać się na różnych poziomach intensywności, w zależności od nasilenia objawów i indywidualnych potrzeb pacjenta:⁴⁰

Leczenie szpitalne: Całodobowa opieka w warunkach szpitalnych, zazwyczaj dla pacjentów wymagających stabilizacji medycznej.
Leczenie stacjonarne: Całodobowa opieka w bardziej domowym środowisku, z multidyscyplinarnym podejściem.
Programy częściowej hospitalizacji (PHP): Pacjenci mieszkają i śpią w domu, ale dojeżdżają na intensywne leczenie w ciągu dnia.
Intensywne leczenie ambulatoryjne (IOP): Mniej intensywne niż PHP, pacjenci uczęszczają na sesje terapeutyczne kilka razy w tygodniu.
Leczenie ambulatoryjne: Najmniej intensywny poziom opieki, pacjenci muszą być w większości kontrolować swoje myśli i zachowania.⁴¹⁴²

Skuteczność różnych metod leczenia

Badania wskazują, że CBT, IPT i CBTgsh, które bezpośrednio skupiają się na napadach objadania się i związanej z nimi patologii, są związane z najbardziej solidnymi wskaźnikami abstynencji od napadów objadania się w krótkim i długim okresie.⁴³

W ogólnym ujęciu, badania pokazują, że CBT, IPT i DBTgsh są skutecznymi metodami leczenia BED, podczas gdy behawioralne leczenie odchudzające (BWL) jest mniej skuteczne w redukcji napadów objadania się.⁴⁴ Terapie CBT i IPT mogą być bardziej skuteczne niż behawioralna terapia utraty wagi (BWLT) w redukcji napadów objadania się w długoterminowej perspektywie.⁴⁵

Metaanaliza 45 badań wykazała umiarkowane poparcie dla skuteczności CBT i samopomocowej CBT oraz skromne poparcie dla IPT, SSRI i lisdeksamfetaminy w leczeniu dorosłych z BED w zakresie zaprzestania lub zmniejszenia częstotliwości napadów objadania się.⁴⁶

Dowody są niejednoznaczne co do skuteczności kombinacji leczenia farmakologicznego i psychologicznego w poprawie wyników BED.⁴⁷ Jednak niektóre badania sugerują, że łączenie psychoterapii i farmakoterapii może prowadzić do niewielkich dodatkowych korzyści.⁴⁸

Wnioski i zalecenia

Na podstawie obecnych dowodów naukowych, rozsądnym podejściem jest skierowanie pacjentów z bulimią nerwicową nieograniczoną do programu CBT prowadzonego przez terapeutę jako leczenia pierwszego rzutu. Pacjenci, którzy nie mają dostępu do programu lub nie reagują na CBT, mogą otrzymać lisdeksamfetaminę lub lek przeciwdepresyjny drugiej generacji.⁴⁹

Ważne jest, aby zrozumieć, że bulimia nerwicowa nieograniczona jest poważnym zaburzeniem, które wymaga fachowego leczenia. Większość osób z BED potrzebuje leczenia, aby poczuć się lepiej, a bez niego może dojść do poważnych problemów zdrowotnych i obniżenia jakości życia.⁵⁰

Cele leczenia BED obejmują:

Zmniejszenie liczby napadów objadania się
Rozwijanie zdrowych nawyków żywieniowych i ćwiczeniowych
Rozwijanie zdrowego poglądu na siebie i swoje ciało⁵¹

Trzymanie się planu leczenia przez długi czas jest najbardziej prawdopodobne, aby zatrzymać zaburzenie z napadami objadania się. Należy pamiętać, że osiągnięcie celów może wymagać czasu.⁵²

Pełne wyleczenie z bulimii nerwicowej nieograniczonej jest możliwe przy odpowiednim wsparciu i leczeniu. Niektórzy pacjenci dochodzą do zdrowia po pierwszym leczeniu, inni zdrowieją, ale mogą wymagać ponownego leczenia.⁵³

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Materiały źródłowe

#1 Binge-eating disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633
The goal for treatment of binge-eating disorder is to have healthy, regular eating habits. Because binge eating often involves shame, poor body self-image and other negative emotions, treatment also addresses these and related mental health conditions, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating. […] Treatment of binge-eating disorder may be done by a team of specialists. The team can include doctors and other healthcare professionals, mental health professionals, and dietitians, all with experience in eating disorders. […] Talk therapy, also called psychotherapy, can help you learn how to exchange unhealthy habits for healthy ones and reduce binge eating. Talk therapy may be in individual or group sessions. Examples of types of talk therapy that can help binge-eating disorder include:
#2 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Binge eating disorder (BED) is the most prevalent eating disorder in adults, and individuals with BED report greater general and specific psychopathology than non-eating disordered individuals. The current paper reviews research on psychological treatments for BED, including the rationale and empirical support for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), behavioral weight loss (BWL), and other treatments warranting further study. Research supports the effectiveness of CBT and IPT for the treatment of BED, particularly for those with higher eating disorder and general psychopathology. Guided self-help CBT has shown efficacy for BED without additional pathology. DBT has shown some promise as a treatment for BED, but requires further study to determine its long-term efficacy.
#3 Binge-eating disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633
Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge eating, such as negative feelings about your body or a depressed mood. CBT also may give you a better sense of control over your behavior and help you gain healthy-eating patterns. A form of CBT called enhanced CBT (CBT-E) is specifically designed to treat eating disorders. […] Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating. […] Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.
#4 What Are theÂ Best Binge Eating Disorder Treatment Options?
https://www.verywellhealth.com/binge-eating-disorder-treatment-5181762
Binge eating disorder treatment can include psychotherapy and lifestyle changes and may include medication. […] Treatment for binge eating disorder typically involves a form of psychotherapy and prescription medication, such as antidepressants. […] Psychotherapy is the most common treatment for binge eating disorder. Several types of therapy are available for treating binge eating disorder, but cognitive behavioral therapy (CBT) is generally the first one tried. […] A form of CBT called Enhanced CBT (CBT-E) has been developed specifically to help people with eating disorders. […] CBT-E emphasizes addressing the underlying disordered thinking that causes eating disorders, rather than the symptoms. […] Interpersonal psychotherapy (IPT) for binge eating disorder helps people work on problems they’re having in their relationships, such as poor communication and arguments with their family, friends, and coworkers.
#5 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Treatments for BED target binge eating, associated eating disorder psychopathology, and the prevention of excess weight gain or modest weight loss. The present paper will review randomized controlled trials (RCTs) of psychological treatments for BED in order to inform current clinical practice and future research. The rationale and empirical evidence for cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), behavioral weight loss treatment (BWL), and dialectical behavior therapy (DBT), as well as promising alternative treatments, will be presented. […] Cognitive behavioral therapy is the most studied and well-established psychological treatment for BED. Overall, research has shown that individual and group formats of CBT are associated with significantly higher abstinence rates compared with no treatment, supportive therapy, and BWL, with individual and group therapy formats producing similar long-term results.
#6 Management of Binge-Eating Disorder in Adults | AAFP
https://www.aafp.org/pubs/afp/issues/2017/0301/p324.html
Therapist-led cognitive behavior therapy (CBT) reduces binge-eating frequency and increases binge-eating abstinence. (Strength of Recommendation [SOR]: A, based on consistent, good-quality patient-oriented evidence.) […] Binge-eating disorder can be treated with psychological and behavior therapies and pharmacotherapy. Psychotherapeutic options include behavioral weight loss therapy, CBT, interpersonal psychotherapy, and dialectical behavior therapy. […] The U.S. Food and Drug Administration approved lisdexamfetamine for treatment of moderate to severe binge-eating disorder. Other treatments include topiramate and second-generation antidepressants. […] Meta-analyses provided strong evidence that therapist-led CBT reduces binge-eating frequency and increases binge-eating abstinence. […] The AHRQ review is consistent with the American Psychiatric Association practice guideline for the treatment of patients with eating disorders, which strongly recommends individual and group CBT for binge-eating disorders, as well as guided self-help programs. […] Based on the AHRQ review, a reasonable approach is to refer patients with binge-eating disorder to a therapist-led CBT program as first-line therapy. Patients who are unable to access a program or who do not respond to CBT may be prescribed lisdexamfetamine or a second-generation antidepressant.
#7 Binge Eating Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK551700/
Effective psychotherapy treatments for binge eating disorder include cognitive behavioral therapy, interpersonal psychotherapy, and dialectical behavioral therapy. […] Cognitive behavioral therapy focuses on identifying and changing maladaptive patterns of thought and behavior. […] Interpersonal psychotherapy focuses on interpersonal stressors, functions, and roles. […] Dialectical behavioral therapy focuses on developing tools for affect regulation. […] Pharmacotherapy should be used as first-line therapy in patients who do not have access to psychotherapy, decline psychotherapy, or prefer medications. The APA recommends starting with selective serotonin reuptake inhibitors or lisdexamfetamine. Medication options include: Lisdexamfetamine (the only medication with Food and Drug Administration approval for moderate-to-severe binge eating disorder in adults). […] Behavioral weight loss is an evidence-based strategy that helps with weight loss and reduces binge eating episodes by decreasing caloric intake, increasing activity, and focusing on the nutritional quality of food.
#8 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Guided self-help CBT (CBTgsh) addresses the need for more widely disseminable therapies for BED. Such treatments are low cost and require minimal specialist care. The majority of CBTgsh treatments provide participants with the self-help manual Overcoming Binge Eating by Christopher Fairburn, as well as regular brief meetings with a therapist. Like traditional CBT, guided self-help targets binge eating by promoting regular eating patterns and moderate dietary restraint through self-monitoring and problem-solving strategies. […] Interpersonal psychotherapy (IPT) has been applied to the treatment of BED based on a strong body of evidence demonstrating a consistent relationship between poor interpersonal functioning and eating disorders. The interpersonal model of binge eating posits that social problems create an environment in which binge eating develops and is maintained as a coping mechanism, serving to reduce negative affect in response to unfulfilling social interactions.
#9 Interpersonal Psychotherapy for Binge Eating Disorder | Society of Clinical Psychology
https://div12.org/treatment/interpersonal-psychotherapy-for-binge-eating-disorder/
DIAGNOSIS: Binge Eating Disorder TREATMENT: Interpersonal Psychotherapy for Binge Eating Disorder […] Interpersonal Psychotherapy (IPT) for binge eating disorder is based on an intervention originally developed for the treatment of depression. […] IPT for binge eating disorder is administered in either group or individual format, and is conducted in approximately twenty weekly sessions, which encompass three phases. […] The first phase of IPT is devoted to identifying specific interpersonal problems areas currently affecting the patient, and choosing which of these areas to focus on for the remainder of treatment. […] In the second phase of IPT for binge eating disorder, the therapist encourages the patient to take the lead in facilitating change in the interpersonal realm. […] The third phase covers maintenance of interpersonal gains and relapse prevention.
#10 What Are theÂ Best Binge Eating Disorder Treatment Options?
https://www.verywellhealth.com/binge-eating-disorder-treatment-5181762
It takes longer to see results with IPT for binge eating disorder and the success rate is lower than it is with CBT-E. […] Treatment for binge eating disorder may involve more than one approach at a time, such as CBT-E and medication. […] Prescription medications that are used to treat other conditions such as depression, attention deficit hyperactivity disorder (ADHD), and epilepsy are sometimes used to treat binge eating disorder as well. […] Topiramate (Topamax) is an anticonvulsant that has been used to treat binge eating disorder. […] Lisdexamfetamine (Vyvanse) is a stimulant used to treat ADHD that has been shown to decrease binge eating. […] Binge eating disorder is best treated under the guidance of a healthcare provider or mental health professional, but there are things you can do on your own to help get the most out of your treatment plan.
#11 Binge Eating Disorder: What It Is, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/17652-binge-eating-disorder
Dialectical behavior therapy (DBT). This method is based on cognitive behavioral therapy, but its specially adapted for people who experience emotions very intensely. It focuses on first accepting those feelings and learning to live with them, and then working to change your behaviors. […] Interpersonal psychotherapy (IPT). IPT is a short-term, focused type of therapy that addresses the current relationship conflicts and stress factors affecting your life. Rather than dig into childhood issues, your therapist will focus on problem-solving your most immediate pain points.
#12 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Research shows that BWL is not as effective as specialist treatments for BED in reducing binge eating. Notably, a recent meta-analysis found that BWL only inconsistently produced reductions in binge eating. […] The modification of DBT for BED is based on the affect regulation model of binge eating, which posits that binge eating occurs in response to intolerable emotional experiences when more adaptive coping mechanisms are not accessible. Engaging in binge eating is hypothesized to provide temporary relief from negative affect, reinforcing the behavior. […] Overall, research shows that CBT, IPT, and CBTgsh, which directly target binge eating and associated pathology, are associated with the most robust short- and long-term binge abstinence rates. Additionally, DBT shows promise as a specialist treatment for BED, but further research is needed to elucidate its long-term efficacy compared with nonspecific and established therapies for BED.
#13 Binge-eating disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633
Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge eating, such as negative feelings about your body or a depressed mood. CBT also may give you a better sense of control over your behavior and help you gain healthy-eating patterns. A form of CBT called enhanced CBT (CBT-E) is specifically designed to treat eating disorders. […] Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating. […] Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.
#14 Binge Eating Disorder (BED) Treatment & Management: Approach Considerations, Consultations, Medication Treatment
https://emedicine.medscape.com/article/2221362-treatment
Guided self-help (GSH) appears to be less effective than CBT or DBT for BED. […] Integrative response therapy, which has the mnemonic RESPONSES (Reflect, Exercise, Start distracting, Problem Solve, Open communication, get distaNce, Soothe, get cEntered, Social and/or pleasurable activities) appeared to be an effective group-based cognitive restructuring and emotion management technique. […] Dialectical behavior therapy (DBT) can be helpful to reduce binge eating, as it helps to reduce sudden intense surges of emotion. […] Mindfulness meditation, when added to other interventions, appeared to be helpful. […] Yoga has appeared to provide lasting maintenance of stable BMI in some persons with BED. […] Bariatric surgery, although proven to help obese individuals with weight loss, may not be as effective in persons with BED unless they also receive an evidence-based intervention to ensure that the weight loss from the bariatric surgery is maintained.
#15 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Guided self-help CBT (CBTgsh) addresses the need for more widely disseminable therapies for BED. Such treatments are low cost and require minimal specialist care. The majority of CBTgsh treatments provide participants with the self-help manual Overcoming Binge Eating by Christopher Fairburn, as well as regular brief meetings with a therapist. Like traditional CBT, guided self-help targets binge eating by promoting regular eating patterns and moderate dietary restraint through self-monitoring and problem-solving strategies. […] Interpersonal psychotherapy (IPT) has been applied to the treatment of BED based on a strong body of evidence demonstrating a consistent relationship between poor interpersonal functioning and eating disorders. The interpersonal model of binge eating posits that social problems create an environment in which binge eating develops and is maintained as a coping mechanism, serving to reduce negative affect in response to unfulfilling social interactions.
#16 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Guided self-help CBT (CBTgsh) addresses the need for more widely disseminable therapies for BED. Such treatments are low cost and require minimal specialist care. The majority of CBTgsh treatments provide participants with the self-help manual Overcoming Binge Eating by Christopher Fairburn, as well as regular brief meetings with a therapist. Like traditional CBT, guided self-help targets binge eating by promoting regular eating patterns and moderate dietary restraint through self-monitoring and problem-solving strategies. […] Interpersonal psychotherapy (IPT) has been applied to the treatment of BED based on a strong body of evidence demonstrating a consistent relationship between poor interpersonal functioning and eating disorders. The interpersonal model of binge eating posits that social problems create an environment in which binge eating develops and is maintained as a coping mechanism, serving to reduce negative affect in response to unfulfilling social interactions.
#17 Treatment for Binge Eating Disorder
https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/binge-eating-disorder/treatment/
The recommended treatments for binge eating disorder are mainly based on cognitive behavioural therapy (CBT), a talking therapy that aims to help you deal positively with the underlying thoughts and feelings that cause the illness by breaking problems down into smaller parts. […] NICE recommends guided self-help focused specifically on binge eating disorder as the first step. […] If guided self-help isnt appropriate for you, NICE recommends group CBT focused on eating disorders. […] For adults with binge eating disorder, it recommends CBT or interpersonal psychotherapy as first-line therapies. […] Both NICE and SIGN guidelines state that psychological therapies for BED do not aim to result in or focus on weight loss. […] Treatment for binge eating disorder should aim to reduce the frequency of binges, tackle thoughts related to bingeing, and improve mood. […] Self-help and support groups where youre able to talk to others going through similar experiences can be useful to both people with eating disorders and their families throughout treatment and in sustaining recovery.
#18 Binge Eating Disorder – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK551700/
Effective psychotherapy treatments for binge eating disorder include cognitive behavioral therapy, interpersonal psychotherapy, and dialectical behavioral therapy. […] Cognitive behavioral therapy focuses on identifying and changing maladaptive patterns of thought and behavior. […] Interpersonal psychotherapy focuses on interpersonal stressors, functions, and roles. […] Dialectical behavioral therapy focuses on developing tools for affect regulation. […] Pharmacotherapy should be used as first-line therapy in patients who do not have access to psychotherapy, decline psychotherapy, or prefer medications. The APA recommends starting with selective serotonin reuptake inhibitors or lisdexamfetamine. Medication options include: Lisdexamfetamine (the only medication with Food and Drug Administration approval for moderate-to-severe binge eating disorder in adults). […] Behavioral weight loss is an evidence-based strategy that helps with weight loss and reduces binge eating episodes by decreasing caloric intake, increasing activity, and focusing on the nutritional quality of food.
#19 Binge-eating disorder – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/diagnosis-treatment/drc-20353633
Lisdexamfetamine dimesylate (Vyvanse) is a medicine for attention-deficit/hyperactivity disorder (ADHD). This is the first medicine approved by the U.S. Food and Drug Administration to treat moderate to severe binge-eating disorder, but only in adults. […] Examples of other types of medicine that may help reduce symptoms of binge-eating disorder include certain medicines used to control seizures and certain antidepressants. […] If you have binge-eating disorder, you and your family may find support groups helpful for encouragement, hope and advice on coping. Support group members can understand what you’re going through because they’ve been there themselves. Ask your healthcare professional or mental health professional about finding a group in your area.
#20 Treatment for Binge Eating Disorder
https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-disorder-treatment
Treatment of binge eating disorder is challenging, because most people feel ashamed of their disorder and try to hide their problem. […] Eating disorders require a big-picture treatment plan that’s tailored to meet your individual needs. The goal is to help you gain control over your eating behavior. Most often, it involves a combination of strategies. […] This is a type of individual counseling that focuses on changing your thinking (cognitive therapy) and behavior (behavioral therapy). It includes practical techniques for developing healthy attitudes toward food and weight, as well as approaches for changing the way you respond to difficult situations. […] Lisdexamfetamine (Vyvanse) is approved by the FDA to treat binge eating disorder. The drug, which is also used to treat ADHD, helps reduce the number of episodes and is the first FDA-approved medication to treat binge eating disorder.
#21 Binge Eating Disorder: Treatment, Therapy, Medication | Psych Central
https://psychcentral.com/eating-disorders/treatment-for-binge-eating-disorder
While medication alone is generally not enough to treat binge eating disorder, some medications may be helpful. […] Lisdexamfetamine (Vyvanse) is a stimulant usually prescribed for attention deficit hyperactivity disorder (ADHD). However, the Food and Drug Administration (FDA) approved the medication to treat moderate to severe binge eating disorder in 2015. […] Antidepressants also are used to treat BED. […] Several treatment guidelines and reviews also recommend topiramate (Topamax), an anticonvulsant, to treat BED. […] For most people with binge eating disorder, outpatient treatment is best. […] Still, sometimes residential or inpatient treatment at a special facility for eating disorders may be necessary. […] While BED most often requires professional help, research indicates that some self-help strategies can be somewhat beneficial as well especially when you have guidance and support from a healthcare professional who specializes in disordered eating.
#22 Management and Outcomes of Binge-Eating Disorder in Adults: Current State of the Evidence | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/binge-eating/clinician
Evidence was insufficient to determine with confidence the effectiveness of other psychological interventions; however, studies of IPT and DBT have been promising. […] Efficacy studies of pharmacological interventions only measured outcomes at the end of treatment (6 to 16 weeks) and had no long-term followup. […] Meta-analyses provided strong evidence that lisdexamfetamine increased binge-eating abstinence and that second-generation antidepressants increased binge-eating abstinence, reduced binge-eating frequency, and reduced eating-related obsessions and compulsions. […] Evidence was inconclusive about the comparative effectiveness of pharmacological interventions to improve BED outcomes. […] Evidence was inconclusive about the effectiveness of any combination of pharmacological and psychological treatments to improve BED outcomes.
#23 Binge eating disorder – Wikipedia
https://en.wikipedia.org/wiki/Binge_eating_disorder
Counseling and some medication, such as certain stimulants (e.g. lisdexamfetamine), selective serotonin reuptake inhibitors (SSRIs), and GLP-1 receptor agonists, may help people with a binge eating disorder (BED). […] Some recommend a multidisciplinary approach in the treatment of the disorder. […] As of July 2024, lisdexamfetamine is the only pharmacotherapy approved by the USFDA and TGA for BED. […] Evidence indicates that its effectiveness in treating BED may be partially due to a psychopathological overlap with Attention deficit hyperactivity disorder, a cognitive control disorder that also benefits from treatment with lisdexamfetamine. […] Medical reviews of randomized controlled trials have established that lisdexamfetamine, administered at doses between 50 and 70 mg, is safe and effective for treating BED.
#24 Treatment for Binge Eating Disorder
https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-disorder-treatment
The antiseizure drug topiramate (Topamax) may also help, but its side effects can include memory problems, tingling sensations in fingers and toes, trouble speaking, and sedation. […] Family support is very important to treatment success. It helps your family members understand your eating disorder and recognize its signs and symptoms so they can support you better. […] Like other eating disorders, binge eating disorder is a serious problem that can be solved with proper treatment. With treatment and commitment, many people with this disorder can overcome the habit of overeating and learn healthy eating patterns.
#25 Management and Outcomes of Binge-Eating Disorder in Adults: Current State of the Evidence | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/binge-eating/clinician
Evidence was insufficient to determine with confidence the effectiveness of other psychological interventions; however, studies of IPT and DBT have been promising. […] Efficacy studies of pharmacological interventions only measured outcomes at the end of treatment (6 to 16 weeks) and had no long-term followup. […] Meta-analyses provided strong evidence that lisdexamfetamine increased binge-eating abstinence and that second-generation antidepressants increased binge-eating abstinence, reduced binge-eating frequency, and reduced eating-related obsessions and compulsions. […] Evidence was inconclusive about the comparative effectiveness of pharmacological interventions to improve BED outcomes. […] Evidence was inconclusive about the effectiveness of any combination of pharmacological and psychological treatments to improve BED outcomes.
#26
https://link.springer.com/article/10.1007/s40501-014-0023-4
Typically, up to three targets exist for treatment in BED: binge eating behavior, eating disorder cognitions, and weight loss. By and large, the same agents are used to address each of these symptoms. […] In general, fluoxetine has shown little added benefit for binge eating, particularly when added to CBT, although there was benefit for weight in one study and for depression in another. […] In a 9-week double-blind, placebo-controlled trial, fluvoxamine was more effective than placebo in reducing binge eating behavior. […] In a 6-week placebo-controlled, double-blind trial, citalopram has been shown to diminish BED symptoms. […] Sertraline has been shown to be effective in the treatment of binge eating in a single 6-week double-blind, placebo-controlled, randomized study. […] In three double-blind, placebo-controlled trials, topiramate was shown to be more effective than placebo in the treatment of BED. […] One 16-week double-blind, placebo-controlled trial has shown that zonisamide is effective in the treatment of BED. […] Acamprosate was shown in one placebo-controlled, double-blind trial to be potentially useful in the treatment of BED. […] Orlistat was shown in one placebo-controlled, double-blinded study to produce greater weight loss than placebo in the treatment of BED. […] Atomoxetine was shown to be effective in reducing binge eating frequency, weight, and overall severity of illness and eating disorder cognitions as compared with placebo. […] Duloxetine had greater impact on frequency of binge eating and overall severity of illness ratings.
#27 Treatment – Binge eating disorder – NHS
https://www.nhs.uk/mental-health/conditions/binge-eating/treatment/
Most people get better from binge eating disorder with treatment and support. […] You’ll probably be offered a guided self-help programme as a first step in treating binge eating disorder. […] If self-help treatment alone is not enough or has not helped you after 4 weeks, you may also be offered cognitive behavioural therapy or medicine. […] If you’re offered CBT, it will usually be in group sessions with other people, but it may also be offered as 1-to-1 sessions with a therapist. […] CBT involves talking to a therapist, who will help you explore patterns of thoughts, feelings and behaviours that could be contributing to your eating disorder. […] You should not try to diet while you’re having treatment because this can make it more difficult to stop binge eating. […] Antidepressants should not be offered as the only treatment for binge eating disorder. But you may be offered an antidepressant in combination with therapy or self-help treatment to help you manage other conditions.
#28 Treatment for Binge Eating Disorder
https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-disorder-treatment
The antiseizure drug topiramate (Topamax) may also help, but its side effects can include memory problems, tingling sensations in fingers and toes, trouble speaking, and sedation. […] Family support is very important to treatment success. It helps your family members understand your eating disorder and recognize its signs and symptoms so they can support you better. […] Like other eating disorders, binge eating disorder is a serious problem that can be solved with proper treatment. With treatment and commitment, many people with this disorder can overcome the habit of overeating and learn healthy eating patterns.
#29
https://link.springer.com/article/10.1007/s40501-014-0023-4
Typically, up to three targets exist for treatment in BED: binge eating behavior, eating disorder cognitions, and weight loss. By and large, the same agents are used to address each of these symptoms. […] In general, fluoxetine has shown little added benefit for binge eating, particularly when added to CBT, although there was benefit for weight in one study and for depression in another. […] In a 9-week double-blind, placebo-controlled trial, fluvoxamine was more effective than placebo in reducing binge eating behavior. […] In a 6-week placebo-controlled, double-blind trial, citalopram has been shown to diminish BED symptoms. […] Sertraline has been shown to be effective in the treatment of binge eating in a single 6-week double-blind, placebo-controlled, randomized study. […] In three double-blind, placebo-controlled trials, topiramate was shown to be more effective than placebo in the treatment of BED. […] One 16-week double-blind, placebo-controlled trial has shown that zonisamide is effective in the treatment of BED. […] Acamprosate was shown in one placebo-controlled, double-blind trial to be potentially useful in the treatment of BED. […] Orlistat was shown in one placebo-controlled, double-blinded study to produce greater weight loss than placebo in the treatment of BED. […] Atomoxetine was shown to be effective in reducing binge eating frequency, weight, and overall severity of illness and eating disorder cognitions as compared with placebo. […] Duloxetine had greater impact on frequency of binge eating and overall severity of illness ratings.
#30
https://link.springer.com/article/10.1007/s40501-014-0023-4
Typically, up to three targets exist for treatment in BED: binge eating behavior, eating disorder cognitions, and weight loss. By and large, the same agents are used to address each of these symptoms. […] In general, fluoxetine has shown little added benefit for binge eating, particularly when added to CBT, although there was benefit for weight in one study and for depression in another. […] In a 9-week double-blind, placebo-controlled trial, fluvoxamine was more effective than placebo in reducing binge eating behavior. […] In a 6-week placebo-controlled, double-blind trial, citalopram has been shown to diminish BED symptoms. […] Sertraline has been shown to be effective in the treatment of binge eating in a single 6-week double-blind, placebo-controlled, randomized study. […] In three double-blind, placebo-controlled trials, topiramate was shown to be more effective than placebo in the treatment of BED. […] One 16-week double-blind, placebo-controlled trial has shown that zonisamide is effective in the treatment of BED. […] Acamprosate was shown in one placebo-controlled, double-blind trial to be potentially useful in the treatment of BED. […] Orlistat was shown in one placebo-controlled, double-blinded study to produce greater weight loss than placebo in the treatment of BED. […] Atomoxetine was shown to be effective in reducing binge eating frequency, weight, and overall severity of illness and eating disorder cognitions as compared with placebo. […] Duloxetine had greater impact on frequency of binge eating and overall severity of illness ratings.
#31 Overview of the treatment of binge eating disorder | CNS Spectrums | Cambridge Core
https://www.cambridge.org/core/journals/cns-spectrums/article/overview-of-the-treatment-of-binge-eating-disorder/AFA81AEC09F49D3D34FCB2CA0300EB75
We performed a qualitative review of treatment studies of binge eating disorder (BED), focusing on randomized clinical trials (RCTs). Limited effectiveness has been demonstrated for self-help strategies, and substantial effectiveness has been shown for cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT and IPT may each be more effective than behavior weight loss therapy (BWLT) for reducing binge eating over the long term. The stimulant pro-drug lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for the treatment of BED in adults based on 2 pivotal RCTs. Topiramate also decreases binge eating behavior, but its use is limited by its adverse event profile. Antidepressants may be modestly effective over the short term for reducing binge eating behavior and comorbid depressive symptoms, but are not associated with clinically significant weight loss. A RCT presented in abstract form suggests that intranasal naloxone may decrease time spent binge eating. There is no RCT of obesity surgery in BED, but many patients with BED seek and receive such surgery. While some studies suggest patients with BED and obesity do just as well as patients with obesity alone, other studies suggest that patients with BED have more post-operative complications, less weight loss, and more weight regain. This evidence suggests that patients with BED would benefit from receiving highly individualized treatment.
#32 Binge eating disorder – Wikipedia
https://en.wikipedia.org/wiki/Binge_eating_disorder
Counseling and some medication, such as certain stimulants (e.g. lisdexamfetamine), selective serotonin reuptake inhibitors (SSRIs), and GLP-1 receptor agonists, may help people with a binge eating disorder (BED). […] Some recommend a multidisciplinary approach in the treatment of the disorder. […] As of July 2024, lisdexamfetamine is the only pharmacotherapy approved by the USFDA and TGA for BED. […] Evidence indicates that its effectiveness in treating BED may be partially due to a psychopathological overlap with Attention deficit hyperactivity disorder, a cognitive control disorder that also benefits from treatment with lisdexamfetamine. […] Medical reviews of randomized controlled trials have established that lisdexamfetamine, administered at doses between 50 and 70 mg, is safe and effective for treating BED.
#33
https://www.fideliscare.org/Member/Helpful-Tools/Health-Resources/Eating-Disorders
Nutritional Counseling: Registered dietitians help individuals develop balanced meal plans, normalize their relationship with food, and achieve a healthy weight. […] Medical Monitoring: Regular medical checkups monitor physical health, manage complications, and address any nutritional deficiencies. […] Medication: In some cases, medication may be prescribed to address co-occurring mental health conditions such as depression, anxiety, or obsessive-compulsive disorder (OCD). […] Support Groups: Connecting with others who have experienced similar struggles can provide support and encouragement.
#34
https://www.hcavirginia.com/specialties/mental-health-and-wellness/eating-disorders
Our group therapy work incorporates DBT skills training in emotion regulation, distress tolerance, interpersonal skills and mindfulness. […] Participants in our partial hospitalization program (PHP) have the opportunity to participate in „real world” activities. […] We offer many types of expressive therapy such as dance or movement, art, poetry, creative writing, drama and play therapies. […] Many patients with eating disorders have a variety of medical needs, so our programs begin with a complete physical exam. […] Nutrition groups include education on various nutrients and why the body needs them. […] All program participants are assigned a psychiatrist upon admittance to the program. […] Our programs offer varying levels of care for eating disorder treatment, including inpatient, partial hospitalization, intensive outpatient and routine outpatient programs.
#35 Treatment – Binge eating disorder – NHS
https://www.nhs.uk/mental-health/conditions/binge-eating/treatment/
Most people get better from binge eating disorder with treatment and support. […] You’ll probably be offered a guided self-help programme as a first step in treating binge eating disorder. […] If self-help treatment alone is not enough or has not helped you after 4 weeks, you may also be offered cognitive behavioural therapy or medicine. […] If you’re offered CBT, it will usually be in group sessions with other people, but it may also be offered as 1-to-1 sessions with a therapist. […] CBT involves talking to a therapist, who will help you explore patterns of thoughts, feelings and behaviours that could be contributing to your eating disorder. […] You should not try to diet while you’re having treatment because this can make it more difficult to stop binge eating. […] Antidepressants should not be offered as the only treatment for binge eating disorder. But you may be offered an antidepressant in combination with therapy or self-help treatment to help you manage other conditions.
#36 Treatment for Binge Eating Disorder
https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/binge-eating-disorder/treatment/
The recommended treatments for binge eating disorder are mainly based on cognitive behavioural therapy (CBT), a talking therapy that aims to help you deal positively with the underlying thoughts and feelings that cause the illness by breaking problems down into smaller parts. […] NICE recommends guided self-help focused specifically on binge eating disorder as the first step. […] If guided self-help isnt appropriate for you, NICE recommends group CBT focused on eating disorders. […] For adults with binge eating disorder, it recommends CBT or interpersonal psychotherapy as first-line therapies. […] Both NICE and SIGN guidelines state that psychological therapies for BED do not aim to result in or focus on weight loss. […] Treatment for binge eating disorder should aim to reduce the frequency of binges, tackle thoughts related to bingeing, and improve mood. […] Self-help and support groups where youre able to talk to others going through similar experiences can be useful to both people with eating disorders and their families throughout treatment and in sustaining recovery.
#37 Treatment for Binge Eating Disorder
https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/binge-eating-disorder-treatment
The antiseizure drug topiramate (Topamax) may also help, but its side effects can include memory problems, tingling sensations in fingers and toes, trouble speaking, and sedation. […] Family support is very important to treatment success. It helps your family members understand your eating disorder and recognize its signs and symptoms so they can support you better. […] Like other eating disorders, binge eating disorder is a serious problem that can be solved with proper treatment. With treatment and commitment, many people with this disorder can overcome the habit of overeating and learn healthy eating patterns.
#38 Binge Eating Disorder (BED) Treatment & Management: Approach Considerations, Consultations, Medication Treatment
https://emedicine.medscape.com/article/2221362-treatment
Cognitive behavior therapy (CBT) is a treatment of choice in binge eating disorder (BED), especially in the context of high levels of specific eating disorder psychopathology, such as overvaluation of body shape and weight. […] A meta-analysis of 45 studies found only moderate support for the efficacy of CBT and CBT guided self-help, and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. […] Family therapy should be considered when family dynamics figure prominently as triggers for binging and in children and younger adolescents. […] IPT is a proven treatment for BED and focuses on identification of interpersonal conflict as triggers for binges.
#39 Evidence-Based Eating Disorder Treatment | The Bulimia Project
https://bulimia.com/eating-disorders/treatment-evidence-based-approaches/
Still, over the years, there have been several schools of therapy and other treatment techniques developed to help people effectively manage their eating disorder symptoms. […] Among these methods, several have been put through the paces of scientific testing, yielding promising results for anyone looking for help with their disordered eating behavior. […] CBT is one of the most widely recommended types of therapy for treating eating disorders. […] The method is most notably connected to treatment for bulimia nervosa (BN) and binge eating disorder (BED). […] Interpersonal psychotherapy (IPT) is another evidence-based treatment frequently used to help people with bulimia nervosa and binge eating disorder. […] Family-based therapy (FBT), also called family-based treatment, is a popular method for treating eating disorders, particularly in adolescent-focused therapy.
#40 Binge Eating Disorder Treatment Plans With Proven Results
https://withinhealth.com/learn/articles/treatment-of-binge-eating-disorder
Several levels of care have been developed to address these varying needs, each with their own treatment goals for binge eating disorder. […] Inpatient treatment Sometimes it may be necessary for a person with BED to be admitted for inpatient treatment, particularly if they are psychologically or medically compromised. […] Care and monitoring is provided around the clock, usually in a hospital setting or a unit specialized in the treatment of eating disorders. […] Residential treatment Round-the-clock care is also available in residential treatment, but these facilities are generally more home-like than hospital. […] Multidisciplinary treatment is provided, including different types of binge eating disorder therapy, nutritional counseling, medical check-ins, medication consultations, and monitoring at mealtimes to prevent harmful eating behaviors and rituals.
#41 Binge Eating Disorder Treatment Plans With Proven Results
https://withinhealth.com/learn/articles/treatment-of-binge-eating-disorder
Partial hospitalization programs (PHPs) are the middle ground of binge eating disorder interventions, with patients living and sleeping at home while commuting to treatment. […] Intensive outpatient treatment (IOP) are a step down from PHPs. […] Outpatient treatment As the least-intensive level of care for BED, outpatient treatment requires patients to be mostly in control of their unhelpful thoughts and behaviors. […] By some estimates, BED is the most common eating disorder in the United States. […] Cognitive behavioral therapy (CBT) is largely considered the leading treatment for binge eating disorder. […] Acceptance and commitment therapy (ACT) incorporates elements of CBT, but takes a different approach to overcoming disordered thoughts and behaviors. […] Guided self-help is a common form of treatment for binge eating disorder, as this therapy treatment plan can generally be easily followed at home.
#42 Types of Eating Disorder Treatment | Levels of Care | The Alliance
https://www.allianceforeatingdisorders.com/types-of-eating-disorder-treatment-levels-of-care/
Eating disorder treatment can be delivered in a variety of settings and approaches and is generally categorized into different levels of care. […] Eating disorder treatment is very individualized and there is no one size fits all. Certain treatment approaches may work for some, but not for others. […] Inpatient or residential eating disorder treatment occurs within a facility where the patient receives 24-hour care. This level of care provides constant supervision and higher levels of support for the patient. […] At the outpatient level of care, the individual lives at home and attends weekly sessions with their provider(s). The treatment providers have deemed the individual as medically stable, and able to recover on an outpatient basis. […] Intensive Outpatient Program (IOP) typically occurs in a specialized setting (i.e. treatment center, hospital, virtually, etc.) where individuals attend programming approximately two to three times a week for at least three hours each time.
#43 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Research shows that BWL is not as effective as specialist treatments for BED in reducing binge eating. Notably, a recent meta-analysis found that BWL only inconsistently produced reductions in binge eating. […] The modification of DBT for BED is based on the affect regulation model of binge eating, which posits that binge eating occurs in response to intolerable emotional experiences when more adaptive coping mechanisms are not accessible. Engaging in binge eating is hypothesized to provide temporary relief from negative affect, reinforcing the behavior. […] Overall, research shows that CBT, IPT, and CBTgsh, which directly target binge eating and associated pathology, are associated with the most robust short- and long-term binge abstinence rates. Additionally, DBT shows promise as a specialist treatment for BED, but further research is needed to elucidate its long-term efficacy compared with nonspecific and established therapies for BED.
#44 Psychological Treatments for Binge Eating Disorder
https://pmc.ncbi.nlm.nih.gov/articles/PMC3433807/
Research shows that BWL is not as effective as specialist treatments for BED in reducing binge eating. Notably, a recent meta-analysis found that BWL only inconsistently produced reductions in binge eating. […] The modification of DBT for BED is based on the affect regulation model of binge eating, which posits that binge eating occurs in response to intolerable emotional experiences when more adaptive coping mechanisms are not accessible. Engaging in binge eating is hypothesized to provide temporary relief from negative affect, reinforcing the behavior. […] Overall, research shows that CBT, IPT, and CBTgsh, which directly target binge eating and associated pathology, are associated with the most robust short- and long-term binge abstinence rates. Additionally, DBT shows promise as a specialist treatment for BED, but further research is needed to elucidate its long-term efficacy compared with nonspecific and established therapies for BED.
#45 Overview of the treatment of binge eating disorder | CNS Spectrums | Cambridge Core
https://www.cambridge.org/core/journals/cns-spectrums/article/overview-of-the-treatment-of-binge-eating-disorder/AFA81AEC09F49D3D34FCB2CA0300EB75
We performed a qualitative review of treatment studies of binge eating disorder (BED), focusing on randomized clinical trials (RCTs). Limited effectiveness has been demonstrated for self-help strategies, and substantial effectiveness has been shown for cognitive behavioral therapy (CBT) and interpersonal therapy (IPT). CBT and IPT may each be more effective than behavior weight loss therapy (BWLT) for reducing binge eating over the long term. The stimulant pro-drug lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for the treatment of BED in adults based on 2 pivotal RCTs. Topiramate also decreases binge eating behavior, but its use is limited by its adverse event profile. Antidepressants may be modestly effective over the short term for reducing binge eating behavior and comorbid depressive symptoms, but are not associated with clinically significant weight loss. A RCT presented in abstract form suggests that intranasal naloxone may decrease time spent binge eating. There is no RCT of obesity surgery in BED, but many patients with BED seek and receive such surgery. While some studies suggest patients with BED and obesity do just as well as patients with obesity alone, other studies suggest that patients with BED have more post-operative complications, less weight loss, and more weight regain. This evidence suggests that patients with BED would benefit from receiving highly individualized treatment.
#46 Binge Eating Disorder (BED) Treatment & Management: Approach Considerations, Consultations, Medication Treatment
https://emedicine.medscape.com/article/2221362-treatment
Cognitive behavior therapy (CBT) is a treatment of choice in binge eating disorder (BED), especially in the context of high levels of specific eating disorder psychopathology, such as overvaluation of body shape and weight. […] A meta-analysis of 45 studies found only moderate support for the efficacy of CBT and CBT guided self-help, and modest support for interpersonal psychotherapy (IPT), selective serotonin reuptake inhibitors (SSRI), and lisdexamfetamine in the treatment of adults with BED in terms of cessation of or reduction in the frequency of binge eating. […] Family therapy should be considered when family dynamics figure prominently as triggers for binging and in children and younger adolescents. […] IPT is a proven treatment for BED and focuses on identification of interpersonal conflict as triggers for binges.
#47 Management and Outcomes of Binge-Eating Disorder in Adults: Current State of the Evidence | Effective Health Care (EHC) Program
https://effectivehealthcare.ahrq.gov/products/binge-eating/clinician
Evidence was insufficient to determine with confidence the effectiveness of other psychological interventions; however, studies of IPT and DBT have been promising. […] Efficacy studies of pharmacological interventions only measured outcomes at the end of treatment (6 to 16 weeks) and had no long-term followup. […] Meta-analyses provided strong evidence that lisdexamfetamine increased binge-eating abstinence and that second-generation antidepressants increased binge-eating abstinence, reduced binge-eating frequency, and reduced eating-related obsessions and compulsions. […] Evidence was inconclusive about the comparative effectiveness of pharmacological interventions to improve BED outcomes. […] Evidence was inconclusive about the effectiveness of any combination of pharmacological and psychological treatments to improve BED outcomes.
#48
https://link.springer.com/article/10.1007/s40501-014-0023-4
Binge eating disorder is a common eating disorder that recently has received increasing attention. Goals in treating binge eating disorder typically include controlling binge eating and diminishing excess body weight. A variety of treatment approaches have been used, including diet/lifestyle modification, psychotherapy, and pharmacologic treatment. […] A number of psychotherapies have been shown to be beneficial, mostly for stopping binge eating, and tend to show little impact on weight loss. […] The most effective approach to treating binge eating disorder (if available) is likely psychotherapy combined with medication management as indicated. […] There are three cornerstones to treatment of BED, as is true for all eating disorders; nutritional therapy, psychotherapy, and medications. […] A number of psychotherapies have been studied and shown to provide benefit, including cognitive behavioral therapy (CBT), interpersonal therapy, and dialectic behavior therapy. […] Psychotherapy is an important intervention in the treatment of BED. CBT, interpersonal therapy, and dialectic behavior therapy have all been studied, and show promise in the treatment of BED. […] Evidence suggests that combining psychotherapy and pharmacotherapy may lead to modest added benefit.
#49 Management of Binge-Eating Disorder in Adults | AAFP
https://www.aafp.org/pubs/afp/issues/2017/0301/p324.html
Therapist-led cognitive behavior therapy (CBT) reduces binge-eating frequency and increases binge-eating abstinence. (Strength of Recommendation [SOR]: A, based on consistent, good-quality patient-oriented evidence.) […] Binge-eating disorder can be treated with psychological and behavior therapies and pharmacotherapy. Psychotherapeutic options include behavioral weight loss therapy, CBT, interpersonal psychotherapy, and dialectical behavior therapy. […] The U.S. Food and Drug Administration approved lisdexamfetamine for treatment of moderate to severe binge-eating disorder. Other treatments include topiramate and second-generation antidepressants. […] Meta-analyses provided strong evidence that therapist-led CBT reduces binge-eating frequency and increases binge-eating abstinence. […] The AHRQ review is consistent with the American Psychiatric Association practice guideline for the treatment of patients with eating disorders, which strongly recommends individual and group CBT for binge-eating disorders, as well as guided self-help programs. […] Based on the AHRQ review, a reasonable approach is to refer patients with binge-eating disorder to a therapist-led CBT program as first-line therapy. Patients who are unable to access a program or who do not respond to CBT may be prescribed lisdexamfetamine or a second-generation antidepressant.
#50 Binge Eating Disorder | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.binge-eating-disorder.hw266473
Most people who have binge eating disorder need treatment to get better. […] Treatment for binge eating disorder includes counseling and medicine. You may need treatment for a long time to recover. […] The goals of treatment are to help you: Reduce your number of eating binges. Develop healthy eating and exercise habits. Develop a healthy view of yourself and your body. […] Sticking to your treatment plan for the long term is most likely to stop binge eating disorder. Remember it can take time to reach your goals. Talk to your doctor about what results are realistic to expect from treatment. […] In most cases, you will need treatment to get better. If you have binge eating disorder, treatment may prevent health problems and improve the quality of your life.
#51 Binge Eating Disorder | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.binge-eating-disorder.hw266473
Most people who have binge eating disorder need treatment to get better. […] Treatment for binge eating disorder includes counseling and medicine. You may need treatment for a long time to recover. […] The goals of treatment are to help you: Reduce your number of eating binges. Develop healthy eating and exercise habits. Develop a healthy view of yourself and your body. […] Sticking to your treatment plan for the long term is most likely to stop binge eating disorder. Remember it can take time to reach your goals. Talk to your doctor about what results are realistic to expect from treatment. […] In most cases, you will need treatment to get better. If you have binge eating disorder, treatment may prevent health problems and improve the quality of your life.
#52 Binge Eating Disorder | Kaiser Permanente
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.binge-eating-disorder.hw266473
Most people who have binge eating disorder need treatment to get better. […] Treatment for binge eating disorder includes counseling and medicine. You may need treatment for a long time to recover. […] The goals of treatment are to help you: Reduce your number of eating binges. Develop healthy eating and exercise habits. Develop a healthy view of yourself and your body. […] Sticking to your treatment plan for the long term is most likely to stop binge eating disorder. Remember it can take time to reach your goals. Talk to your doctor about what results are realistic to expect from treatment. […] In most cases, you will need treatment to get better. If you have binge eating disorder, treatment may prevent health problems and improve the quality of your life.
#53 Binge eating disorder
https://womenshealth.gov/mental-health/mental-health-conditions/eating-disorders/binge-eating-disorder
Binge eating disorder is a serious health problem, but people with binge eating disorder can get better with treatment. […] Regardless of what type of eating disorder you may have, you can get better with treatment. […] Your doctor may refer you to a team of doctors, nutritionists, and therapists who will work to help you get better. […] Treatment plans may include one or more of the following: Psychotherapy. Sometimes called „talk therapy,” psychotherapy is counseling to help you change any harmful thoughts or behaviors. […] Most girls and women do get better with treatment and are able to eat in healthy ways again. Some may get better after the first treatment. Others get well but may relapse and need treatment again.