Weight Discrimination is Associated with the Development of BED for Many People.• Peopleengageinrestrainedeating(dieting)tocombatweightdiscrimination yet restrained eating is considered a key factor in the development of all eating disorders,includingBED.

• MostobesepeoplewithBEDreportmultiplefaileddietingattempts.3

Treatment Considerations :1.Ateamapproach,includingapsychotherapistandnutrition therapist in particular, is suggested.Medically,patientswithBEDmayneedtoruleoutandtreatunderlyingmetabolicconcerns.

• Assessforlevelofcareneeded.Someindividualsmaydowellinoutpatienttherapywhileothersmayneedmoreintensiveeatingdisordertreatment.

• Psychiatricconsequencesneedtobeaddressedincludingcomorbiddisorders,psychosocialfunctioningandqualityoflife.

2.CompassionforthosediagnosedwithBEDisfundamentaltoaneffectiveclient-treatmentproviderrelationship.

• Neutralandaccepting attitudes about body size are key.

• Effectivetreatmentmaynotchangebodysizebutcan reduce incidence of binge eatingandassociatedphysiologicalandpsychologicaldistress.

3. Utilizeahealth-focusedversusweight-focusedapproach.• a health-focused approachemphasizesimprovementsinbeliefs,attitudesandbehaviorsinsteadofchangesinbodysizeorshape.

4.nutritional counseling by a registered dietitian nutritionist can be one essential part of treatment• RDNshouldpursueadvancedtrainingandlearnabouteffectivecounselingstrategieslikecognitivebehavioraltherapy(CBT)andacceptanceandcommitmenttherapy(ACT).

“Binge Eating Disorder (BED) has joined the ranks with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) as an “official” eating disorder. Binge Eating Disorder is in fact a distinct entity. No one knows for sure what causes BED. Similar to Anorexia Nervosa or Bulimia Nervosa, the treatment approach is always bio-psycho-social.”-www.anad.org

Binge eating disorder

of those seeking weight loss treatments can be clinically diagnosed with BED.230-

40%

Identifying someone who has a Binge Eating Disorder:

1

Binge eating disorder is characterized by:• Recurrentepisodesofbingeeatingoccurringat least once a weekfor3months.

• Eatingalargeramountoffoodthanmostpeoplewouldeatinashortperiodoftime(within 2 hours).

• Subjectiveexperienceofloss of control(LOC)relatedtoeating.

And 3 or more of the following behaviors• Eatinguntilfeelinguncomfortablyfull

• Eatinglargeamountsoffoodwhennotphysicallyhungry

• Eatingmuchmorerapidlythannormal

• Eatingaloneoutofembarrassmentoverquantityeaten

• Feelingdisgusted,depressed,ashamed,orguiltyafterovereating

Binge eating disorder is not associated with the recurrent use of compensatory behavior as in bulimia nervosa, and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Nutrition Considerations:

1. Evaluatemealpatternswithfocusonencouragingregular,balancedeatingofadequateamountsoffoodtoproducesatiety.

•Whilethegoalmaybetoeataccordingtointernalcues,manypeoplewithBEDdonotrecognizethesecues.

2.Payparticularattentiontoskippingmeals,eatingtoolightlyatmealsorgoingtoolongbetweenmeals,allofwhicharephysiologicaltriggersthatcanleadtoovereatingatsubsequentmeals.

3.Explorepsychologicaltriggerssuchasattitudesabout“good”or“bad”foodsthatcanleadtoovereating“forbidden”foods.

4.Ensureadequateproteinintaketominimizebloodglucosefluctuationsthatmaytriggerovereating.

SummaryAssessclientsforBED.CoordinatecarewithprofessionalswhotreatBED.EducateteammembersandclientsonweightstigmaandbecomefamiliarwiththeHealthatEverySize®(HAES).BEDisanewdiagnosisthatwillrequireongoingresearch.

For More Information:1.BingeEatingDisorderAssociation:bedaonline.com

2.NationalEatingdisordersassociation:nationaleatingdisorders.org

3.HealthAtEverySize:sizediversityandhealth.org

References1.AmericanPsychiatricAssociation(APA),FiftheditionDiagnosticandStatisticalManualofMentalDisorders(DSM-5)Development,Washington,DC,AmericanPsychiatricAssociation,2012.

2. deZwaanM,BingeEatingDisorderandObesity,IntJObesRelatMetabDisord.2001;5:S51-55.http://www.ncbi.nlm.nih.gov/pubmed/11466589

3. RoehrigM,MashebRM,White,MA,GriloCM.Dietingfrequencyinobesepatientswithbingeeatingdisorder:behavioralandmetaboliccorrelates.Obesity,2009;17:689-697.

Contributing AuthorsBrahmlinSethi,RDandMelanieJacob,RDCSSD

WrittenbySCANregistereddietitians(RDs)toprovidenutritionguidance.Thekeytooptimalmealplanningisindividualization.ContactaSCANRDforpersonalizednutritionplans.Access“FindaSCANRD”atwww.scandpg.orgorbyphoneat800.249.2875.

©2014Sports,Cardiovascular,andWellnessNutrition(SCAN) PhotoCredit:©yayimages.com+myplate.gov

Contact SCANwww.scandpg.org 800.249.2875

About BED

who suffers ?1. TheprevalenceofBEDis estimatedtobe approximately1-5%of thegeneralpopulation.

2. Peoplewithbingeeating disorderreportalower qualityoflifethannon- bingeeatingdisorder.

3. Peoplestrugglingwith bingeeatingdisorder oftenexpressdistress, shame,andguiltovertheir eatingbehaviors.

4. BEDisoftenassociated withsymptomsof depression.

www.nationaleatingdisorders.org

quality of life

distress & shame

depression

Structured eating that encourages eating regularly (every 3-5 hours or so) as well as balanced eating using the Plate Model can provide a bridge to reconnecting with internal cues.