Options for Treatment of Binge Disorder and Holiday Strategies

Health Writer

Binge eaters are typically trying to cope and to comfort themselves when they turn to large amounts of food.   Triggers for a binge can include the food itself, family issues or overwhelming feelings.   If you think about it, our first experience of love and comfort as an infant is being nursed or fed by our mothers.   Experts feel that in some sense the binge eater is trying to comfort himself with food.   One of the best treatments that are currently accepted for binge eating therapy is cognitive behavioral therapy (CBT).   This typically involves a series of counseling sessions with a therapist, focused on identifying the binge behaviors and then substituting other behaviors.   Many therapists do feel that delving deeper to find the root causes that may have instigated the binges is worthwhile, and may play a vital role in long term therapeutic success.   This interpersonal therapy that really looks at your past through a longer series of therapeutix sessions  may help long term binge sufferers.

In CBT  the therapist may work with you to establish very specific mealtime structures, and will often include an after dinner snack.   Since binges can typically occur late at night, that after-dinner snack can be very important in  preventing an overwhelming "craving and binge attack."   It's also important to note that many binge eaters skip meals, eat miniscule meals because they anticipate having a binge later (they just know it's coming) so they are attempting to reduce calories to offset the binge.   That approach typically backfires because the lack of food in the daytime can, in and of itself, promote a desperate binge later.   So you really do want to work on normal and healthy eating patterns that involve balanced and adequate calories at each meal.   You also want to work on strategies that help you cope with your emotions without the use of food.

It's important  to realize that there are no "good foods" or "bad foods" when we   discuss diets or eating in general.   Certain foods should be considered special or treats and eaten less frequently with portion control.    The practice  of forbidding foods  from your diet can simply make the binge eater obsess and ultimately binge on that very food.   Successful therapy needs to establish food moderation, food flexibility, food regularity and reasonable limits.   Another goal of therapy needs to focus on your feelings about your weight and how you look.   If you are preoccupied with your size, you may end up dieting stringently, feeling deprived, and then binging because you are overwhelmed with hunger and a feeling of emptiness.   If your dieitng and restrictive strategies don't achieve marked and rapid weight loss, then the feeling of failure can also spur more binges and weight gain.   This condition is  tru;y confounding, so being mindful about feelings, reactions and behaviors is vital to a successful treatment program.   Researchers also continue to explore drugs and other therapeutic options to enhance the recovery from this disease.

So what to do during the holidays?   Pretty much the same recommendations that apply to someone struggling with weight would apply to the binge eater.

  • Never go to a party hungry
  • Have a small healthy snack or mini-meal before a big holiday dinner
  • Look over all the choices at a buffet before selecting the items you want to eat.
  • Agree that no food is forbidden but that portion control and selectivity  is important
  • Have non-alcoholic beverages to avoid extra calories and to avoid blurring your ability to sense satiation
  • Take home a doggy bag of certain treats you passed on, in small serving sizes for another day
  • Set up a pre-planned series of behaviors to help cope with a feeling of a sudden binge moment- have gum with you to chew, grab a glass of low calorie vegetable juice or a cup of hot tea.
  • Never hover around the buffet once you've taken your plate of food
  • Have a phone appointment set up with your therapist before and/or after holiday parties to review strategies and to talk about any challenging moments