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Dialectical Behavior Therapy for Binge Eating

written by: kodenthal • edited by: Paul Arnold • updated: 10/14/2010

Do you or a loved one feel out of control over your eating? Do you feel like you will never be able to stop eating? Do you feel guilt and shame because of the ways in which you eat? You may have binge eating disorder. If you do, dialectical behavior therapy can help.

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    Binge Eating

    Binge eating is classified in the Diagnostic Statistical Manual (which is used to diagnose mental illnesses) as uncontrollable bouts of excessive eating two or more times a week consistently for six months. People who suffer from binge eating feel as if they don't have the ability to stop when they want to, they are stuck in the act of eating and cannot find a way out.

    For people with this disorder, binge eating is used as a coping skill to escape from overwhelming emotions and difficulties that life presents them with. When people binge, they eat large quantities of food rapidly, to the point of severe discomfort, and are often overwhelmed with guilt after the binge.

    People with binge eating disorder are at risk of diabetes, which can lead to kidney failure, liver failure, circulatory and immune difficulties. There are many types of therapy which have been studied and found to be successful in the treatment of binge eating. Of those therapies, one of the most beneficial is dialectical behavior therapy.

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    Dialectical Behavior Therapy and Binge Eating

    Dialectical behavior therapy is an effective way of treating any kind of eating disorder, including binge eating. Dialectical behavior therapy trains the person to reprogram their thought patterns and gain control of their emotions, so that they no longer feel like they are powerless over the way that they feel.

    There are four main sections to dialectical behavior therapy:

    • Core mindfulness
    • Emotional regulation
    • Interpersonal effectiveness
    • Distress tolerance

    With core mindfulness, the person gains the ability to stay in the present, without distractions of the past or the future. Another component of core mindfulness is recognizing how the person feels in that moment. Identifying the given emotion may make the feelings less overwhelming and more manageable.

    With emotional regulation, the binge eater learns that their emotions are not in control of them, and that in fact, it is the other way around. There are plenty of emotional regulation skills. Riding the wave teaches people to picture each emotion like a wave that washes up on a shore and then disappears. Teflon mind is when the person imagines their mind is like Teflon paper, and the emotions will slide right through them. These two skills let the person know that emotions pass, and if they simply sit with the feeling, and let it run its course, the feeling will disappear. This can help them in the moment when they want to binge. If they learn to sit with the feeling, and know that it will not last forever, they don't need to distract themselves with food.

    Distress tolerance can help them when they are really struggling. Some of the distress tolerance skills include distraction, which can take their mind off of the food, PLEASE, which is an acronym for treat physical illness, healthy eating, avoiding mind altering drugs, sleep and exercise. All five of these can help get the person's mind off of the food and onto something else.

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    Treatment

    People who suffer from this condition should find a therapist who specializes in dialectical behavior therapy and binge eating. Many eating disorder therapists have a working knowledge of DBT, and can help the patient apply it to his or her own life. By practicing and mastering these skills, the food will lose its power, as will the overwhelming emotions, allowing the binge eater to adopt a healthier eating style as well as coping with their emotions. Effective DBT treatment, along with implementation of the skills, has been proven to be a successful way of treating binge eating.

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    Sources

    This article comes from my own experience with DBT