Contributed Article by Robyn L. Goldberg, RD, of AskAboutFood.com
Many of us are familiar with the terms Anorexia Nervosa, and Bulimia, but the eating disorder in its younger stages is called Binge Eating Disorder (BED). This article will discuss the diagnostic features of BED and treatment using the non-diet approach.
Binge-Eating Disorder is classified as having binge episodes occur, usually among the overweight population on average a minimum of twice per week for a period of six months. The symptoms do not occur concurrently with Anorexia Nervosa or Bulimia.
BED is more prevalent among women compared to men, and one may have self-esteem issues relating to their body, relationships with others, with their job, and positive feelings about themselves. Some may have prevalence with Major Depressive Disorder, Personality Disorders, and Substance-Related Disorders.
Many individuals with this form of disordered eating have gone various routes with losing weight. These may include fad diets, pills, and feel they have tried everything except identifying their behavior. The non-diet approach teaches physical hunger vs. mouth hunger and does not focus on the result of weight loss. It focuses on improvements of self-concept and body image, and not classifying foods as good or bad (AKA: forbidden foods). Learning how to work on internal vs. external hunger cues and body dissatisfaction is a key part of the non-diet approach. Also being able to understand that it is the non-hunger eating that one is engaging in, NOT eating “bad” or (ineffective) foods that cause weight gain.
As one progresses towards this approach learning how to focus on eating in response to physical hunger and normalizing feelings about food are key areas. Also size acceptance is an area that one needs to identify with and having their goals be realistic per their bone structure. Also, each approach is very individualized, so one must work with a Registered Dietitian (eating disorder specialist), who can tailor this approach per each specific lifestyle.
Long-term outcomes show that traditional weight-loss diet programs have not been successful because of psychiatric disorders. Cognitive behavior therapy (CBT), interpersonal psychotherapy (IPT) and antidepressant medications have been the routes most commonly used. By using the non-diet approach in conjunction with therapy, long-term results will be more promising than going the route of the “quick fix” to temporary weight reduction.
Robyn Goldberg is a Registered Dietitian who practices in Beverly Hills.
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