Binge Eating Disorder (cont.)
Roxanne Dryden-Edwards, MD
Roxanne Dryden-Edwards, MD
Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
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 practitioners diagnose this disorder by gathering comprehensive medical, family, and mental-health information. The practitioner 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 other eating disorders 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). Practitioners 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 providers perform a mental-status examination as well.
What is the treatment for binge eating disorder?
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As with obese individuals without binge eating disorder, people with this illness tend to lose weight from adopting a low-calorie diet and some will regain weight in the long term. Medications that have been found to be effective in reducing the number and amount of binge episodes in binge eating disorder include topiramate (Topamax) which is used to treat seizures, as well as serotonergic (SSRI) medications that treat anxiety or depression, 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. It's less common, more serious side effects 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 and interpersonal therapy. 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. 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.
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.
Reviewed by Melissa Conrad Stöppler, MD on 6/22/2011
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