May 29, 2016
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Binge Eating Disorder (cont.)

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How is binge eating disorder diagnosed?

As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has binge eating disorder. Therefore, health-care professionals diagnose this disorder by gathering comprehensive medical, family, and mental-health information. The health-care professional will also either perform a physical examination or request that the individual's primary-care doctor perform one. The medical examination will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that has what appear to be mental-health symptoms.

In asking questions about psychological symptoms, mental-health professionals are often exploring if the individual suffers from symptoms of binge eating disorder or another eating disorder but also depression and/or mania, anxiety, substance abuse, hallucinations or delusions, as well as some behavioral disorders. Individuals with binge eating disorder may seem to eat compulsively, having symptoms in common with obsessive compulsive disorder (OCD). Health-care professionals may provide the people they evaluate with a quiz or self-test as a screening tool for binge eating disorder and other eating disorders. Since some of the symptoms of binge eating disorder can also occur with other conditions, the mental-health screening is designed to determine if the individual suffers from any emotional problem. In order to assess the person's current emotional state, health-care professionals perform a mental-status examination, as well.

What is the treatment for binge eating disorder?

As with obese individuals without binge eating disorder, people with this illness tend to lose weight from adopting a low-calorie diet and engaging in regular exercise, and some will regain weight in the long term. While considered adjunctive rather than primary forms of treatment, home remedies like meditation may help reduce the frequency and severity of binge eating disorder symptoms, thereby decreasing the impact of those symptoms on the self-rating scale.

Medications that have been found to be effective in reducing the number and amount of binge episodes in binge eating disorder include lisdexamfetamine (Vyvanse), which is used to treat attention deficit hyperactivity disorder (ADHD) and has been recently approved by the U.S. Food and Drug Administration to treat binge eating disorder, topiramate (Topamax), which is used to treat seizures, as well as serotonergic (SSRI) medications that treat anxiety (anti-anxiety medications) or depression (antidepressants), like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). Sibutramine (Meridia) is an appetite suppressant that has been found to help decrease binge eating and enhance weight loss. SSRIs tend to be well tolerated and have a low incidence of side effects like stomach upset, sleep problems, and sexual dysfunction. Topiramate was first used to treat seizures and is sometimes discontinued by patients because of daytime sleepiness, difficulty thinking, and poor coordination. Sibutramine's most common side effects include headache, constipation, stomach upset, insomnia, and painful menstrual periods. Less common, more serious side effects of sibutramine include palpitations, chest pain, shortness of breath, nausea, and vomiting.

While psychotherapy alone does not tend to result in long-term weight loss in individuals with binge eating disorder, it can be a key component of the rehabilitation ("rehab") and recovery from the emotional problems that are often associated with this disorder. Two forms of psychotherapy that have been found to be effective in that regard include cognitive behavioral therapy (CBT) and interpersonal therapy (ITP). In cognitive behavioral therapy, the mental-health professional works to help the person with binge eating disorder identify, challenge, and decrease negative thinking and otherwise dysfunctional belief systems that trigger unwanted behaviors. Dialectical behavior therapy, which is a specific form of cognitive behavioral therapy that focuses on emotional regulation, has also been found to be an effective means of increasing the length of time between binge episodes (for example, binge abstinence) in preliminary studies. The goal of interpersonal therapy tends to be identifying and managing problems the sufferer of binge eating disorder may have in his or her relationships with others. Participation in one of a number of self-help support groups, like Overeaters Anonymous or Eating Disorders Anonymous, can also be an important part of overcoming this condition.

Understanding and addressing how to treat other mental-health problems that might co-occur with binge eating disorder are important aspects of overcoming this illness. For example, as about 57% of men and 28% of women with binge eating disorder also suffer from a substance-use disorder, treating both problems will enhance the successful recovery from each illness.

Medically Reviewed by a Doctor on 3/18/2015


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