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Compulsive overeating treatments


Binge-eating disorder - Diagnosis and treatment

Diagnosis

To diagnose binge-eating disorder, your medical care provider may recommend a psychological evaluation, including discussion of your eating habits.

Your medical care provider also may want you to have other tests to check for health consequences of binge-eating disorder, such as high cholesterol, high blood pressure, heart problems, diabetes, GERD and some sleep-related breathing disorders. These tests may include:

  • A physical exam
  • Blood and urine tests
  • A sleep disorder center consultation

More Information

  • Urinalysis

Treatment

The goals for treatment of binge-eating disorder are to reduce eating binges and achieve healthy eating habits. Because binge eating can be so entwined with shame, poor self-image and other negative emotions, treatment may also address these and any other mental health issues, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating.

Psychotherapy

Whether in individual or group sessions, psychotherapy (also called talk therapy) can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes. Examples of psychotherapy include:

  • Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns.
  • Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and co-workers. This may help reduce binge eating that's triggered by problematic relationships and unhealthy communication skills.
  • Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.

Medications

Lisdexamfetamine dimesylate (Vyvanse), a drug for attention-deficit hyperactivity disorder, is the first FDA-approved medication to treat moderate to severe binge-eating disorder in adults. A stimulant, Vyvanse can be habit-forming and abused. Common side effects include a dry mouth and insomnia, but more-serious side effects can occur.

Several other types of medication may help reduce symptoms. Examples include:

  • Topiramate (Topamax), an anticonvulsant. Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, there are side effects, such as dizziness, nervousness, sleepiness and trouble concentrating, so discuss the risks and benefits with your medical care provider.
  • Antidepressants. Antidepressants may reduce binge-eating. It's not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood.

While these medications can be helpful in controlling binge-eating episodes, they may not have much impact on weight reduction.

Behavioral weight-loss programs

Many people with binge-eating disorder have a history of failed attempts to lose weight on their own. However, weight-loss programs typically aren't recommended until the binge-eating disorder is treated, because dieting may trigger more binge-eating episodes, making weight loss less successful.

When appropriate, weight-loss programs are generally done under medical supervision to ensure that your nutritional requirements are met. Weight-loss programs that address binge triggers can be especially helpful when you're also getting cognitive behavioral therapy.

More Information

  • Cognitive behavioral therapy
  • Psychotherapy

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Lifestyle and home remedies

Typically, treating binge-eating disorder on your own isn't effective. But in addition to professional help, you can take these self-care steps to reinforce your treatment plan:

  • Stick to your treatment. Don't skip therapy sessions. If you have a meal plan, do your best to stick to it and don't let setbacks derail your overall efforts.
  • Avoid dieting, unless it's supervised. Trying to diet can trigger more binge episodes, leading to a vicious cycle that's hard to break. Talk with your medical care provider about appropriate weight management strategies for you — don't diet unless it's recommended for your eating disorder treatment and supervised by your medical care provider.
  • Eat breakfast. Many people with binge-eating disorder skip breakfast. But, if you eat breakfast, you may be less prone to eating higher calorie meals later in the day.
  • Arrange your environment. Availability of certain foods can trigger binges for some people. Keep tempting binge foods out of your home or limit your exposure to those foods as best you can.
  • Get the right nutrients. Just because you may be eating a lot during binges doesn't mean you're eating the kinds of food that supply all the essential nutrients. Ask your medical care provider if you need to adjust your diet to provide essential vitamins and minerals.
  • Stay connected. Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
  • Get active. Ask your medical care provider what kind of physical activity is appropriate for you, especially if you have health problems related to being overweight.

Alternative medicine

Most dietary supplements and herbal products designed to suppress the appetite or aid in weight loss are ineffective and may be misused by people with eating disorders. And natural doesn't always mean safe. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications.

If you use dietary supplements or herbs, discuss the potential risks with your medical care provider.

Coping and support

Living with an eating disorder is especially difficult because you have to deal with food on a daily basis. Here are some tips to help you cope:

  • Ease up on yourself. Don't buy into your own self-criticism.
  • Identify situations that may trigger destructive eating behavior so you can develop a plan of action to deal with them.
  • Look for positive role models who can help lift your self-esteem. Remind yourself that the ultrathin models or actresses showcased in women's magazines often don't represent healthy, realistic bodies.
  • Try to find a trusted relative or friend whom you can talk with about what's going on.
  • Try to find someone who can be your partner in the battle against binge eating — someone you can call on for support instead of bingeing.
  • Find healthy ways to nurture yourself by doing something just for fun or to relax, such as yoga, meditation or simply a walk.
  • Consider journaling about your feelings and behaviors. Journaling can make you more aware of your feelings and actions, and how they're related.

Get support

If you have binge-eating disorder, you and your family may find support groups helpful for encouragement, hope and advice on coping. Support group members can understand what you're going through because they've been there themselves. Ask your medical care provider if he or she knows of a group in your area.

Preparing for your appointment

Treatment of binge-eating disorder may require a team approach that includes doctors and other medical care providers, mental health professionals and dietitians with experience in eating disorders.

Here's some information to help you get ready for your appointments. Ask a family member or friend to go with you, if possible, to help you remember key points and give a fuller picture of the situation.

What you can do

Before your appointment make a list of:

  • Symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment
  • Key personal information, including any major stresses or recent life changes
  • All medications you're taking, as well as any herbs, vitamins or other supplements, and their dosages
  • A typical day's eating, which can help your medical care provider or mental health professional understand your eating habits

Questions to ask your medical care provider or mental health professional include:

  • What treatments are available, and which do you recommend?
  • If medication is a part of treatment, is a generic drug available?
  • Are there any brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your medical care provider or mental health professional is likely to ask you a number of questions, such as:

  • What does your typical daily food intake look like?
  • Do you eat unusually large amounts of food or until you're uncomfortably full?
  • Do you feel your eating is out of control?
  • Have you tried to lose weight? If so, how?
  • Do you think about food often?
  • Do you eat even when you're full or not hungry?
  • Do you ever eat in secret?
  • Do you feel depressed, ashamed or guilty about your eating?
  • Do you ever make yourself vomit to get rid of calories?
  • Are you concerned about your weight?
  • Do you exercise? How often?

Your medical care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.

By Mayo Clinic Staff

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Compulsive Overeating Treatment, Symptoms, & Causes

What is Compulsive Overeating?

Compulsive overeating is a term that describes the loss of control over one’s eating habits. Compulsive overeating helps some people cope with difficult life events or unpleasant emotions like sadness, fear, boredom or shame. Compulsive overeating is a key warning sign of binge eating disorder. 

Causes of Compulsive Overeating

Compulsive overeating is a form of disordered eating, which means that a combination of genetics, psychological issues and sociocultural factors generally contribute to the cause of this behavior.

Because many people struggling with overeating are of normal or higher weights, they often don’t realize their overeating and co-occurring weight issues stem from emotional issues.

What compulsive overeating is NOT

The cultural narrative around obesity wrongly suggests that:

  • Laziness is to blame for overeating and accompanying weight issues.
  • Individuals have 100 percent control over their food consumption and weight.
  • That willpower alone drives moderation, weight loss and overall health.

It’s important for anyone suffering from an overeating disorder to understand that these statements are not valid.

The symptoms and signs of compulsive overeating are varied and diverse. People with compulsive overeating behaviors may regularly experience one or more behaviors that may be a sign of compulsive overeating.

Take Our Compulsive Overeating Quiz

Signs of Compulsive Overeating

  • Eating what most people would think is an unusually large amount of food
  • Eating much more quickly than usual, or eating slowly and consistently throughout the day and/or night
  • Eating past satiety or until feeling uncomfortably full
  • Eating despite feeling full or not feeling hungry at all
  • Eating alone due to shame or embarrassment about the quantity of food consumed
  • Feeling disgusted, depressed or guilty after overeating
  • Night eating
  • Impulsive eating
  • Compulsive food behaviors like hiding food and eating food out of the garbage
    Binge eating

Behaviors

Eating large amounts of food
Eating what most people would think is an unusually large amount of food

Eating Quickly
Eating much more quickly than usual, or eating slowly and consistently throughout the day and/or night

Impulsive eating

Health Risks Associated with Compulsive Overeating

A number of individuals with compulsive overeating habits feel that they lack the willpower they need to "eat healthy" or "stay on a strict diet. " But, compulsive overeating is most likely not due to a lack of willpower. And dieting may actually make compulsive overeating behaviors worse.

Medical and Physical Health Risks

Many people who compulsively overeat — without compensatory behaviors (vomiting, laxative/diuretic abuse, over-exercise) — are of higher weight. When individuals are overweight or obese they may be more likely to experience one or more of these serious medical conditions:

  • Metabolic syndrome
  • Heart disease
  • Stroke
  • Type 2 diabetes
  • Certain types of cancer

Higher weight patients are also more likely to experience sleep disturbances, aches and pains, hygiene issues, mobility concerns (greater fall risk) and other health risks.

Compulsive Overeating Treatment

We recognize that both behavioral and biological factors contribute to being of a high weight, and that many overweight and obese individuals have a co-occurring eating disorder. Unlike a traditional weight-loss treatment center, however, our compulsive overeating treatment program is not an obesity treatment program or a weight management program.

Find a Treatment Center

Eating Recovery Center's compulsive overeating treatment program offers a comprehensive treatment solution to normalize eating patterns, stabilize medical comorbidities, control weight and improve quality of life issues. 

Patients in our compulsive overeating treatment program may be looking to get help for one or more co-occurring conditions, including, but not limited to:

  • Bulimia nervosa
  • Binge eating disorder
  • Night eating
  • Emotional eating
  • Stress eating
  • Mood disorders
  • Anxiety disorders

At ERC, treatment takes place in a compassionate recovery community that understands what you are going through and that supports people of size.

What Does Compulsive Overeating Treatment Look Like?

Compulsive overeating treatment incorporates medical, therapeutic and nutritional interventions. In treatment, people who overeat learn how to process and let go of stored pain and trauma as they:

  • Eliminate binge eating habits
  • Find healthier ways to manage stress
  • Address substance use
  • Improve sleep
  • Stabilize their physical and mental health

Three levels of care are available in the program to meet each patient's unique recovery needs:

  • Residential Program
  • Partial Hospitalization Program
  • Intensive Outpatient Program

Not sure what level of care is right for you? The appropriate level of care will be recommended following a thorough pre-admission assessment with an eating disorder therapist. You will progress through the levels of care as necessary, or you may discharge back to your home community following program completion.

  • It is estimated that more than 30 percent of higher weight patients attempting to lose weight meet diagnostic criteria for binge eating disorder (BED) and/or bulimia nervosa (BN). 1
  • A complex set of hormones influence and determine hunger and satiety cues as well as how we feel, think and behave around food; an individual’s weight and eating behaviors are largely determined by neurobiology rather than one’s “motivation” or drive to lose weight. 1
  • Biological and genetic factors prime a subset of the population to overeat. 1
  • More than one-third of adults in the US are obese, and approximately 17 percent of children and adolescents aged 2—19 years are obese (Journal of American Medicine (JAMA)).
  • Obese individuals have a 20 percent elevated risk of depression. Specifically for Caucasian, college-educated individuals with obesity, the depression risk increases to 44 percent. (www.obesityaction.org).

1 "Difficulties in Detecting Eating Disorders in Both Normal and Higher Weight Patients," Julie Friedman, PhD and Susan McClanahan, PhD, CEDS. (2016)

Compulsive Overeating FAQs

What is it called when you constantly want to eat?

Constantly wanting to eat is called compulsive overeating or binge eating. People may compulsively overeat because they are bored or because they feel worried or upset about something. If you constantly want to eat and are looking for professional help for this, learn more about treatment for binge eating.

Why do I compulsively overeat?

Some people may overeat because friends or family members do. Others may tend to compulsively overeat because they:

  • Feel anxious or afraid
  • Fee sad or hopeless
  • Feel ashamed or guilty
  • Feel a sense of emptiness
  • Are bored

Certain genetic and psychological factors may also increase the risk of overeating.

How do I stop obsessive overeating?

It is hard to stop overeating without professional help, but overeating is a behavior that can be stopped just like any other behavior. With an experienced treatment team, you can learn how to process emotional pain and trauma and find new coping skills to help you stop overeating.

Is eating too much considered an eating disorder?

Eating too much can be a sign of binge eating disorder, the most common eating disorder in the U.S. People with binge eating disorder regularly:

  • Eat more than most people would
  • Eat rapidly until uncomfortably full
  • Eat when not hungry
  • Eat alone
  • Feel disgusted, sad or ashamed after the binge

Why is compulsive overeating a problem?

Compulsive overeating is a problem because it can be very hard to stop compulsive overeating. Compulsive overeating can lead to weight gain which can increase the risk for multiple physical and mental health concerns, including:

  • Metabolic syndrome
  • Heart disease
  • Stroke
  • Joint pain and mobility concerns
  • Insomnia, anxiety and depression

Is it possible to stop compulsive overeating?

Yes, it is possible to stop compulsive overeating, but stopping compulsive overeating requires far more than willpower and self-control. An experienced eating disorder treatment team can help you identify new coping skills to replace compulsive overeating behaviors. In treatment, you can also process past hurts or traumas.

Is there rehab for overeating?

Rehab for overeating is provided in eating disorder treatment facilities nationwide. In treatment, you can learn how to stop overeating by processing and letting go of pain, trauma and distressing emotions. As you change your emotional state, you learn new coping skills to replace compulsive eating behaviors with healthier alternatives.

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Eating Recovery Center is accredited through the Joint Commission. This organization seeks to enhance the lives of the persons served in healthcare settings through a consultative accreditation process emphasizing quality, value and optimal outcomes of services.

Organizations that earn the Gold Seal of Approval™ have met or exceeded The Joint Commission’s rigorous performance standards to obtain this distinctive and internationally recognized accreditation. Learn more about this accreditation here.

Medical treatment of compulsive overeating by a psychologist, treat the disease by a psychotherapist

Sometimes it happens that delicious food, appetizing appearance of dishes cause a person to get up from the table with a feeling of a full stomach. If such situations occur rarely, overeating can be controlled, then there is nothing to worry about. If we are talking about causeless and uncontrolled appetite, which is preceded by stress or negative emotions, then we can suspect a dangerous eating disorder - compulsive or uncontrolled overeating. It is important not to miss the moment and turn to a psychotherapist in time.

Article content:

  • Disease description
  • Causes
  • Psychological aspect of the problem
  • Methods of psychotherapy in the treatment of illness
  • Possible complications
Seek medical attention if symptoms occur. The information on the page is for reference only and cannot be used for self-diagnosis and self-treatment.

Description of disease

Compulsive overeating (CP) is a dangerous pathological condition. The patient is unable to control his appetite due to stress. The essence and nature of a compulsive disease is well explained by its second name - psychogenic overeating, since the causes of the development of an eating disorder should be sought not in the physiological, but in the mental sphere.

Any stressful situation can provoke a painful condition: the loss of a loved one, the loss of keys, a conversation with superiors in a raised tone, and other unpleasant situations.

Bouts of psychogenic overeating may recur from time to time. As with other eating disorders, the patient considers himself healthy. The exception is excess weight, which accompanies psychogenic overeating. Uncontrolled appetite has clear differences from other diseases of a food nature:

  • if with anorexia the patient ceases to adequately perceive his own body, then with compulsive overeating the problem of excess weight becomes obvious and is the root cause of contacting a psychologist, psychotherapist, other doctors;
  • The binge patient usually does not seek to get rid of food by inducing artificial vomiting, while the symptoms of bulimia are characterized by obligatory cleansing procedures, which the patient cannot refuse.

Causes

It is a normal physiological need to eat exactly when the feeling of hunger arises. If food intake is reduced to nervous chewing, no attention is paid to the amount eaten, it is worth considering that it is bulimia or uncontrolled overeating that can cause increased weight, the appearance of extra centimeters in volume.

Physiological factors can provoke compulsive overeating - dysfunction of the hypothalamus and genetic predisposition. Genetic scientists have identified three genes whose presence in the genetic code leads to obesity and can provoke the development of an eating disorder.

The psychological aspect of the problem of psychogenic overeating

Physiological and genetic causes may be a consequence of the development of an eating disorder, but the psyche plays a central role.

Leading psychotherapists in describing clinical cases of compulsive overeating note that the onset of the disease is preceded by negative life events. Such stress can be caused by social and physiological factors.

In order to understand whether you have a problem or whether you need the help of a psychotherapist, you should honestly answer a number of questions.

  • Have you noticed that your diet is difficult to control?
  • all your thoughts are related to food?
  • Do you prefer to eat alone?
  • Do you tend to overeat when stressed out, distracted from current problems?
  • Do you experience guilt that affects your enjoyment of eating?
  • How often do you start eating without feeling hungry?
  • Do you find it difficult to refuse food if you are treated?

If you answered yes to 4 or more questions, it makes sense to contact a medical institution for advice and clarification of the causes of nutritional problems.

Methods of psychotherapy in the treatment of illness

The solution in the fight against food addiction is to seek help from a specialist. Only a psychologist is able to help find the causes of binge eating disorder and form a healthy model of dealing with stress.

The Center for the Study of Eating Disorders uses the latest psychotherapy techniques accepted in the international medical community.

Depending on the severity of the condition, a treatment algorithm is selected. It can be done on an outpatient or inpatient basis under the supervision of a psychotherapist. The following areas of psychotherapy are used to treat patients with compulsive psychogenic overeating, bulimia, anorexia and other eating disorders:

  • CBT - cognitive behavioral therapy;
  • DBT - Dialectical Behavioral Psychotherapy;
  • FBT - Family Involved Therapy.

All methods have scientifically proven effectiveness, are actively used in practice by psychotherapists and other doctors of "CIRPP" in the fight against overeating.

Family Therapy

Successful Family Psychological Therapy, which was developed for the treatment of patients with eating disorders by the leading specialists of the Maudsley Clinic.

A multi-family group has been organized in CIRP, where not only patients, but also their relatives, as co-dependent persons, receive therapy. In the course of group therapy, the psychotherapist helps to jointly develop the right adaptation tactics, build the right behavior model, and provides the necessary support to parents whose children suffer from eating disorders.

Cognitive behavioral therapy

The program is aimed at finding the causes of eating disorders (bulimia, anorexia, compulsive uncontrolled overeating, etc.). It is important to find out the root cause of the disease, this will help in choosing the right tactics.

DBT - Dialectical Behavior Therapy

The use of Dialectical Behavior Therapy has a positive effect in the treatment of patients with compulsive overeating. The method is aimed at finding new ways to deal with stress, teaching effective emotional regulation techniques that are not related to eating or deliberately refusing it.

At the end of the treatment phase, the patient will be able to painlessly give up destructive ways of dealing with stress, strict weight control and dietary regimens. Bouts of uncontrolled overeating will be left behind.

Psychologists of "CIRPP" use the latest methods of working with people suffering from eating disorders, psychogenic overeating. In addition to providing basic medication, resuscitation, developing an individual diet, the DBT program includes the work of online psychotherapy groups, art therapy, dance therapy led by a psychotherapist, and other eating behavior adjustment programs.

Possible complications

Delayed treatment of eating disorders can adversely affect the condition of a patient suffering from regular overeating. If there is no treatment, then there is a high probability of developing other complications:

  • decrease or increase in blood pressure;
  • aggressive or lethargic behaviour;
  • metabolic disorder;
  • obesity;
  • depression;
  • alcohol or drug addiction;
  • diseases of the cardiovascular system;
  • type 2 diabetes and others.

Gradually, complications can become chronic, which reduces the chances of a full recovery. It is not difficult to avoid such a scenario - it is enough to be attentive to your own health, pay attention to alarming symptoms and consult a doctor in time.

Getting help from a psychologist, nutritionist or psychotherapist is easy: sign up for an initial medical consultation by calling +7(499) 703-20-51 or through the online form.

Author: Maksim Borisovich Sologub

Head Physician of TsIRPP,

psychiatrist, psychotherapist.

signs, causes and treatment. Test

Many people already know about anorexia nervosa and bulimia. To this list of common eating disorders, another one has been added - compulsive overeating. It has recently been included in the updated International Classification of Diseases (ICD-11).

How compulsive overeating differs from ordinary binge eating, why it is dangerous to seize your emotions and how to cope with the disease, said Tatiana Romanovskaya, an assistant at the Department of Psychiatry with Medical Psychology at Belarusian State Medical University, a member of the Belarusian Psychiatric Association .

Compulsive overeating

How does the disease manifest itself?

Compulsive overeating is an attack in which a large amount of food is consumed in a relatively short period of time and there is a feeling of loss of control. After an attack, which can sometimes last all day, a person feels guilty, dissatisfied with himself. Such behavior can be considered a disorder if it is repeated at least twice a week for several months.

Binge eating occurs in 8-10% of overweight people and 25-50% of those seeking weight loss help. Distinguish between hedonic and compulsive overeating. With a hedonistic person, he simply loves to eat, the process of overeating is a pleasure and only sometimes a slight pangs of conscience: he ate a frying pan of fried potatoes - "it's okay, I'll lose weight tomorrow." And with compulsive overeating, it is difficult to stop, there are problems with the quality and quantity of food. Feeling physical and psychological discomfort, the person continues to eat. This is not a lack of will, as some people think, but an eating disorder that needs to be treated.

Why is this happening?

Compulsive overeating develops during adolescence, when the first experiments with diets begin, often leading to anorexia nervosa or bulimia. Later, this restrictive behavior leads to the opposite - to overeating and weight gain, because, unlike bulimia nervosa, patients do not resort to cleansing practices (do not induce vomiting, do not take laxatives, do not exhaust themselves with training).

The disorder may develop in adolescents whose parents frequently use diets or have a history of eating problems that transmit ideas about the value of being light. Or if children grow up in an atmosphere of emotional and psychological abuse. Thus, they seize stress. This is a compensatory mechanism for coping with feelings of loneliness, anxiety, restlessness.

Compulsive overeating often occurs as a response to depression.

At an older age, uncontrolled eating also serves as a mechanism for coping with emotional experiences, not necessarily traumatic. It can be monotony, boredom, lack of pleasure. The less a person "feeds" himself with other emotions, the more close "friend" he becomes a refrigerator, in which you can find a variety of tastes that are missing in life. Or they are looking for a “home psychotherapist” in the refrigerator. For example, the husband drinks, and the wife "snacks": in constant anxiety, waiting for him in the evenings, she compulsively eats, for example, packs of cookies.

Another reason is the difficulty with expressing feelings, when a person does not recognize or denies his emotional experiences, does not know how to cope with them, does not have support, cannot speak out.

Compulsive overeating can also occur against the background of eating habits. For example, one or two meals a day, then hunger provokes compensatory overeating. It is also difficult to control food intake can provoke sausages, sausages, sausages - any processed food saturated with monosodium glutamate. Foods rich in easily digestible carbohydrates also stimulate appetite and hunger, as this is associated with fluctuations in blood glucose and insulin levels.

Any diet aggravates the symptoms of compulsive overeating, the person is in the "hunger (diet) - breakdown" system. This is the case when they say: "minus 3 - plus 7".

Why is compulsive overeating dangerous?

In this disease, a person usually abuses fatty, sweet foods, in connection with which excess weight appears and the metabolic syndrome quickly develops - an increase in the mass of visceral fat, metabolic disorders.

Compulsive overeating has been proven to lead to type 2 diabetes, hypercholesterolemia (an abnormal increase in cholesterol levels), and arterial hypertension.

Treating compulsive overeating

How does psychotherapy help?

Psychotherapy is the only way and method of treatment for compulsive overeating. The work is going in two directions. The first is diet therapy, the development of a nutrition plan. If a person starts the morning with marshmallows and ends with boiled sausage, the chances of recovery are low. Dietary literacy needs to be taught.

The second direction is directly psychotherapy. The gold standard in the treatment of the disease is cognitive behavioral therapy. Usually these are group classes, the course lasts from 12 weeks to a year. One of the tasks is to learn to isolate irrational thoughts about food, yourself, problem situations and interact with them. There are many irrational thoughts: “food helps me relax”, “fruits are not food”, “sugar is needed for the brain”, “I am genetically fat, so everything is useless”, “you can’t eat after 18.00”, etc.

These settings have nothing rational. For example, let's take the postulate about the harmfulness of eating after 18.00. Daily calorie intake is important, not the time of intake.

Be sure to work with emotions: a psychotherapist teaches people to be aware of them and express them, teaches the skills of relaxation and reducing emotional discomfort.

It is often necessary to involve the whole family in therapy, especially when it comes to adolescents who lack support and understanding in the family. For example, a girl is overweight, she is trying to normalize her diet, and family members eat pies and at the same time call her to willpower, devalue her efforts. This often undermines the already not very strong self-confidence, increases problems with eating behavior. Parents need to remember that in adolescence, compulsive overeating is associated with depression and an increased risk of suicide.

Why such a long course?

In some countries, protocols call for follow-up of patients with eating disorders, including compulsive overeating, for 6–10 years. The fact is that the disease has a high recurrence rate.

Very often people simply lack the skills to cope with the situation. I had a client who underwent treatment for compulsive overeating, but after a while she returned. It turned out that she began to overeat at work. The management informed her that her position would be reduced (she is 50 years old, she worked at this enterprise for a long time), and then they organized a new rate and asked her to train an employee. Not having the strength to refuse, feeling offended, the patient went to the eating room, where she ate and could not stop. Eating, as it were, legalized her absence from the workplace and allowed her to be distracted. Having learned about the reduction, she did not fight for herself, but tried to “swallow” the insult.

What methods are used?

Keeping a food diary and a diary of emotions, meditation, self-hypnosis with positive attitudes ("I love myself", "I mean more").

Most psychological problems arise from the desire to become better, to be loved. So the first condition is to normalize the perception of oneself. There are special exercises for this (a person answers questions, for which he respects himself, appreciates what he likes in himself). Even with an eating disorder, it is important to accept your body. Therefore, it is recommended to look at yourself in the mirror daily in the nude or underwear. The goal is to form the right attitude towards the body: “my body looks like I take care of my health.” It's like a child or a pet. We cannot demand agility and smooth coat from a dog if we do not walk it and feed it poorly.

Do I need medication?

Sometimes psychotherapy alone will not help. According to indications, antidepressants can be prescribed, which reduce anxiety, depression, compulsiveness (obsessive seizures).

What should relatives do?

Do not judge, do not depreciate, do not speak rude. People generally do not associate eating behavior with a mental state. And there is a connection. Therefore, advise a relative to contact a psychologist or psychotherapist.

Test: Do you have signs of an eating disorder .

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