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Do you feel like you have lost control over your eating? Do you feel shame about the amount of food you consume? Do you use food as a way to cope with distressing emotions? If you answered yes to any of these questions, you may struggle with binge eating disorder. Registered dietitians play an essential role in the multidisciplinary approach to treating eating disorders. This article discusses the role a registered dietitian nutritionist plays in the treatment of binge eating disorder and what strategies for recovery a dietitian may implement.
Binge eating disorder (BED) is a serious eating disorder characterized by recurrent episodes of uncontrollable eating. Unlike other disorders, BED does not involve compensatory behaviors such as excessive exercise or restrictive eating. To be diagnosed with BED, the following diagnostic criteria are typically considered:
Seeking help is important. If any of the criteria listed above resonate with you or if you are struggling with disordered eating, reach out to a healthcare professional such as a registered dietitian nutritionist. Getting the support and help you need on your path to recovery is crucial to improving your health and quality of life.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses specific criteria to diagnose BED. Your provider will perform a comprehensive clinical assessment and determine if you meet the criteria for BED. It is normal to feel reluctant to open up about these details, but honesty is important to getting the proper diagnosis and treatment. You can start by talking to your primary care practitioner or seeking out a mental health care practitioner. Ensure you are collaborating with a provider that you feel comfortable with. Talking with a provider is a brave step toward recovery.
A nutritionist alone simply will not be enough to navigate the complexities of disordered eating. A registered dietitian is specially trained to provide medical nutrition therapy, which is a crucial component in treating eating disorders. A registered dietitian can educate you about food and nutrition, clarify and correct misinformation, and identify negative beliefs and attitudes toward food. Some dietitians, called Certified Eating Disorders Registered Dietitians (CEDRD), specialize in working with eating disorder clients. These dietitians have extensive training and rigorous education, enabling them to provide individualized therapy for eating disorder clients. Overall, dietitians are effective in improving outcomes for clients with binge eating disorders, especially when part of a treatment team with an interdisciplinary approach to treatment.
Psychotherapy (talk therapy) is proven to be a highly effective tool in treating binge eating disorder clients. Meta-analyses have demonstrated that talk therapy significantly reduces binge eating episodes and promotes abstinence from binge eating. Medicine management has also been shown to be effective in the management of binge eating disorders. Consider an initial consultation with a psychiatrist to see if medicine management is an appropriate treatment tool for you.
Eating schedules for those with binge eating disorder can be chaotic. This can mean skipping meals, overeating at irregular times, or under-eating throughout the day. This reduces connection with binge and fullness cues, disrupts metabolism, leads to blood sugar imbalance, increases fatigue, and causes emotional distress. A lack of structure around meals can also increase the risk of binge eating episodes. Inconsistent eating patterns can trigger intense hunger, cravings, and a loss of sense of control over food, leading to a harmful cycle of overeating and guilt. A registered dietitian can assess your diet patterns and create appropriate interventions to reduce the food chaos and lead you to food freedom.
Many patients with binge eating disorder will undereat after a binge. By depriving the body of balanced and consistent nutrition, the body triggers hunger signals, emotional cravings, and metabolic changes that promote overeating later on. Breaking this cycle can be challenging, which is why it is essential to maintain a regular eating schedule. A dietitian can help ensure that you eat enough food with enough variety throughout the day to help reduce binge eating and support your recovery.
Nutrition misinformation poses a significant challenge in the treatment of eating disorders such as binge eating disorder. For example, a study in the Journal of Medical Internet Research found that pro-anorexia videos on YouTube were more favored and rated by viewers compared to informative videos, indicating a higher risk of engagement with misleading content. This trend is concerning as it suggests that false information can spread more rapidly and widely than accurate, evidence-based content. A dietitian can help you sort out science from misinformation, which can help you create a better relationship with food.
A dietitian can help you feel more confident around foods that you have historically binged on. Once your eating pattern has become less chaotic and you are eating foods you enjoy more regularly throughout the day, your dietitian will work with you on “challenge foods.” Challenge foods are foods you avoid, binge on, and/or foods that evoke anxiety. A dietitian can provide education, emotional support, and practical strategies to help you break free from past cycles of restriction and bingeing and promote a healthier, more balanced relationship with food.
Intuitive eating has been found to be effective in the treatment of binge eating disorder by reducing binge eating episodes, improving body image, and enhancing overall psychological well-being. Intuitive eating encourages a healthier relationship with food by helping you listen to your body’s hunger and fullness cues, promoting mindful eating, and reducing the emotional stress often associated with restrictive dieting. Your dietitian can work with you on building intuitive and healthy eating practices to help you find food freedom.
Meta-Analysis on the Long-Term Effectiveness of Psychological and Medical Treatments for Binge-Eating Disorder. Hilbert A, Petroff D, Herpertz S, et al. The International Journal of Eating Disorders. 2020;53(9):1353-1376. doi:10.1002/eat.23297.
Cognitive Behavioral Therapy for the Eating Disorders. Agras WS, Bohon C. Annual Review of Clinical Psychology. 2021;17:417-438. doi:10.1146/annurev-clinpsy-081219-110907.
The Efficacy of Cognitive-Behavioral Therapy for Eating Disorders: A Systematic Review and Meta-Analysis. Linardon J, Wade TD, de la Piedad Garcia X, Brennan L. Journal of Consulting and Clinical Psychology. 2017;85(11):1080-1094. doi:10.1037/ccp0000245.
Misleading Health-Related Information Promoted Through Video-Based Social Media: Anorexia on YouTube. Syed-Abdul S, Fernandez-Luque L, Jian WS, et al. Journal of Medical Internet Research. 2013;15(2):e30. doi:10.2196/jmir.2237.
Intuitive Eating and Its Psychological Correlates: A Meta-Analysis. Linardon J, Tylka TL, Fuller-Tyszkiewicz M. The International Journal of Eating Disorders. 2021;54(7):1073-1098. doi:10.1002/eat.23509.
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