BED, a Friend, and You

A previous post described the problem. The search for solutions is of course more complicated. Solutions are needed because BED is a disorder that seriously affects the quality of life for millions of humans. An individual who suspects a problem in the self might start by reaching out to a trusted friend, relative, clergy member, or an online community. Even if this is a difficulty not faced by the reader of this page, any one of us might be the trusted friend that someone reaches out to. What then?

Even if we are not experts, and even if we are not sure whether the upset person’s alarm is justified, this much is true: When someone we care about wonders whether their stubborn habit is a problem, the fact that they even suspect a problem is, in and of itself, a problem. The least we can do is validate their autonomy in some way, with verbal reassurances that they are correct to care about potential health conditions that might call for intervention.

Of course, depending on our own position and circumstances, we can offer practical help, like a ride to a clinic, or the money to pay for an appointment. Or we might do a little preliminary research to nudge them into action.

The particulars

For instance, we might sneak a peak at the Mayo Clinic’s very thorough page on binge-eating disorder and garner some facts to pass along. The object here is for the patient to feel more in control, and eventually, to actually be more in control. This sounds boring, but the key to control is the banishment of randomness, and the acquisition of healthy, regular habits.

The patient can probably expect to be dealing with a whole team of experts, including a mental health professional and a sleep disorder specialist (regular habits, remember?). Any large and respected medical institution will offer similar information and advice, along with both standard methods and specialized possibilities.

There will be blood and urine tests, and various other measurements of this and that. The prospective patient will be asked a ton of questions, both objective (“How often are you physically active?”) and subjective (“How often do you think about food?”). As the honest friend who is urging this person to seek help it might, depending on what kind of relationship you two have, be useful to remind them that in order to be effectively helpful, every professional they encounter will need accurate, up-to-date information.

Whoever conducts this interview will want to know about the patient’s typical daily intake of food, and how large the servings tend to be. They will be curious about whether the person tends to eat past the point of discomfort. Does consumption take place even when there is no actual hunger? Have they made previous efforts to lose weight, and of what did those efforts consist of?

Does the person subjectively feel that things are out of control? What about eating secretly, hiding food, lying to family members about what and how much they take in? Is the eating itself the larger concern, or is it the body weight and size? Does the person experience depression, shame or guilt related to eating? Is vomiting ever involved? What about laxatives or pharmaceuticals, prescribed or otherwise?

What’s out there

Speaking of drugs, Vyvanse, or lisdexamfetamine dimesylate (which was developed to alleviate ADHD) has been prescribed to treat moderate-to-severe binge-eating disorder, but it is only approved for adults. Of course as always, before prescribing anything the doctor must be told about any other drugs the patient is already taking, along with any supplements, herbs, etc. The Mayo Clinic page notes that a few other meds (officially approved to control depression and seizures) are sometimes prescribed, but interestingly, makes no mention of the recently fashionable GLP-1 drugs.

There are support groups designed for individuals and for families, and a painfully hesitant person might consider attending a meeting first just to dip a toe into the water. Even more distance can initially be maintained by making the first contact with any such organization online. Of course, there is talk therapy, both individual and group, in several different forms.

Cognitive behavioral therapy is of course mentioned, along with an enhanced variety called CBT-E that is “specifically designed to treat eating disorders.” Other formats are also mentioned:

Integrative cognitive-affective therapy (ICAT). This type of talk therapy may be helpful for adults with binge-eating disorder. This therapy can help you change the emotions and behaviors that trigger binge eating.

Dialectical behavior therapy. This type of talk therapy can help you learn behavioral skills to help you deal with stress, manage your emotions and improve your relationships with others. These skills can lessen the desire to binge eat.

Your responses and feedback are welcome!

Source: “Binge-eating disorder,” MayoClinic.org, undated
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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources